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Comment by novia | Hacker News Reader

This is not new. It's new that it has a brand name, but there have stories released repeatedly about exposure therapy for some time.

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Of course it's not new. The FDA will not make recommendations if a treatment is not tested thoroughly.

Based on previous articles on the subject, the only brand name I associate with peanut allergy is Bamba.

https://en.wikipedia.org/wiki/Bamba_(snack)#Peanut_allergy

It’s news in that it’s taking a step toward being available to real people. The previous stories you’re talking about were about research studies, not drugs available to the public.

The “drug” is just purified peanut protein. Comparable treatments have been offered by allergy specialists for a while and not just in the context of clinical studies.

If it’s FDA approved, it’s a pretty big step forward. Previously-available desensitization therapies for food allergies (OIT, SLIT) are not FDA approved and thus are not covered by insurance.

It's measured peanut flour. This sound like yesterdays $200 sling. I understand the lab setting, and administration should be expensive, but letting a company patent ground up peanuts weighed and in a capsule sounds a bit insane.

Insurace covers many procedures that are not FDA approved because they don't require special drugs or devices. Covering OIT with unapproved peanuts would probably be cheaper than OIT using this $4000/year peanut extract.

Insurance doesn’t cover OIT. Perhaps they will once it’s actually a cheaper option vs the FDA approved treatment that they’re eventually required to cover. Currently they simply decline to cover it at all because there is no downside to them.

But the reason cannot be simply that they "are not FDA approved and thus are not covered by insurance" given than many non-FDA-approved things are covered. They could cover them already (and they would if they thought ER visits would be reduced as a result). And as far as I know some insurance plans do actually cover these treatments.

1. Yes, they could hypothetically cover whatever they want beyond what is required by law. They don’t cover food allergy desensitization because covering it costs money and denying it has no downside for the insurance companies.

2. What non-FDA approved treatments are typically covered?

1. Anaphylactic shocks also cost them money. And they can also limit access to drug-based treatments if they don’t find them justified.

2. Tonsillectomy, physiotherapy... are you really unable to come up with some examples of surgical procedures and other physical and mental therapies not based on drugs?

You’re right. The limit isn’t just FDA approval. OIT and SLIT have, to my understanding, no medical approval of any meaningful sort. It’s an extremely early treatment (relatively speaking) and considered experimental.

« The drug itself consists of peanut flour. »

....yep.

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