- Poster presentation
- Open Access
Is molecular allergology cost-effective and cost saving in children with suspected peanut allergy compared to double blind placebo controlled food challenge (DBPCFC), open oral food challenge and skin prick test in Sweden?
© Glaumann et al; licensee BioMed Central Ltd. 2013
- Published: 25 July 2013
- Thermo Fisher Scientific
- Skin Prick Test
- Diagnostic Approach
- Quality Adjust Life
- Food Challenge
Peanuts are one of the most common foods causing allergic reactions in children. IgE-ab sensitization to peanut has been reported in 7–11% of children in Western countries and the prevalence of peanut allergy (PA) in children varies between 0.75% and 3%. Given the PA impact on quality-of-life (QoL), accurate diagnosis is crucial because many sensitized individuals are actually tolerant to peanut. Peanut sensitization established by IgE antibodies (IgE-ab) in blood or skin prick test (SPT) often needs to be confirmed by the “gold standard” Double-blind placebo-controlled food challenge (DBPCFC), a risky and expensive procedure. In clinical practice an open oral food challenge (OC) is performed instead of a DBPCFC. PA can be effectively diagnosed using molecular allergology (MA), identifying subjects at risk for PA reactions (IgE-ab to Ara h 1-2-3). No cost-effectiveness (CE) analyses are available on MA for allergy.
Three 5-year Markov models simulate the flow of 200 children PA suspected presenting to the general practitioner. The models compare different diagnostic approaches (DBPCFC, OC, SPT and MA), computing the cost-per-QALY (Quality Adjusted Life Year) gained based on data from the literature. Calculations were performed for Sweden and BaseCase® was used to present results. Care giver indirect costs are included in a sensitivity analysis.
SPT: 44851 SEK
DBPCFC: 24278 SEK
MA: 11267 SEK
In Sweden, MA increases QoL, and it is associated with reduced costs per patient with respect to the other strategies. The hypothesized usage of MA could be a valid alternative and a useful diagnostic tool replacing the “gold standard” DBPCFC in selected cases, DBPCFC still being useful in subjects with conflicting immunological/clinical results.
S Glaumann: None declared, L-L Hermansson: Employee of Thermo Fisher Scientific, B Mascialino: Employee of Thermo Fisher Scientific, G Hubben: Employee of BaseCase Software, M Borres: Employee of Thermo Fisher Scientific, C Nilsson: None declared.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.