In vivo and in vitro allergy diagnostics: it's time to re-appraise the costs

Clin Chem Lab Med. 2007;45(3):391-5. doi: 10.1515/CCLM.2007.077.

Abstract

Background: The in vivo skin prick test (SPT) is widely considered less expensive than in vitro gamma-immunoglobulin E (IgE) determination in the diagnosis of allergy. The aim of the present paper is to evaluate the relevance of component-resolved in vitro diagnosis in comparison to extract-based diagnosis and the relative global costs in relation to clinical outcomes.

Methods: For 50 individuals with suspected seasonal allergic rhinitis, we compared the costs of skin testing with those of specific IgE antibody measurement.

Results: The costs were higher for in vitro than in vivo testing. However, the clinical information obtained using recombinant reagents allowed correct identification of the sensitizing molecule.

Conclusions: Recombinant allergens for specific IgE in vitro measurement provide more reliable information for immunotherapy prescription. This should be translated into a significant reduction in the overall costs sustained by the healthcare system.

MeSH terms

  • Adolescent
  • Adult
  • Allergens*
  • Automation
  • Child
  • Female
  • Humans
  • Hypersensitivity / diagnosis*
  • Hypersensitivity / economics*
  • Italy
  • Male
  • Middle Aged
  • Recombinant Proteins
  • Skin Tests / economics

Substances

  • Allergens
  • Recombinant Proteins