Congresswoman Schrier Introduces Legislation for Accurate Penicillin Allergy Verification

Millions of patients believe they are allergic to penicillin, but evidence shows that the vast majority of patients with a self-reported allergy can safely take penicillin after verification testing and evaluation. Testing, if needed, and removing an incorrect penicillin allergy label from a patient's electronic medical record is a relatively easy, low cost and important public health intervention that can improve patient outcomes, reduce healthcare costs, and help prevent antimicrobial resistance (AMR). People who report allergy to penicillins have to bypass a whole class of safe, inexpensive antibiotics and use sometimes more potent, expensive, and otherwise unnecessary antimicrobials.

To improve antibiotic stewardship and combat AMR, the PAVE Act seeks to identify and de-label Medicare patients who have been previously labeled with a penicillin allergy but who are not truly allergic. The legislation adds "penicillin allergy verification and evaluation" as part of Medicare's Initial Preventive Physical Exam (IPPE) and Annual Wellness Visit (AWV). IPPEs are covered for new Medicare Part B enrollees within the 12 months and AWVs are covered annually.

The PAVE Act is supported by a wide variety of clinician and patient stakeholder groups, including the American Academy of Allergy, Asthma & Immunology, which provided feedback in drafting the bill.

"Research shows that 95% of patients with a self-reported penicillin allergy in their medical records can actually safely take penicillin," said Congresswoman Kim Schrier, M.D. "This is often due to an allergy that has been outgrown or a misdiagnosis. The PAVE Act will significantly reduce the number of inaccurate penicillin allergies in patient records and will allow those patients to be treated, when necessary, with a very effective, very inexpensive category of antibiotics. By using penicillins instead of jumping straight to higher powered antibiotics, we can also avoid worsening the crisis of antibiotic resistance.

"As a physician, I know just how important it is to have a full picture of a patient's health and wellness. Without accurate health information, patients and their health care providers can't make informed health decisions," said Congressman Bucshon, M.D. "It has become apparent that millions of patient records contain inaccurate information about a penicillin allergy-maybe because of a misdiagnosis, or because the individual outgrew the allergy later in life. This legislation will provide our seniors with better access to penicillin allergy verification testing, ensuring that they can receive treatments most appropriate for their situation."

"The American Academy of Allergy, Asthma & Immunology (AAAAI) enthusiastically applauds Representatives Bucshon, Bera, Griffith, Peters, Murphy, Schrier, Kelly, DelBene, Miller-Meeks, and Underwood for their leadership in introducing the PAVE Act", said Dr. Paul Williams, President, AAAAI. "Millions of patients believe they are allergic to penicillin, but evidence shows that 95% of patients with a self-reported penicillin allergy in their electronic medical record can safely take penicillin. The PAVE Act would add penicillin allergy verification and evaluation for Medicare beneficiaries, which will improve healthcare outcomes for these patients, while also reducing healthcare costs and help fight antimicrobial resistance. As we approach National Penicillin Allergy Day on September 28, the AAAAI looks forward to working with the bill champions to educate the public on penicillin allergy testing and advance this important legislation."

Additional Supporting Organizations:

American Academy of Allergy, Asthma & Immunology (AAAAI), American Academy of Otolaryngic Allergy (AAOA), American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), American College of Allergy, Asthma & Immunology(ACAAI), American College of Physicians (ACP), American Gastroenterological Association (AGA), American Geriatrics Society (AGS), Allergy and Asthma Network (AAN), American Medical Association (AMA), Asthma and Allergy Foundation of America (AAFA), Food Allergy & Anaphylaxis Connection Team (FAACT), Food Allergy Research & Education (FARE), Infectious Diseases Society of America (IDSA), International Food Protein Induced Enterocolitis Syndrome Association (I-FPIES), The Mast Cell Disease Society, Inc. (TMS), Peggy Lillis Foundation (PLF)