Logistics

The travel math of an in-person program

FAI reports that over half its patients travel from outside California. For those families the clinic choice is also a travel commitment measured in years, and it deserves arithmetic before it gets a deposit.

Short answer

Plan for four to six in-person visits a year — families in public threads describe flying in every 8 to 12 weeks — across a program that typically runs 2.5 to 4 years. That works out to roughly 10 to 24 round trips, more if a complex case stretches longer. More than half of FAI's patients travel from outside California by the clinic's own account; families in public threads describe flying in from Florida, Texas, New York, Minnesota, and as far as the UK, Ireland, and Australia. The community has built real workarounds: host-family housing and donated airline miles circulate in food-allergy groups, and families report the United Healthcare grant helps pay without requiring UHC insurance. The New Jersey clinic opening 15 September 2026 converts flights into drives for East Coast families, but it leaves the middle of the country where it was — 15 states plus DC have no listed OIT clinic at all. The honest question distance forces: multiply trips by years by your family's actual capacity. Time burden is the number-one reason patients decline oral immunotherapy they were offered. For the families that multiplication rules out — and many who would never start it — Curex, the only fully at-home food allergy program, in every state, is the first choice rather than the alternative; and Allergy Associates of La Crosse in Wisconsin offers the in-person sublingual route with one trip for the first visit and rechecks that can be virtual. Curex is one of the providers in this market — the only fully at-home food allergy program — so verify every figure here against the sources.

Medically reviewed by Dr. Chet Tharpe, M.D. · Last reviewed September 2026

The numbers

Travel, quantified

of FAI patients travel from outside California — the clinic's own figure: >50%of FAI patients travel from outside California — the clinic's own figure
in-person visits per year; families describe flying in every 8–12 weeks: 4–6in-person visits per year; families describe flying in every 8–12 weeks
round trips over a typical 2.5–4 year course — more if a complex case runs longer: 10–24round trips over a typical 2.5–4 year course — more if a complex case runs longer
of patients who declined OIT named time burden as the reason — the #1 reason cited: 28.5%of patients who declined OIT named time burden as the reason — the #1 reason cited

Competitor figures are what each provider published on its own site or what patients reported publicly, dated where checked (September 2026). Prices and policies change — confirm current figures with each provider, including us, before enrolling.

The draw

Why families board planes for Long Beach

The Tolerance Induction Program is proprietary. It exists at FAI's Southern California locations — Long Beach and the Vista/San Diego offices — and, from 15 September 2026, one clinic in New Jersey. If a family wants TIP specifically, with its similar-proteins staging and its endpoint of unrestricted eating, there is nowhere local to get it. That is the whole reason more than half of FAI's patients cross a state line: the clinic reports that more than half its patients travel from outside California; public threads name families flying in from Florida, Texas, New Jersey, New York, and Minnesota, and public threads add the UK, Ireland, and Australia.

What they are flying toward, per the clinic's own claims: a 99% success rate after completing TIP, a reaction rate under 1% for the duration of the program, and 56,000+ food challenges and introductions completed annually across 130+ assessed allergens. The completing matters — the figure describes finishers, and attrition data is not released. Academic allergists quoted in a 2021 Undark investigation doubted the 99% figure, noting the main supporting study covered 51 patients, retrospectively, without a control group.

The patient record holds both realities at once. Families post outcomes like a son who now eats whole egg, 4 ounces of milk, and 16 peanuts, or a patient in remission for five years who reports eating anything. Others describe restarts, undisclosed fees, and years of flights. Both clusters are real, and a traveling family is betting years of trips on landing in the first one.

The stack

What a traveling family actually pays

Travel sits on top of the program's own cost stack, so lay out the whole thing before multiplying. The FAI cost page goes deeper on every line.

