title: Household costs associated with objectively diagnosed allergy to staple foods in children and adolescents.
abstract: BACKGROUND
  We previously reported that indirect and intangible costs burden households with a food allergic adult. We now extend our investigation to households with food allergic children and adolescents.
  
  
  OBJECTIVE
  The objective of this study was to estimate direct, indirect, and intangible costs of food allergy in households with a child and/or adolescent with objectively diagnosed allergy to staple foods (cow's milk, hen's egg, and/or wheat), and to compare these costs with age- and sex-matched controls.
  
  
  METHODS
  Direct and indirect cost parent-reported data collected via the Food Allergy Socio-Economic Questionnaire of 84 children (0-12 years) and 60 adolescents (13-17 years) with objectively diagnosed allergy to staple foods ("cases") and age- and sex-matched controls (n = 94 children; n = 56 adolescents) were compared. Annual household costs were calculated. Total household costs included direct plus indirect costs. Intangible costs included parent-reported health of their child and/or adolescent, standard of living, and perceptions of well-being.
  
  
  RESULTS
  Amongst cases, total household costs were higher by €3961 for children and €4792 for adolescents versus controls (P < .05), and were driven by direct (eg, medications) and indirect (eg, time with health care professionals) costs. For children only, a history of anaphylaxis was associated with higher direct costs than no anaphylaxis (€13,016 vs €10,044, P < .05). Intangible costs (eg, parent-reported health of a child and/or adolescent) were significantly impacted amongst cases versus controls (P < .01).
  
  
  CONCLUSIONS
  Households with a child and/or adolescent with objectively diagnosed allergy to staple foods have higher total household costs than controls. Direct and indirect costs were significantly higher for cases versus controls amongst children only. Amongst both age groups, such allergy adversely impacted intangible costs.
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jennifer L P
authors.initials: JL
authors.lastname: Protudjer
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Sven-Arne
authors.initials: SA
authors.lastname: Jansson
authors.affiliation: Swedish Council on Health Technology Assessment, SBU, Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, and Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Marianne
authors.initials: M
authors.lastname: Heibert Arnlind
authors.affiliation: Allergy Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Bengtsson
authors.affiliation: The Swedish Asthma and Allergy Foundation, Stockholm, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Kallström-Bengtsson
authors.affiliation: Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Marklund
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Roelinde
authors.initials: R
authors.lastname: Middelveld
authors.affiliation: Allergy Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Georgios
authors.initials: G
authors.lastname: Rentzos
authors.affiliation: Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
authors.forename: Ann-Charlotte
authors.initials: AC
authors.lastname: Sundqvist
authors.affiliation: Allergy Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Åkerström
authors.affiliation: Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden; Department of Clinical Research and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Östblom
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Dahlén
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden. Electronic address: staffan.ahlstedt@ki.se.
authors.forename: Staffan
authors.initials: S
authors.lastname: Ahlstedt
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D005512:Food Hypersensitivity / Q000191:economics*; D006801:Humans; D007223:Infant; D008297:Male; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Adolescents; Children; Direct costs; Food allergy