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Palforzia oral immunotherapy (peanut) - a licensed peanut OIT programme.

For children aged 4–17 with confirmed peanut allergy who want to build tolerance to accidental exposure. A consultant paediatric allergist, the licensed Palforzia programme, and honest talk about the year-long commitment.

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Indicative pricing

What private Palforzia oral immunotherapy costs in the UK.

In short

A full first-year Palforzia programme: £6,000–£12,000 including drug, visits and follow-up.

ItemIndicative range
Paediatric allergy consultation£250–£450
Baseline oral food challenge£600–£1,200
Palforzia induction dose in clinic£400–£800
Up-dosing visits (11 fortnightly)£300–£600 each
Palforzia drug cost (year 1)£3,000–£6,000
Maintenance follow-up (yearly)£300–£600
Anaphylaxis + EpiPen training£120–£220

The problem

A licensed programme, run properly, with adrenaline on the table.

  • A licensed programme, not off-label OIT

    Palforzia is MHRA-licensed for peanut OIT in 4–17s and uses a standardised, quality-controlled peanut protein.

  • Adrenaline on the table

    Every up-dosing visit runs in a resus-equipped room with a paediatric anaphylaxis pathway.

  • Honest on the commitment

    A year of up-dosing, then indefinite daily maintenance. We say up front whether that fits family life.

When it helps

When Palforzia oral immunotherapy is the right step.

  • Confirmed peanut allergy aged 4–17

    IgE-confirmed peanut allergy with a plausible reaction history.

  • Family highly worried about accidental exposure

    Where the goal is reducing risk of a serious reaction after crumbs or trace contamination.

  • Well-controlled asthma

    Asthma must be stable - Palforzia is not started in poorly controlled asthma.

  • A family who can commit to daily dosing

    Missed doses matter - a family that can run the routine every evening.

  • A clinic within travelling distance

    11 fortnightly visits over about 6 months - geography matters.

  • Not for adults over 17 currently

    Licensing limits Palforzia to under-18s at initiation.

  • Not the only path

    Some families reasonably choose strict avoidance and rescue medication instead.

  • Red flag: airway swelling, breathlessness or collapse

    Adrenaline first, 999 second. Every family with a diagnosed allergy needs to be clear on this.

Options

Peanut OIT is one option - not the only one.

  • Palforzia (peanut OIT)

    The only MHRA-licensed peanut OIT product in the UK.

  • Non-Palforzia peanut OIT

    Specialist centres run peanut flour OIT - off-label, individualised.

  • Tree nut OIT

    Off-label programmes for cashew, hazelnut, walnut, in selected centres.

  • Milk and egg OIT

    Structured up-dosing programmes for children with persistent CMPA or egg allergy.

  • Sublingual immunotherapy for food

    Investigational for peanut in some centres - not licensed.

  • Epicutaneous immunotherapy

    Patch-based OIT - investigational, not yet standard UK care.

  • Omalizumab as OIT adjunct

    Anti-IgE biologic used in selected multi-food allergic children.

  • Strict avoidance + rescue plan

    Still a valid choice for many families - done properly it works.

Safety and recovery

What to expect - honestly.

  • Reactions during up-dosing

    Up to a third of children have mild-to-moderate reactions during up-dosing; most are managed with antihistamines.

  • Anaphylaxis risk

    A small but real risk of anaphylaxis - the reason every up-dose is in a resus-equipped room.

  • Eosinophilic oesophagitis

    Palforzia can trigger EoE in a small percentage - persistent reflux or dysphagia needs review.

  • Daily dosing at home

    Doses must be taken with food, in a calm setting, not during illness or exercise.

  • Illness and exercise

    Doses paused during febrile illness and for 3 hours around vigorous exercise.

  • Asthma control is non-negotiable

    Palforzia is stopped or paused if asthma flares.

  • Long-term maintenance

    Maintenance dosing continues indefinitely - stopping loses the tolerance.

  • School and travel planning

    The programme needs a plan for school, holidays and time zones.

  • Red flag: airway swelling, breathlessness or collapse

    Adrenaline first, 999 second. Every family with a diagnosed allergy needs to be clear on this.

Your notes

Your report in four parts.

A UK consultant reviewing notes
  1. Header

    Diagnosis and eligibility

    How peanut allergy was confirmed and why Palforzia was chosen.

  2. Technique

    Induction and up-dosing schedule

    Dose escalations to date, tolerance and any reactions.

  3. Findings

    Reactions and management

    What happened, what was given, and how the plan changed.

  4. Impression

    Maintenance dose, review dates and emergency plan

    Read this first: your daily dose, review dates and adrenaline plan.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Paediatric allergy is available on the NHS but 6–18 months waits are typical for a first specialist appointment; it is usually covered by private insurers when medically indicated.

Frequently asked

Everything we get asked about Palforzia oral immunotherapy.

  • When is Palforzia OIT actually worth doing?

    When a child aged 4–17 has confirmed peanut allergy, well-controlled asthma, and the family can commit to daily dosing plus fortnightly clinic visits during up-dosing. The goal is protection from accidental exposure, not free eating of peanuts.

  • What does the Palforzia programme involve?

    An initial dose escalation day in clinic, then 11 fortnightly up-dosing visits over about 6 months, then daily maintenance dosing at home indefinitely. Every up-dose is given in a resus-equipped clinic room.

  • How much does Palforzia cost privately in the UK?

    Roughly £3,000–£6,000 for the drug in year 1, plus £300–£600 per up-dosing visit and £250–£450 for consultations. A full first-year programme typically comes in at £6,000–£12,000.

  • Is Palforzia available on the NHS?

    Yes, through specialist NHS paediatric allergy centres following NICE guidance - access is expanding but still limited by geography and waiting lists.

  • What happens if we miss doses?

    Doses missed for more than 3–4 days usually mean stepping the dose down and restarting under supervision. This is normal - the clinic will guide it.

  • Can my child eat peanuts after finishing the programme?

    The realistic goal is protection from accidental exposure - most children on maintenance can tolerate the equivalent of 1–2 peanuts without a reaction. Freely eating peanuts is not the aim.

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