The Impact of Double-Blind Placebo- Controlled Food Challenge (DBPCFC) on the Socioeconomic Cost of Food Allergy in Europe

BACKGROUND: Double-blind placebo controlled food (DBPCFC) is the gold standard diagnostic test in food allergy because it minimizes diagnostic bias. OBJECTIVE: To investigate the potential effect of diagnosis on the socioeconomic costs of food allergy. METHODS: A prospective longitudinal cost analysis study was conducted in Spain and Poland within the EuroPrevall project. Food-allergic patients were enrolled into the study and in all cases diagnosis was confirmed through a standardized DBPCFC. Data were collected through a self-administered survey on all aspects of health and social care resource use, costs of living, and costs of leisure activities. Costs were measured before and 6 months after the DBPCFC and reported in international dollars with 2007 as the benchmark year. RESULTS: Forty-two patients were enrolled. Twenty-one patients had a negative DBPCFC and the suspected food was reintroduced into their diet. Comparing total direct costs before and after the DBPCFC, the reactive group spent a significantly higher amount (median increase of $ 813.1 over baseline), while the tolerant group's spending decreased by a median of $ 87.3 (P=0.31). The amount of money spent on food 6 months after diagnosis was also significantly higher in the reactive group (P=40). Finally, a larger, but not statistically significant, decrease in total indirect costs was observed in the tolerant group compared with the reactive group ($538.3 vs $ 32.3). CONCLUSION: DBPCFC has an impact on indirect and direct costs of living. The main contrubition to this increase was money to spent on food. Keywords: Food allergy. Double-Blind Placebo-Controlled Food Challenge. Diagnosis. Socioeconomic impact.