Allergy Treatment Nothing to Sneeze At
Boyle, Annette M., Medical Economics
FORECASTED GROWTH IN DEMAND FOR CARE COULD MEAN A NEW REVENUE OPPORTUNITY
Allergies afflict more than 50 million Americans, according to the American College of Allergy, Asthma, and Immunology (ACAAI). The Centers for Disease Control and Prevention reports that patients seeking relief from the condition's trademark congestion, coughing, and itchy eyes account for more than 13 million medical visits annually.
The United States currently has fewer than 6,000 board-certified allergists and immunologists, and the ACAAI expects that number to drop by 6.8% over the next 10 years, even as demand is forecast to grow by 35%. As a result primary care physicians (PCPs) who can identify and effectively resolve patients' underlying allergies have a significant opportunity to meet a need, while boosting practice revenue.
IDENTIFYING THE NEED
Allergy is the fifth-most common chronic disease in the United States across all ages and the third-most common chronic condition in children. In the average primary care practice, 20% of patients suffer from allergies.
In the South, the incidence is even greater. The Asthma and Allergy Foundation of America includes eight Southern cities in its top 10 "allergy capitals" for 2011. Internists and family physicians frequently see patients who present with rhinitis, sinusitis, or other allergy-like symptoms, making initiating conversation about allergy treatment and customized immunology a natural part of those patient visits.
"It's interesting to me that many physicians treat the symptoms without knowing what specific allergies a patient has," says Bernice Gonzalez, MD, of Vital Life Wellness Center in San Antonio, Texas, and a medical advisory board member of United Allergy Labs (UAL). "Testing allows us to determine the allergens that cause the problem and to monitor the effectiveness of treatment just like we do for diabetes or other diseases."
CHOOSING THE RIGHT TESTING METHOD
If you decide to offer allergy testing, your first decision is which method to use. The two approved ways to identify allergies in the United States are through a skin prick test and an in vitro blood test.
Traditionally, allergists have determined a patient's specific allergen sensitivities using the skin prick test. In 15 states, you can use the same method without committing to an extended program of study or significant upfront expense by contracting with an organization such as UAL.
If you contact the company, UAL sends a representative to evaluate your practice for suitability for its process.
"Typically, a practice with three or four providers-physicians, nurse practitioners, physician assistants-has sufficient patient flow to justify the fulltime trained technician and on-site lab we provide," says Nick Hollis, UAL president and chief executive officer. Within a month of the visit, a clinical allergy lab specialist and the necessary lab equipment and supplies are in place.
The lab requires about 150 square feet of space, with a sink, counter, storage, and a refrigerator to preserve antigens. UAL manages the inventory, compliance, and quality aspects of the lab. The physician is responsible for the clinical aspects of the testing.
Under UAL's system, when a patient presents with a history and a physical exam that support a likely diagnosis of allergy, you can order a skin test to be done by the allergy technician in your practice. UAL panels test for up to 48 allergens and typically are configured to assess sensitivity to the allergens common in your geographic area. A response to the test appears within about 15 minutes.
The technician administering the test will analyze the reaction on the skin and give you the results to review and discuss with the patient Skin tests cannot be used to determine the degree of sensitivity to specific allergens. Because of the risk of anaphylaxis, skin tests in PCP offices are not used to detect food allergies. …