Allergist Care Results in Lower Healthcare Costs for Peanut Allergy Patients

Matthew Greenhawt, MD, MBA, MSc, FAAAAI

Visits to allergists could reduce the total healthcare costs for patients with peanut allergies.

A team, led by Matthew Greenhawt, MD, MBA, MSc, FAAAAI, Children’s Hospital Colorado, presented new data on healthcare costs and utilization for those with peanut allergies in new data presented during the 2022 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting.

There is no real data on the influence and cost of allergist management on peanut allergy-related healthcare utilization.

Identifying the Data

In the study, the investigators analyzed IBM MarketScan Commercial Claims and Encounters Database for peanut allergy diagnosis and reaction-related codes between January 2010 and June 2019. Each patient included in the analysis was 64 years and younger and then matched with a control group of non-peanut allergy food allergy participants.

The investigators measured and compared outcomes using t-tests and chi-square tests for 12 months pre- and post-first claim date.

Overall there were 72,854 participants with peanut allergies, 39,068 of which had at least 1 allergist visit (53.6%). The study also included 166,825 age-matched control group participants.

Costs and Medical Episodes

The analysis shows patients with peanut allergies had higher National Drug Codes and ICD-10 codes who visited an allergist compared to those with peanut allergies who did not visit an allergist during both baseline and follow-up (all P <0.001).

In addition, individuals with peanut allergies with an allergist visit were prescribed epinephrine at a significantly higher rate than those with peanut allergies without an allergist visit (RR, 1.67; P <0.001).

The rates of epinephrine claims (69.9% vs 63.3%), mean epinephrine costs ($676 vs $493), and proportion with peanut anaphylaxis episodes (48.9% vs 20.7%) were all higher in the peanut allergy and allergist visit group (all P <0.001).

Similarly, the proportion of anaphylaxis episodes also was higher in the peanut allergy group, compared to the control group (53.1% vs 31.6%; P <0.001).

However, the control group had higher total healthcare costs ($7,863 vs $7,261; P <0.001). Healthcare costs were lower for individuals with peanut allergies with an allergist visit ($6,347) compared to those in the study with peanut allergies but did not visit an allergist ($8,270) (P <0.001). However, there was no significant differences in peanut allergy reaction-related costs between the 2 peanut allergy cohorts.

“Higher rates of anaphylaxis were seen among the [peanut allergy] group with an allergist visit recorded during the follow-up period (53.6% of overall [peanut allergy] group) compared to those without,” the authors wrote. “Allergist care was associated with a reduction in total healthcare costs and higher rates of epinephrine prescription.”

The study, “Effect of Allergy Specialty Care on Healthcare Utilization Among Children with Peanut Allergy in the US,” was published online in the Journal of Allergy and Clinical Immunology.