ALLERGY-RELATED HEALTHCARE RESOURCE USE AND COSTS IN PATIENTS WITH MULTIPLE VERSUS SINGLE FOOD ALLERGIES

Abstract

<h3>Introduction</h3> Clinical and economic burden associated with food allergy and allergic diseases is not well characterized, particularly for patients with multiple food allergies (MFA). We explore healthcare resource utilization (HRU) and annual cost estimates of those living with food allergy (FA). <h3>Methods</h3> Patients with ≥1 insurance claim for FA or anaphylactic reaction due to food in 2015-2018, and with continuous enrollment in a health plan ≥12 months before and after the first FA/reaction (index) were identified from the US MarketScan claims databases. Single FA (SFA) cases were defined as those having only 1 documented food allergen (excluding allergy to an unknown food); MFA cases were those with >1 document food allergen. The associations between MFA and 1-year post-index allergy-related HRU and costs were estimated using multivariable regression analysis. <h3>Results</h3> Patients with MFA (N=32,595) and SFA (N=94,802) had mean(SD) age of 11(12) and 20(18) years and were 43% and 52% female. For MFA/SFA cohorts, annual incidences of allergy-related hospitalizations were 2.7%/2.5%, emergency department visits were 16%/11%, and outpatient visits were 80%/54%. After baseline adjustment and compared with SFA, MFA was associated with greater likelihood of: allergy-related hospitalizations (odds ratio [OR][95%CI]: 1.42[1.30,1.55]); emergency department visits (OR[95%CI]: 1.84[1.76,1.91]); outpatient visits (incidence rate ratio: 1.27[1.26,1.28]), p<0.001). In the MFA/SFA cohorts, the estimated 1-year total direct medical costs (95%CI) were $1103 ($1045,$1160)/$760 ($727,$793), respectively. <h3>Conclusion</h3> Allergy-related clinical and economic burden is high in patients with FA, and greater in patients with MFA compared with SFA, highlighting unmet need for treatment and disease management.