Estimating Cost-Effectiveness of Confirmatory Oral Food Challenges in the Diagnosis of Children With Food Allergy
Introduction . Food allergies affect 8% of the pediatric population in the United States with an estimated annual cost of US$25 billion. The low specificity of some of the main food allergy tests used in diagnosis may generate false positives incurring unnecessary costs. We examined the cost-effecti...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2019-11-01
|
| Series: | Global Pediatric Health |
| Online Access: | https://doi.org/10.1177/2333794X19891298 |
| _version_ | 1818302746422411264 |
|---|---|
| author | Abdullah Alsaggaf MD James Murphy MD Sydney Leibel MD, MPH |
| author_facet | Abdullah Alsaggaf MD James Murphy MD Sydney Leibel MD, MPH |
| author_sort | Abdullah Alsaggaf MD |
| collection | DOAJ |
| description | Introduction . Food allergies affect 8% of the pediatric population in the United States with an estimated annual cost of US$25 billion. The low specificity of some of the main food allergy tests used in diagnosis may generate false positives incurring unnecessary costs. We examined the cost-effectiveness of oral food challenges (OFC) as confirmatory tests in the diagnosis of food allergy. Methods . We constructed a decision tree with a Markov model comparing the long-term (15 years) cost and effectiveness—in the form of quality-adjusted life years (QALY)—of confirmatory OFCs compared with immediate allergenic food elimination (FE) after a skin prick test or blood immunoglobulin E (IgE) level in children with suspected food allergy. For costs, we included the costs of OFCs and the reported annual costs of having a food allergy, including direct medical costs and costs borne by families. Results . The cost of OFC strategy was $8671 compared with $18 012 for the FE strategy for the length of the model. Also, the OFC strategy had a total QALY of 21.942 compared with 21.740 for the FE strategy. In the OFC strategy, the total cost was $9341 less than FE and the increase in QALY after OFCs led to a 0.202 higher effectiveness in the OFC strategy. Conclusion . In conclusion, our study shows that the confirmatory OFC strategy dominated the FE strategy and that a confirmatory OFC for children, within a year of diagnosis, is a cost-effective strategy that decreases costs and appears to improve quality of life. |
| first_indexed | 2024-12-13T05:43:48Z |
| format | Article |
| id | doaj.art-1426bda872d445bf943930652b655a02 |
| institution | Directory Open Access Journal |
| issn | 2333-794X |
| language | English |
| last_indexed | 2024-12-13T05:43:48Z |
| publishDate | 2019-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Global Pediatric Health |
| spelling | doaj.art-1426bda872d445bf943930652b655a022022-12-21T23:57:43ZengSAGE PublishingGlobal Pediatric Health2333-794X2019-11-01610.1177/2333794X19891298Estimating Cost-Effectiveness of Confirmatory Oral Food Challenges in the Diagnosis of Children With Food AllergyAbdullah Alsaggaf MD0James Murphy MD1Sydney Leibel MD, MPH2University of California San Diego, La Jolla, CA, USAUniversity of California San Diego, La Jolla, CA, USARady Children’s Hospital San Diego, San Diego, CA, USAIntroduction . Food allergies affect 8% of the pediatric population in the United States with an estimated annual cost of US$25 billion. The low specificity of some of the main food allergy tests used in diagnosis may generate false positives incurring unnecessary costs. We examined the cost-effectiveness of oral food challenges (OFC) as confirmatory tests in the diagnosis of food allergy. Methods . We constructed a decision tree with a Markov model comparing the long-term (15 years) cost and effectiveness—in the form of quality-adjusted life years (QALY)—of confirmatory OFCs compared with immediate allergenic food elimination (FE) after a skin prick test or blood immunoglobulin E (IgE) level in children with suspected food allergy. For costs, we included the costs of OFCs and the reported annual costs of having a food allergy, including direct medical costs and costs borne by families. Results . The cost of OFC strategy was $8671 compared with $18 012 for the FE strategy for the length of the model. Also, the OFC strategy had a total QALY of 21.942 compared with 21.740 for the FE strategy. In the OFC strategy, the total cost was $9341 less than FE and the increase in QALY after OFCs led to a 0.202 higher effectiveness in the OFC strategy. Conclusion . In conclusion, our study shows that the confirmatory OFC strategy dominated the FE strategy and that a confirmatory OFC for children, within a year of diagnosis, is a cost-effective strategy that decreases costs and appears to improve quality of life.https://doi.org/10.1177/2333794X19891298 |
| spellingShingle | Abdullah Alsaggaf MD James Murphy MD Sydney Leibel MD, MPH Estimating Cost-Effectiveness of Confirmatory Oral Food Challenges in the Diagnosis of Children With Food Allergy Global Pediatric Health |
| title | Estimating Cost-Effectiveness of Confirmatory Oral Food Challenges in the Diagnosis of Children With Food Allergy |
| title_full | Estimating Cost-Effectiveness of Confirmatory Oral Food Challenges in the Diagnosis of Children With Food Allergy |
| title_fullStr | Estimating Cost-Effectiveness of Confirmatory Oral Food Challenges in the Diagnosis of Children With Food Allergy |
| title_full_unstemmed | Estimating Cost-Effectiveness of Confirmatory Oral Food Challenges in the Diagnosis of Children With Food Allergy |
| title_short | Estimating Cost-Effectiveness of Confirmatory Oral Food Challenges in the Diagnosis of Children With Food Allergy |
| title_sort | estimating cost effectiveness of confirmatory oral food challenges in the diagnosis of children with food allergy |
| url | https://doi.org/10.1177/2333794X19891298 |
| work_keys_str_mv | AT abdullahalsaggafmd estimatingcosteffectivenessofconfirmatoryoralfoodchallengesinthediagnosisofchildrenwithfoodallergy AT jamesmurphymd estimatingcosteffectivenessofconfirmatoryoralfoodchallengesinthediagnosisofchildrenwithfoodallergy AT sydneyleibelmdmph estimatingcosteffectivenessofconfirmatoryoralfoodchallengesinthediagnosisofchildrenwithfoodallergy |