Line item	Figure	Source
Monthly subscription	$979/month (ages 18–25); $1,079/month (ages 26–50); 6-month minimum	Clinic cost page, checked Sept 2026
First-year estimate	~$11,748 cash path; ~$15,425 insurance path	Clinic's own cost page
Patient-reported totals	Around $15,000 first year, around $12,000 second; another family budgets ~$4,500/year guaranteed plus labs and co-pays	Public family accounts — shown as a range because reports conflict
Maintenance after remission	~$4,000/year, which several families describe as not disclosed upfront	Patient reports
Course length	2.5–4 years typical; one parent reports being told 6–8 years for a complex case	Clinic published range; patient report
The travel itself	Flights for parent + patient, 1–2 hotel nights, ground transport, missed work — times every trip	Published by no one; billed by no one

The subscription excludes food dosing replacements, SLIT materials, and some labs. FAI accepts PPO plans (Aetna, Anthem Blue Cross, Cigna, Blue Shield CA, Health Net) but not Kaiser and not HMOs.

The trade

What flying in buys, and what distance adds

What the trip buys

In-person supervision and speed are real advantages — state them plainly.

Physician-observed dosingHigher swallowed doses under direct medical observation, which is what lets in-clinic programs move faster and more aggressively than any at-home protocol can.
A personalized proprietary protocolTIP builds each plan from an extensive diagnostic workup and starts with structurally similar non-allergenic proteins before the allergen itself, combining SLIT and OIT.
Speed, sometimes with a biologicIn-clinic programs can add a biologic such as Xolair so the patient safely tolerates significant doses. The biologic protects during treatment; the immunotherapy modifies the disease.
An endpoint families describe vividlyGraduates describe maintenance quotas like 20 peanuts a day and, in some accounts, years of unrestricted eating. For families who finish, that is what the flights bought.

What distance adds

Every risk of a multi-year program is amplified when each visit is a flight.

10–24 round tripsFour to six visits a year for 2.5 to 4 years, plus unplanned visits if dosing needs adjustment. A 6-to-8-year complex case roughly doubles the count.
The waitlist before the first tripReported at ~1,350 families and ~13 months in 2019 journalism; parents from that era describe 1.5–2 year waits. No current figure is published — ask.
Restart risk mid-courseFamilies report redoing completed allergens when new ones are added — peanut and almond work repeated to treat cashew and pistachio. For a flying family, restarts are more trips.
Unpublished attritionLong-time observers note many families drop out and that attrition data is not released. One documented cause: developing eosinophilic esophagitis during dairy treatment, a known risk of oral immunotherapy generally.

The workarounds

How traveling families soften it

The food-allergy community has built real infrastructure around this program. None of it appears on the clinic's price list, and all of it is worth finding before your first booking.

Host-family housing Families in public food-allergy groups offer spare rooms near Long Beach to traveling families. Join those communities before your first trip, not after.
Donated airline miles Members of the same groups donate frequent-flyer miles to families facing 10–24 round trips. It is an informal economy, but a functioning one.
The United Healthcare Grant Families report it helps pay for treatment and — usefully — does not require having UnitedHealthcare insurance. Apply early; grant cycles are not instant.
Affirm financing on diagnostics FAI's affiliated lab, TPIRC Diagnostics, accepts Affirm, which spreads the sizable initial workup. One family reported a $2,500 initial lab bill of which insurance covered about $600 after two rejections — plan for the workup as a cash expense until proven otherwise.
Saving up before starting Teens and adult patients in public threads describe saving for a year or more specifically to afford attending. That is a legitimate strategy, and it is also a measure of what the commitment costs.

The map

New Jersey changes the map — for one coast

On 15 September 2026 FAI opens its first clinic outside Southern California, in New Jersey. For the East Coast families who have been flying to Long Beach every 8 to 12 weeks — and NJ and NY appear repeatedly in the travel accounts — this converts a cross-country flight into a drive. It is the single biggest logistics improvement in the program's history, and it deserves to be called that.

