Economic Impact of Childhood Fpies and IgE-Mediated Food Allergies

Rationale: FPIES can result in repeated emergency room visits and extensive dietary modifications. Health-care costs for the families with children with FPIES have not been studied before.  The primary goal of this survey was to determine the economic impact of FPIES compared to IgE-mediated food allergies (IgE-FA).

Methods: Anonymous survey was administered online to the parents of children with FPIES and IgE-FA. The economic impact survey (adapted from Gupta al., 2013), assessed direct medical, out-of-pocket, and indirect costs.

Results: Sixty-one FPIES responses and 131 IgE-FA responses were analyzed. In the past year, children with FPIES had 436 outpatient visits, 36 emergency room visits, and 18 hospitalizations versus 290 outpatient visits, 33 emergency room visits, and 2 hospitalizations for children with IgE-FA allergies. Out-of-pocket health-related costs were $7233 per child with FPIES, compared to $5029.8 per child with IgE-FA, P<0.001. The largest expense for FPIES families was special diets, $2583.4 per child, while for the IgE-FA families the largest expense was education and supervision, $1531 per child. In the past year, FPIES families missed an average 8.4 days of school and/or work versus average 4.8 days missed school and/ or work days for IgE-FA families, P=0.007. However, four FPIES families stated they had to give up their job in order to look after their child and reported an average salary loss due to FPIES as $75,000/family. 

Conclusions: Childhood FPIES and IgE-FA result in significant self-reported direct and indirect costs for health care systems and families.