Benefits of oral allergy drops

October 2014
By Thomas Stark, MD Diplomate American Board of Otolaryngology Fellow American Academy of Otolaryngology Allergy

A growing trend in immunotherapy in America offers lower cost, greater convenience and an efficiency recognized by peer- reviewed studies and international health organizations − and has been used successfully in Europe for more than six decades.

Oral allergy drops are an increasingly popular alternative to subcutaneous injections for patients who suffer from a variety of allergies due to dust, plant pollens and other sources of allergic reaction. A daily dose of allergy drops, specifically matched to the needs of the patient, are a safe, effective alternative to weekly or monthly office visits that are a burden for many adults and children suffering from symptoms associated with allergic reactions to environmental stimuli. Sublingual immunotherapy employs the same effective compounds used in allergy shots, but is delivered by a daily dose of treatment via a few drops placed under the tongue. Oral drops are especially effective for children who may develop reluctance to continue weekly shot treatments out of fear or anxiety.

Initial allergy testing remains the same − via injections, usually in the upper arm of adults or on the backs of young children, using a numbing cream. Once allergic reactions have been identified, a specialist can determine a course of treatment best suited to the patient.

Traditional allergy shot therapy often requires weekly or monthly trips to the doctor’s office for shots. Over time, such visits become expensive and often inconvenient. In many cases patients develop a variety of excuses to miss or reschedule appointments − or end treatment altogether simply because of inconvenience.

Sublingual drops offer greater expediency because they can be used in the convenience of the home without office visits. And because they are administered daily, some patients report drop therapy is better tolerated, more efficient and more effective. They feel better sooner.

Allergy drops have been used effectively for more than 60 years. In some European countries, sublingual immunotherapy represents 50 percent of allergy treatment. The World Health Organization and an international workgroup including U.S. allergists have endorsed it as an effective alternative to injection therapy. I have used oral allergy drops in my practice for 13 years and found them to be both efficient and effective.

While the FDA has yet to officially approve sublingual therapy, all components used in oral allergy drops are approved by the organization and safe for patient use. The main deterrent for patients is that many insurance companies will not cover the actual cost of the drops. Insurance providers will pay for office visits and allergy testing procedures, but not the cost of the drops themselves. At present, the savings in less frequent office visits for weekly or monthly shots − to say nothing of the convenience factor − motivates many patients to cover the cost of drops out of pocket. Taking time off from work or taking children out of school for weekly allergy shots is problematic for most people.

But this may be changing as the major pharmaceutical companies get involved.

Merck & Company, a giant in the pharmaceutical industry, is producing immunotherapy in pill form for certain types of grass and ragweed allergies. As drug companies investigate alternatives to weekly shots, more options, including pills or oral drops will continue to become increasingly popular.

Because of the prevalence of seasonal allergy problems in our part of the country, a growing number of primary care physicians are developing working relationships with allergy specialists to test and treat their patients. My staff works with a number of primary care practices in Harris, Montgomery and Walker Counties by scheduling time at their offices to do allergy testing, evaluation and treatment recommendations for their patients.

The cooperative process is proving to be beneficial for all concerned. Primary care physicians are able to offer convenient access to specialized treatment to their patients. They also extend their range of treatment options and enhance potential revenue by maintaining patient care instead of referring them to an outside specialist unnecessarily.

Oral allergy drops are a safe, convenient and effective option that can play a beneficial role in controlling bothersome symptoms. The benefits of sublingual immunotherapy apply not only to patients, but to physicians as well.