[Economic aspects of allergies: status and prospects for Austria]

Evaluation of Non-animal Methods for Assessing Skin Sensitisation Hazard: A Bayesian Value-of-Information Analysis

This paper offers a Bayesian Value-of-Information (VOI) analysis for guiding the development of non-animal testing strategies, balancing information gains from testing with the expected social gains and costs from the adoption of regulatory decisions. Testing is assumed to have value, if, and only if, the information revealed from testing triggers a welfare-improving decision on the use (or non-use) of a substance. As an illustration, our VOI model is applied to a set of five individual non-animal prediction methods used for skin sensitisation hazard assessment, seven battery combinations of these methods, and 236 sequential 2-test and 3-test strategies. Their expected values are quantified and compared to the expected value of the local lymph node assay (LLNA) as the animal method. We find that battery and sequential combinations of non-animal prediction methods reveal a significantly higher expected value than the LLNA. This holds for the entire range of prior beliefs. Furthermore, our results illustrate that the testing strategy with the highest expected value does not necessarily have to follow the order of key events in the sensitisation adverse outcome pathway (AOP).

iPAC: an initiative to fight the burden of allergies in children

Allergies and asthma are common diseases in most parts of the world. Together, they represent a major burden on global health, as well as on health costs. However, efficient preventive measures are still lacking, and treatments are mostly symptomatic. The pathogenesis of the "allergic marathon'', the progression of the disease throughout childhood into adulthood is only partly understood. In addition, treatment protocols addressing the pathogenesis of the disease are not available to all patients, either due to economical reasons, or to insufficient efficacy or safety of the procedures. This editorial introduces a supplement dedicated to identify directions and means to fight the burden of allergies in childhood. This initiative is coordinated by iPAC (international Pediatric Allergy and Asthma Consortium).