Allergy immunotherapy among Medicaid-enrolled children with allergic rhinitis: patterns of care, resource use, and costs.
BACKGROUND
Although research demonstrates that allergy immunotherapy (IT) improves allergic rhinitis (AR) outcomes, little is known about IT patterns of care and associated resource use and costs among US children with diagnoses of AR.


OBJECTIVE
We sought to examine characteristics associated with receiving IT, patterns of IT care, and health care use and costs incurred in the 6 months before versus after IT.


METHODS
We performed retrospective Florida Medicaid claims data (1997-2004) analysis of children (<18 years of age) given new diagnoses of AR.


RESULTS
Of 102,390 patients with new diagnoses of AR, 3048 (3.0%) received IT. Male patients, Hispanic patients, and those with concomitant asthma were significantly more likely to receive IT. Approximately 53% completed less than 1 year and 84% completed less than 3 years of IT. Patients who received IT used significantly less pharmacy (12.1 vs 8.9 claims, P < .0001), outpatient (30.7 vs 22.9 visits, P < .0001), and inpatient (1.2 vs 0.4 admissions, P = .02) resources in the 6 months after versus before IT. Pharmacy ($330 vs $60, P < .0001), outpatient ($735 vs $270, P < .0001), and inpatient ($2441 vs $1, P < .0001) costs (including costs for IT care) were significantly reduced after IT.


CONCLUSIONS
Despite suboptimal treatment persistence (only 16% of patients completed 3 years of IT), resource use and costs after treatment were significantly reduced from pre-IT levels.
Hankin
Cheryl S
CS
BioMedEcon, LLC, PO Box 129, Moss Beach, CA 94038, USA. cherylhankin@biomedecon.com
Cox
Linda
L
Lang
David
D
Levin
Arthur
A
Gross
Gary
G
Eavy
Gene
G
Meltzer
Eli
E
Burgoyne
Doug
D
Bronstone
Amy
A
Wang
Zhaohui
Z
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003888:Desensitization, Immunologic / Q000191:economics* / Q000379:methods; D005260:Female; D005431:Florida; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000191:economics / Q000628:therapy*