ArticleAllergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology2025
Cost-effectiveness of watchful waiting versus immediate emergency department transfer after epinephrine autoinjector use in Canada.
Article in Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- Real-World Shelf Life of Epinephrine Auto-Injectors in Canada: Implications for Renewal Frequency and Patient Burden.Journal of market access & health policy · 2026Article
- Real-World Shelf Life of Adrenaline Auto-Injectors at Pharmacies in Denmark, Finland, Sweden, and Norway.Journal of market access & health policy · 2026Article
- Acute Allergic Reactions and Severe Anaphylaxis: Underlying Causes, Management Strategies, and Future Directions.Archives of internal medicine research · 2026Article
- Emergency Monitoring Following A Diagnosis of Anaphylaxis.Current allergy and asthma reports · 2025Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundUntil recently, immediate emergency department (ED) transfer after food-related anaphylactic reactions was recommended regardless of symptom resolution following use of an epinephrine autoinjector (EAI). We evaluated the cost-effectiveness of delayed ED transfer after EAI use in non-medical settings (watchful waiting) compared to immediate ED transfer among pediatric patients with food allergies in Canada.
methodsWe developed a probabilistic Markov model of individuals starting at age of one year who are at risk of severe food-related allergic reactions requiring epinephrine. We evaluated medical costs (in 2022 Canadian dollars) and quality-adjusted life years (QALY) of each strategy over a 20-year horizon. In the base case, we assumed a tenfold increase in food allergy fatality for patients under watchful waiting, which we increased to 100- to 1,000-fold in sensitivity analysis. The analysis was conducted from the Canadian healthcare system perspective with a 1.5% annual discount rate and a willingness-to-pay (WTP) threshold of $50,000 per QALY.
resultsImmediate ED transfer following EAI use resulted in a decreased risk of food allergy fatality of 9.2 × 10
conclusionsWatchful waiting for symptom re-occurrence following EAI administration in non-medical settings is cost-effective.
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Registered trials
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