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Original Investigation |

The Economic Impact of Childhood Food Allergy in the United States

Ruchi Gupta, MD, MPH1,2,3; David Holdford, RPh, PhD4; Lucy Bilaver, PhD2,5; Ashley Dyer, MPH2; Jane L. Holl, MD, MPH2,3; David Meltzer, MD, PhD6
[+] Author Affiliations
1Smith Child Health Research Program, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
2Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, Illinois
3Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
4Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond
5School of Nursing and Health Studies, Northern Illinois University, DeKalb
6Departments of Medicine and Economics and Harris School of Public Policy, University of Chicago, Chicago, Illinois
JAMA Pediatr. 2013;167(11):1026-1031. doi:10.1001/jamapediatrics.2013.2376.
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Importance  Describing the economic impact of childhood food allergy in the United States is important to guide public health policies.

Objective  To determine the economic impact of childhood food allergy in the United States and caregivers’ willingness to pay for food allergy treatment.

Design, Setting, and Participants  A cross-sectional survey was conducted from November 28, 2011, through January 26, 2012. A representative sample of 1643 US caregivers of a child with a current food allergy were recruited for participation.

Main Outcomes and Measures  Caregivers of children with food allergies were asked to quantify the direct medical, out-of-pocket, lost labor productivity, and related opportunity costs. As an alternative valuation approach, caregivers were asked their willingness to pay for an effective food allergy treatment.

Results  The overall economic cost of food allergy was estimated at $24.8 (95% CI, $20.6-$29.4) billion annually ($4184 per year per child). Direct medical costs were $4.3 (95% CI, $2.8-$6.3) billion annually, including clinician visits, emergency department visits, and hospitalizations. Costs borne by the family totaled $20.5 billion annually, including lost labor productivity, out-of-pocket, and opportunity costs. Lost labor productivity costs totaled $0.77 (95% CI, $0.53-$1.0) billion annually, accounting for caregiver time off work for medical visits. Out-of-pocket costs were $5.5 (95% CI, $4.7-$6.4) billion annually, with 31% stemming from the cost of special foods. Opportunity costs totaled $14.2 (95% CI, $10.5-$18.4) billion annually, relating to a caregiver needing to leave or change jobs. Caregivers reported a willingness to pay of $20.8 billion annually ($3504 per year per child) for food allergy treatment.

Conclusions and Relevance  Childhood food allergy results in significant direct medical costs for the US health care system and even larger costs for families with a food-allergic child.

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