More than 90% of patients who carry a documented penicillin allergy label are found not to be allergic when formally tested, and a new cost analysis from British Columbia suggests that removing those incorrect labels could deliver meaningful savings to the healthcare system, particularly for children, pregnant people and rural residents.
The study, published in Allergy, Asthma & Clinical Immunology, analyzed the potential economic impacts of a provincial penicillin allergy de-labelling initiative run in collaboration with BC Children’s Hospital, BC Women’s Hospital and the BC Centre for Disease Control in Vancouver between 2019 and 2024.
The researchers conducted a retrospective review using data extracted from the de-labelling program, combined with reference data from existing North American and European databases covering 2020 to 2025. They calculated drug-cost differentials, hospitalization costs and costs associated with secondary complications to estimate overall savings following implementation of the program.
Among the special populations studied, which included pediatric patients, antepartum pregnant people and rural populations, the team estimated lifetime savings of up to $6,581 per patient and immediate savings of up to $949 within three years of de-labelling.
The distribution of those savings varied across groups. Overall lifetime savings were highest in populations with a higher risk for infection, such as peripartum populations, compared with others in their age cohort. The largest lifetime drug cost savings were seen in the pediatric population, particularly among children under five years of age.
Geography also mattered.
An unconfirmed penicillin allergy label carries lifelong consequences. Patients who are incorrectly labelled are often denied first-line beta-lactam antibiotics and instead receive broader-spectrum alternatives, which the study notes negatively affect patient outcomes and generate significant costs for the healthcare system through more expensive drugs, hospitalizations and secondary complications.
The authors conclude that, irrespective of the population examined, de-labelling was associated with significant cost savings in their analysis. They argue that this supports more widespread implementation of penicillin allergy de-labelling programs, with a particular focus on the special populations included in the study.
As a retrospective cost analysis based on a single provincial quality improvement program and reference databases, the findings represent estimates of potential savings rather than measured outcomes of a randomized intervention, and the authors describe the results as supporting the case for broader program implementation.
Subject of Research: Economic evaluation of a penicillin allergy de-labelling program in pediatric, pregnant and rural populations in British Columbia, Canada
Article Title: The economic impacts of a penicillin allergy de-labelling program in special populations: a cost analysis
Article References: Kim, M. J., Mak, R., Dionne, F., Mitton, C., Abrahams, B., Albayati, H., McAlpine, A., Elwood, C., & Wong, T. (2026). The economic impacts of a penicillin allergy de-labelling program in special populations: a cost analysis. Allergy, Asthma & Clinical Immunology. https://doi.org/10.1186/s13223-026-01071-9
Image Credits: AI Generated
DOI: 10.1186/s13223-026-01071-9
Keywords: penicillin allergy, de-labelling, cost analysis, antibiotic stewardship, pediatrics, pregnancy, rural health, British Columbia, healthcare costs, beta-lactam antibiotics, economic, impacts
News Source: Ophelia Keating. (October 28, 2026). Penicillin allergy de-labelling could save thousands per patient, Canadian cost analysis finds. Scienmag.
