The prevalence of different allergies has been explored in the previous articles across 5 case countries and comparisons have been drawn with prevalence in India. The findings implicate that incidence of several allergic responses has been rising continuously mainly due to development in technology and increase in severe pollution. Allergic reactions in present times are affecting nearly 20-30% of the Indian population. Allergy has become a cause of concern for both individuals and government. This is because of its social and economic impact in terms of cost of healthcare, loss of working hours and lower quality of life among others. This article explores the social and economic burden of allergic diseases in India.
Social burden of allergic diseases
Among the allergies which are prevalent in India, Asthma and Allergic Rhinitis mostly impact the population. Statistics reflect that nearly 20-30% of the population suffers from allergic rhinitis. Similarly, 15% develop asthma reflecting serious health burden impairing quality of life (Tripathi and Patterson 2001). Both the diseases are associated with bothersome symptoms which impact the daily activities, quality of sleep and overall productivity contributing to a social burden. Further, both diseases are linked with several co-morbidities like conjunctivitis, sinusitis, polyposis, respiratory infections (WAO, 2013). This leads to social implications like;
- decreased quality of life
- sleeping disorders
- learning and attention impairment
- mouth breathing dental malocclusion.
Further, another disease prevalent in India is urticaria. Studies show that it impairs a patient’s quality of life and overall job performance (Zuberbier et al 2009). Social burden of the disease has been found to people involved in manual labour work. On the other hand wherein cold urticaria is found to completely disable the employees to work out of doors. Poor quality of life among urticaria patients can be attributed to the fact that the patients have to spend on the cost of therapy. In addition patients often face fatigue with the use of anti-histamines. In such situations, people are unable to explain skin lesions and social isolation leads to frustration (Khan et al, 2013). Similar social isolation burden can be when patient is suffering from other allergic responses like eczema, occupational allergy or insect allergy.
Economic burden of allergic diseases
In terms of economic burden of the common allergic reactions, most of the allergies carry both direct and indirect economic burden. While the direct costs include;
- physician visit
- laboratory tests
- treatment of co-morbiditie.
On the other hand indirect costs include,
- absenteeism from work
- decreased productivity at work and
- impaired productivity
With 55 % of all allergies in India is caused due to allergic rhinitis, and it is thus imperative to determine the overall direct and indirect economic burden of the disease. A recent study by Ghosal et al, (2016) show that overall mean cost of respiratory disorder is $637 per patient per annum. Out of which 62.2% was due to lack of productivity. The highest direct cost was due to medications which contribute 61.1% of the total cost. Similarly, in case of asthma, the total medical cost was 36.7% of which 59.5% was medication cost.
Further, occupational and insect allergy can range from mild to life threatening manifestations. Along with the direct cost of treatment, indirect costs includes reduced earning capacity, insurance and compensation schemes in the organization and burden on employers. Similarly in case of drug-related hypersensitivity, both direct and indirect costs are adding to the economic burden. Although indirect costs can be reduced once the allergy has been identified, however, direct cost of use of alternative medicine will increase (WAO 2013).
Need for more standardised diagnostics
Allergies are prevalent among all age groups and often seen among those with genetic predisposition. Common clinical allergies affecting Indian population include Asthma, Allergic rhinitis, and urticaria. However, it was left unaddressed as to what are the social and economic burden of these allergic reactions. The statistics are alarming and social and economic burden of allergic diseases has an overall effect on the society. This should be systematically monitored in order to develop standardised diagnostic and treatment procedures.
- Ghoshal, A. G., Ravindran, G. D., Gangwal, P., Rajadhyaksha, G., Cho, S.-H., Muttalif, A. R. B. A., … Wang, D. Y. (2016). The burden of segregated respiratory diseases in India and the quality of care in these patients: Results from the Asia-Pacific Burden of Respiratory Diseases study. Lung India : Official Organ of Indian Chest Society, 33(6), pp. 611–619. http://doi.org/10.4103/0970-2113.192878.
- Patel D. (2010), Assessing Economic and HQRL Burden of Food Allergy and Anaphylaxis in the US. Thesis, Virginia Commonwealth University.
- Khan S., Maitra A., Hissaria P., Roy S., Anand P. M., Nag N., Singh H., (2013) Chronic Urticaria: Indian Context—Challenges and Treatment Options, Dermatology Research and Practice, pp.1-8.
- Tripathi A., & Patterson R., (2001) Impact of allergic rhinitis treatment on quality of life, Pharmaeconomics, 19(9), pp. 891-9.
- WAO Report (2013), WAO-White book on Allergy, A World Federation of Allergy, Asthma & Clinical Immunology Societies.
- Zuberbier T, Asero R, Bindslev-Jensen C, Canonica GW, Church MK, Giménez-Arnau AM, Grattan CE, Kapp A, Maurer M, Merk HF, Rogala B, Saini S, Sánchez-Borges M, Schmid-Grendelmeier P, Schünemann H, Staubach P, Vena GA, Wedi B. (2009) EAACI/GA²LEN/EDF/WAO Guideline: Management of Urticaria. Allergy, 64: pp.1427-1433.