HEALTH ECONOMICS, MEDICAL EDUCATION AND COST-EFFECTIVE HEALTH CARE IN ALLERGY

Health Care Delivery and Health Economics in Allergy 

• Asthma and allergic diseases are significant causes of morbidity on a global scale. 

• Asthma disproportionately affects minorities and people from lower socio-economic groups. 

• The total global cost of care for people with asthma and allergic disorders is disproportionately high despite the relatively low cost per person mainly due to the high prevalence of these disorders. 

• The most effective management for these disorders is to teach patients self-management skills. 

• Education should focus on training physicians to promote and foster self-management skills in their patients

Medical Education in Allergy

The intended outcomes for clinician and healthcare professionals training in allergy are to: 

• Produce graduates equipped to further their careers in healthcare and in particular to enhance the number of individuals trained in the mechanisms and management of allergic diseases. 

• Develop an understanding of the processes involved in improving the management of patients with allergic disease. 

• Develop new areas of teaching in response to the advance of scholarship and the needs of vocational training. 

• Provide a training in research skills. 

• Develop skills and understanding of the more complex components of allergic disease encountered in specific areas of practice.

The Cost-Effectiveness of Consulting an Allergist

• Allergic diseases are chronic conditions with systemic involvement that can affect multiple organs and systems throughout the lifespan of atopic (allergic) subjects. 

• In assessing the economic burden of allergic diseases, the costs of several organ-specific diseases need to be aggregated, including the nose (allergic rhinitis), sinuses (rhinosinusitis); lungs (asthma); skin (atopic eczema); and others. 

• Cost-effective analyses (CEA) assess the comparative effects of one health care intervention over another, under the premise that there is a need to maximize the effectiveness relative to its cost. 

• A cost-effective intervention could, if incorrectly used, generate unnecessary costs, provide no benefit and even cause harm.

• The allergist is an expert in tailoring therapy to the individual patient and adjusting treatment dosages in more severe or complex cases. The main defining characteristics of allergists are their appreciation of the importance of external triggers in causing diverse diseases; their expertise in both the diagnosis and treatments of multiple system disorders, including the use of allergen avoidance and the selection of appropriate drug and/or immunological therapies; and their knowledge of allergen specific immunotherapy practices. 

• Misinterpretation of the results of diagnostic tests by nonspecialists can lead to over-diagnosis and inappropriate management which can be harmful for the patient. It may lead to over-prescription of therapy and costly and unnecessary allergen avoidance measures, including exclusion diets that can lead to nutritional deficiency and secondary morbidity. Conversely, the under-appreciation of the severity of asthma can lead to life-endangering under-treatment or the lack of potentially life-altering immunotherapy.

 • The cost-effectiveness of allergist consultation will be demonstrated by improved patient outcomes and experiences together with a reduction in unnecessary expenditure by payer, society or patient/family.