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. 2022 Nov;33(11):e13883.
doi: 10.1111/pai.13883.

Out-of-hospital health care costs of childhood food allergy in Australia: A population-based longitudinal study

Xinyang Hua  1 , Kim Dalziel  1   2 , Tim Brettig  2   3 , Shyamali C Dharmage  1   2   3 , Adrian Lowe  1   3 , Kirsten P Perrett  2   3   4   5 , Rachel L Peters  3   5 , Anne-Louise Ponsonby  1   2   3   6 , Mimi L K Tang  2   3   4   5 , Jennifer Koplin  1   2   5
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Out-of-hospital health care costs of childhood food allergy in Australia: A population-based longitudinal study

Xinyang Hua et al. Pediatr Allergy Immunol. 2022 Nov.

Abstract

Background: Australia has one of the highest prevalence of childhood food allergy in the world, but there are no data on its economic burden in Australia.

Methods: We used data from the HealthNuts study, a population-based longitudinal study undertaken in Melbourne, Australia. Infants were recruited at age 12 months between Sept 2007 and Aug 2011 with food allergy diagnosed using oral food challenges. Health care costs of out-of-hospital services were collected through data linkage to Australia's universal health insurance scheme Medicare. Two-part model was used to compare costs after controlling for potential confounders.

Results: 2919 children were included, and 390 (13.4%) had challenge-confirmed food allergy at age 1 year. Compared with children without food allergy, children with food allergy had significantly higher costs for GP visits, specialist visits, tests, and prescriptions in the first four years of life. The total Medicare cost associated with food allergy from age 1 to 4 years was estimated to be AUD$889.7 (95% CI $566.1-$1188.3) or €411.0 (95% CI €261.5-€549.0) per child. This was projected into an annual Medicare cost of AUD$26.1 million (95% CI $20.1-$32.3 million) or €12.1 (95% CI €9.3-€14.9 million) based on population size in 2020.

Conclusions: Childhood food allergy causes considerable Medicare costs for out-of-hospital services in the first four years after birth in Australia. These findings can help anticipate the financial impact on the health care system associated with childhood food allergy, act as a useful costing resource for future evaluations, and inform management of childhood food allergy internationally.

Keywords: burden; child; food allergy; health care costs.

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Conflict of interest statement

Kirsten Perrett is Chair of the scientific advisory board for AllergyPal. Her institution has received research grants from the National Health and Medical Research Council, Immune Tolerance Network, DBV Technologies, and Novartis and consultant fees from Aravax; outside the submitted work. Other authors declare no conflict of interest. S.C.D. and A.J.L. declare they have received research funds from GSK’s competitively awarded Investigator Sponsored Studies programme, for unrelated research. A.J.L. has also received donations of interventional product (EpiCeram) from Primus Pharmaceuticals for unrelated research.

Figures

FIGURE 1
FIGURE 1
Total four‐year out‐of‐hospital MBS (for medical services) and PBS (for prescriptions) costs for children without and with challenge‐confirmed food allergy at year 1, and for children with different types of food allergy, by category of services (2020 AUD$). Results were inverse probability weighted. The error bar represents the 95% confidence interval of the estimation. GP, general practitioner; MBS, Medicare Benefits Schedule; PBS, Pharmaceutical Benefits Scheme
FIGURE 2
FIGURE 2
Out‐of‐hospital MBS (for medical services) and PBS (for prescriptions) costs for children with challenge‐confirmed food allergy at year 1 and with other allergic diseases, by year after birth (2020 AUD$). Results were inverse probability weighted. The error bar represents the 95% confidence interval of the estimation. FA, food allergy; MBS, Medicare Benefits Schedule; PBS, Pharmaceutical Benefits Scheme
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