The following is the summary of “Impact of Allergy Specialty Care on Health Care Utilization Among Peanut Allergy Children in the United States,” published in the December 2022 issue of Allergy and Clinical Immunology by Greenhawt, et al.

There needs to be more information about how allergist management affects peanut allergy (PA)-related healthcare utilization. To see if visiting an allergist can help reduce the price of PA treatment. Patients younger than 64 years old with PA diagnosis/reaction-related codes from the IBM MarketScan Commercial Claims and Encounters Database were compared to age- and gender-matched controls non-PA food allergy (NPAFACs). In addition, 12 months before and after the first claim date, outcomes were measured and compared.

 There were 72,854 people with PA (39,068 with at least one visit to an allergist, or 53.6% of the total) and 166,825 NPAFACs. At both time points, those with PA who had seen an allergist had more National Drug Codes and International Classification of Diseases, 10th Revision codes (all P<.001). More epinephrine was provided to people with PA who had seen an allergist than to those who hadn’t (rate ratio [RR], 1.67; P<.001). Comparing the PA group with and without an allergist visit, the former had significantly higher rates of epinephrine claims, mean epinephrine expenses, and proportion with peanut anaphylaxis (69.9% vs. 63.3%, $676 vs. $493, 48.9% vs. 20.7%; all P< .001). In the PA group, 53.1% had anaphylactic episodes, but only 31.6% did in the NPAFAC group (P<.001). 

There were no statistically significant differences in PA reaction-related costs between PA groups, but total healthcare costs were higher in the NPAFAC group than the PA group ($7863 vs. $7261; P<.001) and lower for people with PA who had seen an allergist than those who had not ($6347 vs. $8270; P<.001). The percentage of the PA group who experienced anaphylaxis increased to 53.6% during the follow-up period, compared to that of the PA group who did not consult an allergist at any point. A decrease in overall health care costs and an increase in epinephrine prescription rates were shown to be connected with seeing an allergist.