Table 1. Simulation Model Inputs.
| Variable | Model Reference | Source |
|---|---|---|
| US life table | National Vital Statistics Reports, April 2017 | Arias et al,16 2017 |
| Incidence of food allergy fatality | 5 to 19 y: 3.25 (95% CI, 1.73 to 6.10) cases per 1 million at-risk person-years (sensitivity, 3.25 to 33) | Umasunthar et al,17 2013 |
| ≥20 y: 1.81 (95% CI, 0.94 to 3.45) cases per 1 million at-risk person-years (sensitivity, 1.81 to 18.1) | ||
| Probabilities, % | ||
| Unintentional peanut exposure if allergic | 11.7 Per year (sensitivity, 5 to 50) | Vander Leek et al,18 2000 |
| Moderate to severe reaction after peanut exposure | 52 (sensitivity, 10 to 70) | Vander Leek et al,18 2000 |
| Hospitalization after severe food-allergic reaction | 0.18 Per year after allergic reaction (sensitivity, 0.16 to 0.20) | Shaker,19 2017 |
| Outpatient visits for food allergy after allergic reaction | 20.4 Per year after allergic reaction (sensitivity, 20.0 to 21.0) | Shaker,19 2017 |
| Spontaneous peanut tolerance | 1.1 Per year (age range, 5 to 20 y) (sensitivity, 0.5 to 2) | Skolnick et al,20 2001 |
| Students at risk for anaphylaxis | 8 (range, 5 to 11) | Gupta et al,22011 |
| Costs, 2018 US $ | ||
| Personal epinephrine autoinjector (annual cost per twin pack) | 715 (95% CI, 685 to 743) | Shaker et al,10 2017 |
| Undesignated school epinephrine | 1430 Per school (shared by total No. of children at risk in each school) | Shaker et al,10 2017; Gupta et al,2 2011; Chicago Public Schools21 |
| Hospitalization | 5899 (95% CI, 5732 to 6066) | Patel et al,22 2011; Bureau of Labor Statistics23 |
| ED visit | 691 (95% CI, 689 to 693) | Patel et al,22 2011; Bureau of Labor Statistics23 |
| Outpatient visit for food-allergic reactions | 235 (sensitivity, 225 to 245) | Patel et al,22 2011; Bureau of Labor Statistics23 |
| Ambulance runs for allergic reactions | 573 (sensitivity, 512 to 632) | Patel et al,22 2011; Bureau of Labor Statistics23 |
| Pediatrician visits (mean incremental annual cost for food allergy diagnosis) | 100 (sensitivity, 94 to 105) | Bureau of Labor Statistics23; Gupta et al,24 2013 |
| Allergist visits for food allergy (mean incremental annual cost for food allergy diagnosis) | 149 (sensitivity, 143 to 155) | Bureau of Labor Statistics23; Gupta et al,24 2013 |
| Nutritionist visits for food allergy (per year) | 17 (sensitivity, 15 to 18) | Bureau of Labor Statistics23; Gupta et al,24 2013 |
| Alternative health care professional visits for food allergy (per year) | 25 (sensitivity, 22 to 27) | Bureau of Labor Statistics23; Gupta et al,24 2013 |
| Incremental annual grocery costs (living with food allergy) | 310 (sensitivity, 290 to 330) | Bureau of Labor Statistics23; Gupta et al,24 2013 |
| Job-related opportunity costs from food allergy (per year) | 2597 (sensitivity, 0 to 2697) | Bureau of Labor Statistics23; Gupta et al,24 2013 |
| Additional Assumptions | ||
| Fatality reduction from undesignated school epinephrine | 10-Fold (sensitivity, 10-fold to 100-fold) | NA |
| Start age, y | 5 (sensitivity, 3 to 7) | NA |
| Annual discount rate | 0.03 (sensitivity, 0 to 0.03) | Bureau of Labor Statistics23 |
| Negative health state consequence for food allergy | −0.09 (sensitivity, −0.02 to −.11) | Mittman et al,25 1999; Carroll and Downs,26 2009 |
Abbreviations: ED, emergency department; NA, not applicable (meaning that this was an assumption we made and there is no source).