Shyamali C. Dharmage

Background Australia has one of the highest prevalence of childhood food allergy in the world, but there are no data on its economic burden in Australia. Methods We used data from the HealthNuts study, a population‐based longitudinal study undertaken in Melbourne, Australia. Infants were recruited at age 12 months between Sept 2007 and Aug 2011 with food allergy diagnosed using oral food challenges. Health care costs of out‐of‐hospital services were collected through data linkage to Australia's universal health insurance scheme Medicare. Two‐part model was used to compare costs after controlling for potential confounders. Results 2919 children were included, and 390 (13.4%) had challenge‐confirmed food allergy at age 1 year. Compared with children without food allergy, children with food allergy had significantly higher costs for GP visits, specialist visits, tests, and prescriptions in the first four years of life. The total Medicare cost associated with food allergy from age 1 to 4 years was estimated to be AUD$889.7 (95% CI $566.1–$1188.3) or €411.0 (95% CI €261.5–€549.0) per child. This was projected into an annual Medicare cost of AUD$26.1 million (95% CI $20.1–$32.3 million) or €12.1 (95% CI €9.3–€14.9 million) based on population size in 2020. Conclusions Childhood food allergy causes considerable Medicare costs for out‐of‐hospital services in the first four years after birth in Australia. These findings can help anticipate the financial impact on the health care system associated with childhood food allergy, act as a useful costing resource for future evaluations, and inform management of childhood food allergy internationally.