Allergy shots, an age-old treatment for allergy sufferers, are getting a shot in the arm from new research. This proven therapy saves money; accelerated schedules deliver relief in weeks, rather than months; and alternative methods are on the horizon, according to allergists at the annual scientific meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Boston, Nov 3-8.
"For over a century, we have known allergy immunotherapy is highly effective and improves quality of life," said Ira Finegold, MD, ACAAI chair of the Immunotherapy and Diagnostics Committee. "Recent research brings immunotherapy to the forefront of patient-centered, cost-effective care, furthers our understanding of the immune system and offers promising new delivery alternatives."
Reducing Costs
Allergy immunotherapy is the only treatment available that actually changes the immune system, making it possible to prevent the development of new allergies and asthma. According to research by Cheryl Hankin, PhD, BioMedEcon president and chief scientific officer, allergy immunotherapy also significantly reduces healthcare use and costs for prescription medications, outpatient visits, and inpatient stays.
Dr. Hankin's research examined over 7 million patients enrolled in Florida Medicaid from 1997 to 2008 and compared the healthcare use and costs of children and adults with allergies who received allergy immunotherapy to similar patients who did not receive this treatment. Within three months, compared to patients who did not receive allergy immunotherapy, those who received allergy shots showed significant reductions in the number and costs for prescription, outpatient, and inpatient services.
Compared to children with allergies who did not receive allergy immunotherapy, children who received this treatment saved Florida Medicaid, on average, more than $1,000 within the first three months of treatment, and saved the state nearly $6,000 after 18 months. Results were even more compelling for adults. Average savings to Florida Medicaid were about $1,200 after three months of allergy immunotherapy, and exceeded $7,000 after 18 months.
"Allergy immunotherapy is a well-established, safe and effective treatment. Our research clearly shows that this treatment is also cost effective and these cost benefits occur almost immediately," said Dr. Hankin. "Allergies and asthma are serious, high cost, debilitating, chronic illnesses. In light of the current U.S. healthcare crisis, our findings strongly suggest that it is in the best public health interest to promote increased access to allergy immunotherapy for patients who suffer from allergies."
Accelerating Patient-Centered Care
Conventional allergy immunotherapy requires a considerable time commitment since an allergy shot is given once or twice a week for about five months. The amount of allergen is gradually increased until a maintenance dose is reached, so there is no longer a reaction to the allergen. Research presented by allergist Richard Weber, MD, ACAAI vice president, shows allergists who use accelerated schedules known as "cluster" and "rush" immunotherapy find patients experience benefits faster and reach their maintenance dose sooner.
"You shouldn't have to put your life on hold to treat your allergies," said Dr. Weber. "Accelerated schedules offer patients more flexibility, faster results and a treatment plan they are more likely to follow because it reflects their needs and busy lifestyle."
Rush immunotherapy typically involves a patient getting multiple injections two or three days in a row, but schedules may be varied either shorter or longer to suit circumstances.
Cluster immunotherapy aims to help patients reach a point where they no longer react to the allergen in a few weeks by giving two to four injections 30 minutes apart for one day each week for three weeks.
"Research shows accelerated schedules are safe and effective options, and they appeal to patients who do not want to commit to weekly allergy shots for five or six months," said Dr. Weber.
Injecting New Methods into Immunotherapy
Allergy shots in the U.S. are given subcutaneously (SCIT) or "under the skin". But new methods are being investigated:
•Intralymphatic immunotherapy (ILIT) involves injecting allergens into a lymph node. Initial research shows this method gives a longer lasting and more effective response suggesting the dose and duration of therapy could essentially be shortened.
•Epicutaneous immunotherapy (EPIT) is another new approach where a patient's skin is lightly scraped and a patch is applied to deliver the allergens through the bloodstream. This promising new strategy merits further research.
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