Cost of allergy immunotherapy: sublingual vs subcutaneous administration

Abstract

The cost of SCIT varies dramatically according to insurance plan whereas the cost of SLIT varies between practices. When loss of productivity and travel expense are added into the cost of SCIT, SLIT might be comparable in cost and more convenient for the patient. Although the lack of insurance coverage for SLIT currently makes it more expensive than SCIT, we have found that the financial gap is much smaller than initially thought, especially when indirect costs and plans with less than 80% coverage or high weekly co-pay are factored into the equation.

Predictive models in the diagnosis and treatment of autoimmune epilepsy

“…According to the National Institute of Allergy and Immunology, annual autoimmune disease treatment costs have been estimated to be greater than $100 billion in the United States . Due to lack of randomized control trials for management of certain autoimmune conditions, such as limbic encephalitis or autoimmune epilepsy, and lack of approval of immunotherapy by agencies such as the U.S. Food and Drug Administration (FDA), many insurance companies refuse to reimburse costs . This may lead to delay in treatment or no treatment, thereby leading to lifelong neurologic deficits.…”

“…24,25 Due to lack of randomized control trials for management of certain autoimmune conditions, such as limbic encephalitis or autoimmune epilepsy, and lack of approval of immunotherapy by agencies such as the U.S. Food and Drug Administration (FDA), many insurance companies refuse to reimburse costs. 26 This may lead to delay in treatment or no treatment, thereby leading to lifelong neurologic deficits. A scoring system that predicts likelihood of response to immunotherapy could serve as an evidence-based means to reassure health insurers of the nonexperimental nature of treatment recommendations.…”

Patient preferences for route of allergy immunotherapy: a comparison of four delivery methods

“…Recent studies have examined direct and indirect cost differences between SCIT and SLIT. Seiberling et al 19 compared costs of SCIT vs SLIT and AIT in the United States. Because SLIT is not covered by insurance, cost depends on factors such as number of antigens used and the prerogative of the practice.…”

New advances in allergy immunotherapy

“…When allergens are taken up by epithelial or subcutaneous Langerhans cells in a sensitized individual, they stimulate T regulatory (Treg) cells, which increase interleukin (IL)-10 and transforming growth factor beta production, leading to downregulation of the allergic response and an increase in the T-helper (Th)1/Th2 ratio [11]. Limitations to the acceptance of SCIT include the inconvenience of weekly office visits, the fear of needles, discomfort from local reactions, and the risk of systemic reactions, which ranges from 0.05 to 3.2% of injections [12]. SCIT for food allergy, using aqueous peanut extract, has been found to produce an unacceptably high rate of systemic reactions [13].…”