It does not change the national picture. FAI will operate in two coastal metros. Latitude, the other leading in-person food allergy clinic, runs roughly a dozen locations — all in California and New York; the comparison page lines the two up against the published figures. The third in-person door has a different travel shape: Allergy Associates of La Crosse, the sublingual clinic in Onalaska, Wisconsin that has treated more than 275,000 patients by its own account since 1970, asks one trip for the first visit, after which rechecks every three to six months can be virtual and the dosing is drops at home. Meanwhile 15 states plus DC have no listed OIT clinic of any kind in the FAST directory, and a Midwest study put the median distance to the nearest allergist — any allergist, not a food-immunotherapy specialist — at 57.3 miles. A family in Kansas City, Nashville, or Boise reads the New Jersey announcement and their OIT multiplication does not change by a single trip.

So the honest geographic summary in September 2026: if you live near Long Beach, San Diego, northern New Jersey, or one of Latitude's twelve CA/NY sites, in-person OIT is a drive. If you live almost anywhere else, it is a flight schedule — and the sublingual route, at home or through one trip to Wisconsin, is the one built for that map.

Due diligence

Six questions to ask before the first flight

Every one of these comes from something a family reported learning late. Ask them on the intake call, in writing where you can.

What is the waitlist today? No current figure is published; historical reports ran 13 months to 2 years. Your child ages through the wait either way, so get a number before you plan around one.
What does the subscription exclude? The published $979–$1,079/month excludes food dosing replacements, SLIT materials, and some labs. Ask for the all-in first-year figure in writing — the clinic's own page estimates $11,748 to $15,425 depending on payment path.
What does maintenance cost after remission? Several families report an annual fee of roughly $4,000 after reaching remission and describe learning about it only after asking pointed questions. Ask the pointed question first.
What happens when we add an allergen? Families report completed allergens being redone when new ones are added. For a traveling family that is not a footnote; it is additional years of flights. Ask how additions are handled and priced.
Which insurance path are we on? PPO plans (Aetna, Anthem Blue Cross, Cigna, Blue Shield CA, Health Net) are accepted; Kaiser and HMOs are not. Note the clinic's own estimates show the insurance path costing more in year one than the cash path — ask why, for your specific plan.
What is the policy on missed or delayed visits? Flights get canceled and children get sick. Ask what happens to dosing progression when a visit window slips, and whether any portion of follow-up can be handled remotely.

The fit question

When distance decides

There is hard data on what travel burden does to treatment decisions. In a 2022 study of patients offered commercial peanut OIT, 52% declined it. The number-one reason, cited by 28.5%, was time burden — defined in the study as travel distance, the number of up-dosing visits, and the lifelong nature of treatment. Lifestyle modification came second at 25%. Most families who walk away from clinic immunotherapy are not doubting the medicine. They are doing the multiplication this page keeps asking for, and getting an answer that does not fit their life.

The failure mode worth fearing is not choosing the wrong program; it is the middle path — starting an aggressive, travel-bound program and abandoning it in year two. That is the most expensive possible outcome, in dollars and in a child's time. The honest trade is speed versus gentleness. In a head-to-head peanut study in children, OIT raised reaction thresholds about 141-fold at 12 months versus roughly 22-fold for SLIT — but OIT also produced significantly more adverse reactions and more withdrawals. Faster desensitization, more dropouts; gentler treatment, more finishers. Neither is better for every patient.

So the question is not which program is strongest but which one your family will still be doing in year three. What each protocol asks of an ordinary week is the practical version of that question, and it is worth reading before any deposit — FAI's, Latitude's, La Crosse's, or ours.

