Health sector costs of self-reported food allergy in Europe: a patient-based cost of illness study.

INTRODUCTION: Food allergy is a recognized health problem, but little has been reported on its cost for health services. The EuroPrevall project was a European study investigating the patterns, prevalence and socio-economic cost of food allergy. AIMS: To investigate the health service cost for food-allergic Europeans and the relationship between severity and cost of illness. METHODS: Participants recruited through EuroPrevall studies in a case-control study in four countries, and cases only in five countries, completed a validated economics questionnaire. Individuals with possible food allergy were identified by clinical history, and those with food-specific immunoglobulin E were defined as having probable allergy. Data on resource use were used to estimate total health care costs of illness. Mean costs were compared in the case-control cohorts. Regression analysis was conducted on cases from all 9 countries to assess impact of country, severity and age group. RESULTS: Food-allergic individuals had higher health care costs than controls. The mean annual cost of health care was international dollars (I$)2016 for food-allergic adults and I$1089 for controls, a difference of I$927 (95% confidence interval I$324-I$1530). A similar result was found for adults in each country, and for children, and was not sensitive to baseline demographic differences. Cost was significantly related to severity of illness in cases in nine countries. CONCLUSIONS: Food allergy is associated with higher health care costs. Severity of allergic symptoms is a key explanatory factor.

Social and economic costs of food allergies in Europe: development of a questionnaire to measure costs and health utility.

OBJECTIVES: To develop a questionnaire to measure the additional social costs of food allergies (FAs). DATA SOURCE AND STUDY SETTING: People with FAs and sampled members of the general population (with and without FAs) in the Netherlands and the United Kingdom in 2006. STUDY DESIGN: (1) Literature review. (2) Focus group to identify key costs of FAs and seek views on the questionnaires. (3) Pilot survey to test the questionnaires in cases and controls. DATA COLLECTION: Twenty-eight participants in the United Kingdom and the Netherlands with clinically or self-diagnosed FAs took part in one of five focus groups. A case-control postal survey was conducted in the United Kingdom and the Netherlands (with 125 FA cases and 62 controls). PRINCIPAL FINDINGS: Methods exist to measure social costs in chronic illness, but not FAs. Focus groups found features of FAs likely to impact costs of living. Pilot results suggest higher costs of living and health care costs, and well-being in FAs. CONCLUSION: The questionnaire is proposed for use in wider European and other comparative studies of FAs.

Food-allergic consumers' labelling preferences: a cross-cultural comparison.

BACKGROUND: Recent changes in European food safety legislation have resulted in the implementation of statutory requirements regarding the traceability and labelling of 12 food allergens. This article describes research conducted to establish if current food labelling practices are perceived to be adequate by food-allergic consumers, and whether further policy changes need to be implemented in order to optimize consumer protection. METHODS: A total of 40 food-allergic consumers were recruited in both the Netherlands and Greece. Participants were people suffering from one or more of the three most common food-allergies, milk, egg, and/or peanut or tree nut. In a retail environment, participants were given a list of 15 potentially problematic food products which they were asked to buy as if for their own household. The participants were observed during the course of product selection and questioned about specific problems they experienced, as well as information preferences for food allergy information. RESULTS: Participants reported many problems linked to the readability of the label (e.g. font size, contrast). Not all packages contained relevant allergy information, and many participants reported that the ingredients list was insufficient for their needs. Personal experience of particular products was an important factor in the selection process. Dutch participants reported frustration regarding frequent changes in recipes of products available in the supermarket. CONCLUSIONS: In general, food-allergic consumers were not satisfied with the current labelling practices. Information was thought to be unclear or insufficient, which resulted in personal stress and feelings of insecurity. Further research is needed to identify how best allergy information might be provided.