1. 26 Countries Thanks to all the UEMS delegates involved
OUR WAY OF WORKING
26 Countries Thanks to all the UEMS delegates involved
JACQUES GAYRAUD MD, DIONYSIS GIANNAKOPOULOS MD
June 2014

2. DENMARK
GERMANY
SWEDEN
FINLAND
ESTONIA UK
IRELAND
LITHUANIA
POLAND
NETHERLANDS
CZECH REP.
BELGIUM
AUSTRIA
FRANCE
HUNGARY
SLOVENIA
SLOVAKIA
ROMANIA
PORTUGAL
BULGARIA
ESPANA
GREECE
CYPRUS
TURKEY
SWITZERLAND
ITALY

3. ALLERGOLOGY AS A SPECIALITY
ITALY
PORTUGAL
SPAIN
GREECE
CROATIA
SWITZERLAND
ROMANIA UK
SWEDEN
SLOVAKIA
CZECH REP.
LITHUANIA
LUXEMBURG
CYPRUS
NETHERLANDS
YES:14
SUBSPECIALITY:6
FINLAND
FRANCE
GERMANY
TURKEY
POLAND
ESTONIA
HUNGARY
DENMARK SLOVENIA
AUSTRIA*
BELGIUM
IRELAND
NO:5

4. ALLERGOLOGY DIVISIONS/ DPTs IN MEDICAL SCHOOLS
YES
FINLAND
CROATIA
ITALY
CZECH REP.
LITHUUANIA
SPAIN
PORTUGAL
NETHERLANDS
FRANCE
GERMANY
DENMARK
AUSTRIA
SWITZERLAND
TURKEY
SWEDEN
BELGIUM
ROMANIA UK
SLOVAKIA NO
GREECE
HUNGARY
SLOVENIA
CYPRUS
ESTONIA
In the vast majority of european countries there are all divisions

5. 4 34 55 In mother spe. 2 5 4 (Univ) +3 7-10 4+2 14+11 16 38-40 7 2+3
COUNTRIES
Number of years for training in Allergology
Allergology training centres
Allergology trainees/year
ESPANA 4 34 55
SLOVENIA
In mother spe. 2
PORTUGAL 5
4 (Univ) +3
7-10
NETHERLANDS
4+2
LITHUANIA
CZECH REP.
14+11 16
ITALY
38-40
HUNGARY 7
GREECE
2+3 3 7
FRANCE 17 25
GERMANY
18 months
50-100
IRELAND
SLOVAKIA

6. 2+5 0-10 - 5 (ENT, Dermat, Pulmo., Ped) 3+3 27 20-30 2-4 ?
COUNTRIES
Number of years for training in Allergology
Allergology training centres
Allergology trainees/year
FINLAND
2+5
0-10
DENMARK -
CYPRUS
AUSTRIA
5 (ENT, Dermat, Pulmo., Ped)
SWITZERLAND
3+3 27
20-30
BELGIUM
2-4 ?
SWEDEN
internal med+2 8 5
TURKEY
3+5 15
10
ESTONIA
4 years C.IMN 2
3 CLIN IMN
ROMANIA 4
20-25 UK
6-13
POLAND 3
BULGARIA

7. SPECIALTY OR SUBSPECIALTY OF PAEDIATRIC ALLERGY
AUSTRIA NO
SPAIN
LITHUANIA
SLOVAKIA
POLAND ?
GREECE
BULGARIA
YES UK
ROMANIA
GERMANY
FRANCE
YES (competence)

8. COMPLEMENTARY ALLERGY TRAINING FOR GPS, OTHER SPECIALISTS OR PARA MEDICAL PROFESSIONALS
AUSTRIA NO
SPAIN
YES, N.A.
LITHUANIA
YES
SLOVAKIA
POLAND
GREECE
BULGARIA UK
ROMANIA
GERMANY
FRANCE
Is there?

9. UNIVERSITY/PREGRADUATE LEVEL
HOURS DEVOTED TO ALLERGY
AUSTRIA 6
SPAIN
0-30
LITHUANIA 30
SLOVAKIA 14
POLAND
GREECE
BULGARIA 18 UK -
ROMANIA
GERMANY
6-12( no formal obligation)
FRANCE
6+2
Recent data from 7 countries :from 0-30 hours

10. DISEASES FOR ALLERGISTS
In 22 european countries
Asthma
Rhinitis, conjunctivitis
Food allergy
Drug allergy
Venom allergy
Anaphylactic shock
Immunotherapy
Urticaria, angioedema
Eczema
In the vast majority
Skin allergy
Contact dermatitis
Occupational asthma
Primary Immuno deficiencies
In a few countries
AIDS
Transplantation

11. Prices of Allergy in Europe (2014)
Country
1st Cs
Follow Cs
SP CE T.
SP native T.
IDR test
Patch test
ESS - Other
notes 1
Austria 50 15 20 25 2
Belgium
40.05
23.78
19.88
(hosp)
Derm+ 3
Croatia
12,61
5,44
5,45
10,89 4
Czech Rep.
24.4
12.4
0.9€/Ag
1.1€/Ag
0.8€/Ag 5
France
23 – 56
23 – 28.8
28.8
36.05
29.3 – 43.15 6
Germany -
45.33
16.28 (1?)
62.65 7
Greece
50 – 80
30 – 50
65.45
120 – 180
150 8
Hungary
33 – 83 (SPT)
24 – 60 (SPT)
1.6€/Ag
100 – 66 9
Italy
26.7
15.9
23.2
32.5 10
Netherlands
285
Hosp.+ spe
(360€) 11
Portugal
7.75 12
Slovenia 27
9 - 9 13
Spain 18 14
Sweden
T/nurse
Switzerland
14.71/13.95
41.07 (10)
(/+10)
26.69
54.42 (10)
Mean Price
26.6 €
19 €
21.8 €
34 €
34.5 €

