HealthDay News — Childhood food allergies cost the United States an estimated $24.8 billion each year, most of which is attributable to indirect costs for families due to missed work and career sacrifices, study findings indicate.

The bill for direct costs for in-office, emergency and other medical care totals $4.3 billion per year, Ruchi Gupta, MD, from the Ann & Robert H. Lurie Children’s Hospital of Chicago, and colleagues reported in JAMA Pediatrics.

Out-of-pocket costs per family for copays, medications  and special diets or childcare to avoid allergens came to approximately $5.5 billion per year, averaging out to $931 per child per year. About 31% of these costs were from purchasing specialty and allergen-free foods ($1.7 billion), the researchers determined.

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However, the biggest cost driver was lost opportunities for caregivers due to a change in or loss of a job, at $14.2 billion. “Unlike other common childhood diseases in which most costs are borne by the healthcare system, childhood food allergy disproportionately burdens family finances,” the researchers wrote.

Gupta and colleagues performed a weighted cross-sectional survey of 1,643 caregivers of a child with a current food allergy from Nov. 28, 2011 through Jan. 26, 2012. Only one child per household were included in the analysis.

The most common food allergies were peanut (29%), milk (22%) and shellfish (19%) allergies, and approximately one-in-four participants reported ever having a severe reaction.

Calculations for specific food allergy-related events and care were as follows:

  • $1.9 billion for hospitalizations
  • $819 million for outpatient visits to allergists
  • $318 million in work missed due to time caregivers spent at allergist visits (using the mean national hourly wage)
  • $764 million for emergency department visits
  • $148 million for work missed due to emergency department visits
  • $543 million for pediatrician visits
  • $165 million for caregiver work missed due to pediatrician visits

Slightly more than 9% of caregivers reported foregoing labor market activities as a result of their child’s food allergies — most often restricted career choices (6%) or giving up a job (5%). The cost of such missed opportunities was estimated to be $2,399 per child annually, for a total of $20.5 billion annually along with out-of-pocket and productivity costs. 

For food allergy treatment, caregivers reported a willingness to pay as much as $3,504 per year per child ($20.8 billion annually). Extra childcare or changes in childcare accounted for $857 million annually, and changing schools to avoid allergen exposures accounted for $650 million annually.

“Childhood food allergy results in significant direct medical costs for the U.S. health care system and even larger costs for families with a food-allergic child,” the researchers concluded.

Study limitations included self-reported data, and the potential for food allergy overdiagnosis based on laboratory test findings without confirmation from a food challenge.

Also, a large proportion of participants were recruited from a food allergy advocacy organization, which may have lead to over representation of children with more severe food allergies. Childhood mortality and missed school days were not included in the cost analysis.


  1. Gupta R et al. JAMA Pediatr. 2013; doi: 10.1001/jamapediatrics.2013.2376.