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April 10, 1991

Reimbursement for In Vitro Allergy Tests-Reply

Author Affiliations

American In Vitro Allergy and Immunology Society Englewood, NJ

American In Vitro Allergy and Immunology Society Englewood, NJ

JAMA. 1991;265(14):1826-1827. doi:10.1001/jama.1991.03460140054019

In Reply.—  I agree with Bousquet and Michel that there are no tests that are a substitute for the physician's assessment of an individual patient's problems. However, arguing that a better test for allergy disease is likely to contribute to an increase in allergy costs is difficult for me to comprehend.The experience among members of our society (American In Vitro Allergy and Immunology Society) indicates that there are large numbers of patients who had met the criteria for allergy immunotherapy by previous standards but who are RAST negative. Despite low IGE scores, both specific and total, most of these patients had been undergoing injection therapy for years and had been referred for a second opinion, only to discover that they were not in a group that could benefit from immunotherapy. Our argument would be that in vitro testing has a better chance of distinguishing the truly allergic from the