“[Our] work supports that allergy evaluation is an inexpensive intervention and that given the downstream benefits may well be cost-effective,” said study co-author Rochelle Walensky, MD, MPH, Professor of Medicine at Harvard Medical School and a practicing Infectious Disease physician at MGH. “Certainly, cost [is] a major consideration [in the decision as to whether to perform an evaluation]; however, it is not the only one. There is a large population of people with a documented, though unverified, penicillin allergy and the demand for testing may easily overwhelm the ‘supply’ of allergists and/or immunologists to conduct such testing, especially in more rural communities without less access to subspecialty care. We advocate that it may serve the community well to expand the workforce available to conduct such testing.”
Indeed, with this in mind, the authors of the JACIIP
paper performed additional assessments varying “provider type, clinical setting, procedure type, and personnel timing,” all of which led to “modest changes,” they note in TDABC estimates (range $214 to $246). However, they found that higher costs were associated with performing allergy evaluation in a “low-demand practice setting” ($268) and after including “clinician documentation time” ($288). Overall, the lowest TDABC estimate for penicillin allergy evaluation in their analysis was $40 and the highest was $537.
Dr. Walensky told Contagion®
: “Given the relatively low cost and anticipated substantial clinical and economic benefit, we would advocate for routine allergy evaluation among those who are reported to have an unverified penicillin allergy and that such expenses should be covered by insurance.”
Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.
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