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. Conclusion: 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.