Getting to know

Allergic diseases are generally associated with low mortality rates. However, these diseases often significantly impair the quality of life of sufferers over many years. Health care professionals are becoming increasingly aware that allergic disease represents a substantial and increasing drain on the public health budget. To evaluate the real socio-economic cost of allergic disease, both the direct and indirect costs associated with the disease must be considered. Direct costs relate strictly to the medical resources and care that the patient requires whereas indirect costs result from non-medical expenses or financial losses incurred as a consequence of the illness.

The cost of health care provision associated with allergic disease has been increasing over the last decade and this trend is expected to continue in the future. Obviously, the largest components of direct costs are those associated with drugs and outpatients visits. However, several studies indicate that a very large proportion of allergic patients (50-80%), are not adequately diagnosed and treated and/or do not comply with prescribed treatment. Consequently, this results in a large number of patients with uncontrolled or inadequately controlled allergic disease, mainly asthma. This group of patients is responsible for the greater part of the costs associated with the treatment of allergic disease. In asthma, for instance, 50% of all direct medical cost (and a similar proportion of the total asthma-related costs) is generated by 10% of the asthmatic population suffering from severe asthma. A rise in the severity of disease symptoms indicates poor therapeutic control of the disease. It leads to lost work or schooldays, increased visits to emergency departments, an excessive number of in-patient stays in hospital and an unacceptable death rate... 

Health authorities, patients and doctors want to contain or reduce the costs of allergic diseases. Indeed cost containment will be mandatory for the success of current health-care policies in all European countries.
How this goal can best be achieved is still a matter of debate. More extensive screening of allergic patients, better diagnosis and follow-up and treatment with the new, more active drugs and encouraged patient compliance with treatment, will undoubtedly increase health care costs, but lead to better care and treatment of patients. However, better control and treatment of allergic diseases could dramatically cut the healthcare resources burden by reducing the number of emergency department visits and hospitalizations associated with the progressive rise in the severity of inadequately managed allergic disease. Concurrently, the burden of the disease for patients will be reduced; the indirect costs of allergic diseases will be contained. Furthermore, the allergic march from atopic dermatitis or allergic rhinitis to asthma could be stemmed or slowed.

There is no doubt that any action to reduce or limit health care coverage will diminish the quality of medical care for allergy patients and have significant health and safety implications for the general public.
Fortunately, a lot of initiatives aimed to achieve a better, more cost effective management of allergic diseases are underway. Improved coordination of European research in allergy is being achieved thanks to GAČLEN (Global Allergy and Asthma European Network) initiatives. This network aims to upgrade the level of research, avoid unnecessary duplication of research and prioritize the most promising research avenues. Guidelines for optimal management of allergic diseases are currently being issued to health care professionals. 
The next steps will be to increase public awareness of allergy to ensure a better identification and diagnosis of allergic patients, and improve the patient's compliance with the prescribed treatment regime and the self-management of his/her disease in collaboration with existing patients' organizations.