Cost-effectiveness Analysis of Using Allergy Tests in Primary Care in Italian Children

RATIONALE: To evaluate cost effectiveness of using allergy test results (ATr) (ImmunoCAPTM) in primary care management of patients with allergy-related symptoms. METHODS: Effectiveness and outcome measurements were derived in a before-and-after (GI, GII) study (two years follow-up). 344 patients (GI=194, GII=150, 10 clinicians) were analyzed and clinically classified into: allergic-pos, allergic-neg, or uncertain. In GII the clinicians had access to ATr while this was not the case in GI. Only direct costs were included. Costs of drug (cost/year/patient) were: antihistamine €70, steroids €378 and bronchodilators €37. New visit and referral costs were €65 each. In GII, in addition allergy test costs were included in the year-one analysis: €12 for the initial test and if positive, additional €88 for specific determinations. Effectiveness of the test was set to 1, if there was an agreement between ATr (positive or negative) and clinician's classification otherwise it was set to 0. RESULTS: The expected effectiveness increased in GII (GI=0.52, GII=0.88). The estimated total mean costs were €784 and €590 in GI and GII respectively. Thus a maximally saving of €194/patient could be demonstrated when allergy test was used. Also when lowering medication consumption in the range between 30 and 70% there was still a significant difference in expected total mean cost between GI and GII. CONCLUSIONS: Using allergy test in patients seeking primary care with allergy-like symptoms could be cost-effective as it has higher effectiveness and is cost saving.