Can I Afford Sublingual Immunotherapy (SLIT)?

While most insurance companies cover allergy testing as well as initial and follow-up visits with your allergy doctor, some of them are restrictive about the type of allergy immunotherapy that they will cover.

While most will cover allergy shots (also known as subcutaneous immunotherapy or SCIT), fewer will cover allergy drops (also known as sublingual immunotherapy or SLIT).


(David Kennedy / unsplash)

What’s the difference between SCIT and SLIT?

Besides the obvious difference—SCIT is administered through shots and SLIT is administered through allergy drops dispensed under the tongue—these two types of immunotherapy work in the same way. They expose the body to allergens in gradually increasing amounts, helping the immune system to become desensitized to them.

While allergy shots have been around for longer, there is impressive evidence showing that SLIT produces comparable results to allergy shots.

The Case for SLIT

The Cochrane Collaboration, World Health Organization (WHO) and ARIA guidelines (Allergy Rhinitis and its Impact on Asthma) have all confirmed the effectiveness of SLIT, as has a robust body of research studies (hundreds and growing). In fact, the 2007 ARIA guidelines affirmed that the volume and quality of evidence supporting SLIT now outpaces SCIT evidence.

In addition to being effective, SLIT is also safer than allergy shots, allowing it to be taken in the comfort of home rather than at the doctor’s office.

Europe is strides ahead of the U.S. in adopting SLIT as a mainstream treatment for allergies. European doctors have been prescribing SLIT for 60 years, and in some countries, including France and Italy, SLIT use significantly surpasses that of SCIT.

The Hidden Costs of Allergy Shots

If your insurance company covers allergy shots, but not allergy drops, you may assume that shots are going to be the better deal for you. However, before you make your decision, it’s important to consider some of the less-obvious costs of allergy shots.With these taken into account, many people find that even with insurance covering allergy shots, allergy drops are still the better deal.

  1. Copays. Insurance companies will often require a copay with each allergy shot. If you’re getting an allergy shot twice a week, this can add up significantly.
  2. Travel costs. If you’re heading to the doctor’s office a couple of times per week for shots, there will be wear and tear on your car as well as gas charges (unless you drive an electric car).
  3. Missed work. If you work, you may find yourself having to leave during work hours to get your allergy shots (unless your doctor happens to offer extended hours).

SLIT Savings

If your insurance does not cover the sublingual immunotherapy cost, talk to your doctor about a discount. Many physicians will offer a reduced price for self-pay patients because it frees them from the hassle of seeking insurance reimbursement.

And if your time is short, make sure to weigh the hassle of SCIT vs. SLIT. SLIT brings the freedom to take your daily drops wherever and whenever you want. With SLIT, you only have to visit the doctor for checkups every few months as opposed to SCIT where you’re at the doctor’s office a couple of times per week. Even if you end up paying more for SLIT, this kind of convenience may be worth it to support your busy lifestyle.

SLIT’s Unique Advantages

Another thing to consider beyond the costs of SLIT is its unique capabilities to help parts of the population that allergy shots can’t. At AllergyEasy, we’ve seen many young patients whose quality of life is threatened by allergies—those with disfiguring eczema or allergic rhinitis so bad they can’t sleep well or chronic ear infections. Allergy shots aren’t considered safe for children less than age 7 or 8, but SLIT has been found to be safe for younger children. That means that these kids don’t have to wait to get relief from their allergic misery.

Patients with uncontrolled asthma are considered too high of a risk for allergy shots, but SLIT is often an option for these patients. In addition, SLIT works for frequent travelers who can’t see their allergy doctor on a regular basis for shots.

And finally, while shots aren’t a safe option for treating food allergies, SLIT has been found to be both safe and effective for wheat, milk, and nut allergy treatment and more.

The Takeaway

SLIT advocates are working hard to get more insurance companies to pay for this effective and convenient treatment. In the meantime, when you factor in the unseen costs of allergy shots, as well as the unique benefits of SLIT, you may find that SLIT is easier on your pocketbook than you might think and better for your quality of life.

Call AllergyEasy about sublingual immunotherapy and find out how to make the cost of allergy drops fit into your budget.

About The Author

Stuart H. Agren, M.D.

Stuart H. Agren, M.D. completed his undergraduate studies at the University of Utah and went on to earn his Doctor of Medicine from Tulane University School of Medicine in 1974. He completed additional training at L.D.S. Hospital in Salt Lake City, Utah and then established his private medical practice starting in 1975. Dr. Agren completed a mini-residency in Industrial Medicine at the Robert Johnson School of Medicine at Rutgers University and also completed training to become a certified Medical Review Officer.

Dr. Agren was the Medical Director at TRW and McDonnell Douglas in Mesa, Arizona and at Stauffer Chemical and Kennecott Copper in Salt Lake City, Utah. He also served as an adjunct faculty member at Arizona State University.

In his private medical practice, Dr. Agren specialized in family practice and allergy. In his work as a private practice allergist, he was one of the first doctors in the country to prescribe sublingual immunotherapy to his patients as an alternative to subcutaneous immunotherapy (allergy shots). He has also been a trailblazer in the field of food allergy treatment and research, developing a program to treat multiple food allergies simultaneously using sublingual immunotherapy. Dr. Agren has been featured on local CBS, NBC, and ABC news affiliates and won the peer-nominated “Top Doc” award from Phoenix Magazine.

After 20 years in private practice, Dr. Agren became the Founder and President of AllergyEasy, which helps primary care physicians around the country offer allergy testing and sublingual immunotherapy treatment to their patients. Over 200 physicians in over 32 states use the AllergyEasy program to help their patients overcome environmental and food allergies and asthma.