Allergy Therapy WITHOUT the shot
5/8/2019
Allergy Drops
Sublingual Immunotherapy (SLIT)
Does It work?
SLIT is a newer therapy, so the research is not as robust, but the 2013 position paper from the World Allergy Organization states that the “open, controlled trials suggest that the clinical efficacy of SLIT is comparable to injection immunotherapy.” Research also suggests that improvement in symptoms may be seen earlier in SLIT therapy as compared to SCIT. The other main advantage of the allergy drop therapy is its convenience.
Is it safe?
Current research suggests that allergy drops are even safer than allergy shots. This is the reason that we allow patients to give themselves the allergy drops at home. The incidence of major side effects that require the use of epinephrine is only 1:100,000 and there has never been a reported death with allergy drop therapy.
How much will it cost?
SLIT is not covered by insurance in the state of TN at this time. We have worked to develop a cash pay program that minimizes the out of pocket expenses to the patient and makes the price similar (or cheaper) to the patient. After the initial testing (which is covered by insurance), the patient pays $350 every three months for their treatment vials.
What does the treatment involve?
The first dose of allergy drops are given in the allergy office under supervision. There are no shots or needles in sublingual immunotherapy. After the initial dose, the patient will follow the instructions for increasing the dose at home until the maintenance dose is reached. The patient will be on their full maintenance dose within a few days. Once the patient is on maintenance dose, they will continue to take their allergy drops at home every day. This continues for 3-4 years, with the patient only coming to the office to pick up a new vial of allergen every 3 months.
Allergy Shots
Subcutaneous Immunotherapy (SCIT)
Does It work?
The conclusion from many well-controlled clinical trials suggests that most (70-90%) patients will have significant improvement in their allergies that results in fewer symptoms as well as need for less medication. In most patients (80-90%) this effect lasts even after the treatment phase ends. There also can be a decreased chance of developing asthma or an improvement in asthma symptoms if they are already present.
Is it safe?
Immunotherapy is a safe intervention when it is performed under the supervision of a knowledgeable physician. Most patients experience few or no side effects. Common side effects include swelling or redness at the site of the allergy injection. More severe side effects such as anaphylaxis, need for administration of epinephrine, and even death have been reported but are extremely rare (2:1,000 for serious events, 1:2,000,000 for fatality).
How much will it cost?
Once initial testing is complete, the approximate cost to the patient will depend on the insurance provider and whether the deductible has been met. Until the deductible is met, the patient will pay for the treatment vials and the shot administration. In our practice, the cost for three months of treatment with each insurer is as follows: BC/BS of TN $298, Cigna $380, Humana $412, United $321.
What does the treatment involve?
The first several months are spent in the escalation phase where the dose of allergen is increased slowly. This includes a weekly shot in the upper arm that is administered in our office under supervision. This lasts several months until the patient is at their maintenance dose. Once the maintenance dose is reached, the patient will continue to have weekly or bimonthly shots in the clinic for 3-4 years.