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Reimbursement for In Vitro Allergy Tests

Jean Bousquet, MD, PhD; François Bernard Michel, MD
JAMA. 1991;265(14):1826. doi:10.1001/jama.1991.03460140054018.
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To the Editor.—  We read with great interest the Medical News & Perspectives article1 concerning reimbursement for in vitro laboratory tests for the diagnosis of allergy.Dr Russell I. Williams, Jr, presidentelect of the American In Vitro Allergy and Immunology Society, stated that "this test is reasonable, the cost-benefit ratio is reasonable." Later, he indicated that "it is actually in the Blues' [Blue Cross/Blue Shield] best interest to pay for in vitro tests because fewer patients with false-positive test results are given unnecessary immunotherapy."There is no doubt that IgE tests have significantly improved the diagnosis of immediate-type allergic diseases and have made many, if not a large proportion, of the provocative challenges obsolete. However, they do not solve all the problems of the diagnosis of allergy, and different tests can be used. Allergists favor skin tests, which appear to be more precise than in vitro tests, and they


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