The peanut pill, Palforzia, has been approved by the FDA, so what are food allergy patients supposed to think?
Here is what we know. Palforzia (peanut flour in a capsule) is to be used as oral immunotherapy (OIT) for 4 to 17 year-olds with a confirmed diagnosis of peanut allergy. It should help mitigate allergic reactions, including anaphylaxis, that may occur with accidental exposure to peanuts. Those who take Palforzia must continue to avoid peanuts in their diets. The goal is to be slowly desensitized to 300 mg of peanut protein, or approximately one peanut, with the help of an allergist. Studies have shown than 67.2% of Palforzia desensitized patients could tolerate an oral challenge of two peanuts. The list price for the treatment has been set at $890 per month or $11,000 per year, with the potential for a copay assistance program. This will not cover office visits for administration of the product in a safe environment. We do not know when Palforzia will be available for purchase, but it will likely be within 2020.
In comparison, some specialized allergy offices, like Chacko Allergy, are already practicing OIT, or desensitization, to peanut and multiple other foods in children as young as 6 months of age. We are using real peanuts and peanut products like peanut butter or Bamba. We gradually increase the daily intake of peanut to a goal of 3-8 peanuts. After a few months on this dose, most patients are able to pass a peanut challenge to three-times that amount, giving them the confidence to encounter peanut in their daily life. This can all be done for the cost of the office visits and, literally, peanuts.