12. IMMUNOTHERAPY IMMUNOTHERAPY SIT SCIT SLIT TABLETS AUSTRIA Yes
COUNTRY
SIT
SCIT
SLIT
TABLETS
AUSTRIA
Yes
CZECH REP
FINLAND
FRANCE
GREECE
POLAND
ROMANIA
SLOVENIA
SPAIN
yes
SWEDEN
SWITZERLAND
TURKEY UK
Yes?
PORTUGAL
IMN is practiced in all 3 ways, SCIT, SLIT, TAB in all european countries

13. COUNTRY SPECIALISTS PRESCRIBING LEGAL BUILD-UP PHASE MANTEINANCE
AUSTRIA
All, ped, ENT, Pulm, Derm
Any
CZECH REP
Allergists
Allergists, hosp or private
FINLAND
Ped all, ped, ENT, pulm
specialist
Hosp or private
Hosp, private, primary care
FRANCE
All, few Pulm, ENT, ped, intern, GP
Hosp, private,
GREECE
All, few ENT, Pulm
POLAND
Allergists, pulm
IT units
ROMANIA
Allergists, hosp
SLOVENIA
All, few Pulm and ped
SPAIN
Allergists, few ENT, pulm
Allergists, primary care
SWEDEN
SWITZERLAND
Any, but recomended All
any
TURKEY
PORTUGAL
Allergists, pulm,ped UK
allergists, hosp
But it is surprising that although they do not have the same allergy training as us, in many european countries, doctors of other specialties can also prescribe our therapies

14. ANAPHYLAXIS GUIDELINES IN EUROPE
YES NO
Hungary
France UK
Germany
Slovenia
Finland
Czech republic
Sweden
Spain
Switzerland
Netherlands
Greece
Romania
Denmark
Portugal
Italy
As for anaphylactic guidelines, European countries are shared, half of them have, half not. In mine, we are now working on that.

15. CME Mandatory: YES:14, NO:9 Benefits to practitioners: YES:8, NO:13
1. FRANCE
10. CZECH REP.
2. HUNGARY
11. SWITZERLAND
3. ITALY
12. TURKEY
4. AUSTRIA
13. BELGIUM
5. SPAIN
14. ROMANIA
6. NETHERLANDS
15. GREECE
7. SLOVENIA
16. UK
8. LITHUANIA
17. CYPRUS
9. GERMANY
18. IRELAND
NO 1. DENMARK 2. PORTUGAL 3. FINLAND 4. SWEDEN 5. ESTONIA 6. IRELAND
Whereas they are mandatory in 14 countries, but beneficial only in 8
Mandatory: YES:14, NO:9
Benefits to practitioners: YES:8, NO:13

16. ALLERGOLOGY PRACT. STATUS
ALLERGOLOGISTS/POPULATION(P)
ITALY: ?/P=1/?
CZECH REP. : 520/P=1/20192
LITHUANIA : 28+11/P=1/92337
NETHERLANDS : 8+20/P=1/573850
PORTUGAL: 205/P=1/50000
SPAIN : 800/P=1/50097
FIN LAND: 107/P=1/48445
DENMARK : 3+30/P=1/162693
GREECE: 103/P=1/106796
SWEDEN: 100/P=1/100000
ROMANIA: /P=1/121955
FRANCE: /P=1/34743
HUNGARY : 200/P=1/50000
GERMANY :  5000/P=1/16450
SLOVENIA: 92/P=1/21739
CYPRUS: 2/P=1/383657
AUSTRIA:400/P=1/20000
SWITZERLAND:?+148 / P=1/?
BELGIUM: /P=1/21861
TURKEY:90/P=1/800000
ESTONIA:31/P=1/43290
UK: 27+86/P=1/529009
POLAND:850/P=1/45442
IRELAND:2/P=1/
What’s the ratio of allergists per population? Are we sufficient in terms of population? I can not tell for other countries, but Best ratio seems to be in germany and the worse in ireland

17. DISTRIBUTION OF ALLERGOLOGISTS ACCORDING TO THEIR STATUS (:PUBLIC/PRIVATE/BOTH)
COUNTRY
ALLERGISTS
ALL + SPE
HOSP.ALL
PRIVATE
BOTH
Austria 15
400
Czech Rep.
590
140
450
Estonia 2
Finland 90 30 60
France
505
1273
112 (GP)
Greece
115 17 98
Lithuania 34 33 1
Netherlands 8 20 22 6
Portugal
150
Spain
700
550
200
Sweden 70
Switzerland
162 12
More specifically the distribution of…. Can be seen in this slide

18. STRUCTURES/INSTITUTIONS FOR OUR REPRESENTATION PATIENTS’ ASSOCIATIONS
SCIENTIFIC SOCIETY
YES :23
NO:IRELAND
YES(19)
NO (5)
PATIENTS’ ASSOCIATIONS

19. THANKS TO ALL UEMS DELEGATES