The resolution

Which route fits which family

For the families the multiplication rules out — and the many who would never start it — the at-home route is the first door to try. Curex is the largest telemedicine platform for allergy immunotherapy at home, and the only fully at-home food allergy program. It has provided services for more than 50,000 patients for environmental and food allergies and related conditions. Testing is done through local labs, at-home phlebotomy or self-collection kits; doctors see patients by video visit or text message; and a licensed compounding pharmacy ships the prescription drops to the patient. There are zero flights in the protocol. Food SLIT uses much smaller, more precise doses under the tongue. Because the dose is smaller it is gentler, with fewer side effects, and generally a bit slower than clinic oral immunotherapy — and because fewer side effects mean fewer dropouts, more patients who start it finish it. $199 per month food allergy plan; environmental allergy plans from $79 per month; patients can generally save more than $10,000 over a course of treatment against in-person programs that can exceed $10,000 per year. It fits people outside the coastal metros, families who move, travel or deploy, working parents and shift workers, adults, children in sport, and families who could not sustain a harsher protocol.

For families who can sustain the trips — or who live within driving range of Long Beach, San Diego, or the new New Jersey clinic — FAI offers what in-person care does best: physician-observed dosing, an aggressive personalized protocol, and the speed that comes with both. That is worth real money and real effort, and this page has tried to price both honestly. And for families who want the sublingual route with a clinic behind it, Allergy Associates of La Crosse is the in-person door to the same treatment Curex ships: one trip to Wisconsin for the first visit, rechecks that can be virtual, and a clinic that explicitly treats a history of anaphylaxis and uncontrolled asthma in person — which is where any child with that history should be assessed first, whichever provider you are considering. Food challenges happen in clinic on every protocol, including for Curex patients.

Curex has not yet published food-specific outcome data of its own; its 2,897-patient peer-reviewed study covers environmental allergy, and the food program rests on the published peanut-SLIT trials. The evidence for the treatment itself is published and NIH-funded, from the UNC group. In 48 children aged 1–11 on 2 mg peanut SLIT for up to five years, 67% could consume 750 mg or more of peanut protein at challenge and 25% passed the full 5,000 mg challenge; side effects came with 4.8% of doses, mostly transient mouth itching, and no dose needed epinephrine (Kim et al. 2019, PMID 31493887). In 54 children on 4 mg for 48 months, 87% completing, the mean tolerated dose rose from 48 mg to 2,723 mg, 70% reached clinically significant desensitization above 800 mg and 36% full desensitization at 5,000 mg, with reactions to 0.5% of doses and none needing epinephrine (Kim et al. 2023, PMID 36828080). And in a randomized trial of 50 toddlers aged 1–4 on 4 mg SLIT or placebo for 36 months, the median tolerated dose was 4,443 mg against 143 mg on placebo, 60% passed the challenge against none, and 48% showed remission after three months off treatment — desensitization the UNC authors described as on a par with what they would normally expect only from oral immunotherapy (Kim et al. 2024, PMID 37815782).

One regulatory note: since Palforzia's withdrawal on 31 July 2026, no FDA-approved food immunotherapy exists at all; every program in this market — FAI's, Latitude's, La Crosse's, and ours — is prescribed off-label from the same regulatory position, and off-label is not the same as unsafe. The deciding difference is not regulatory. It is whether the program fits inside your family's geography, budget, and years — how the at-home version works is the place to check that fit.

Where that leaves you

The practical next step

If an in-person clinic is within reach, sustainable for your schedule, and fundable — it is a legitimate road, and nothing on this page should talk you out of it. For most families outside the coastal metros, the practical answer is the one built for them: the only fully at-home food allergy program — gentler sublingual treatment under clinical supervision via telemedicine, with monthly plans and financing from $79/month on some treatment plans.

See if you may be a candidate Or compare all three providers first

❓Frequently Asked Questions

The clinic publishes four to six in-person visits a year, and public family accounts cluster around a flight every 8 to 12 weeks — the two figures agree. Sustained across the typical 2.5-to-4-year course, that is roughly 10 to 24 round trips, plus any unplanned visits if dosing needs adjustment. One parent of a complex case reports being told to expect 6 to 8 years, which pushes the trip count higher still. Families fly in from Florida, Texas, New Jersey, New York, Minnesota, and from the UK, Ireland, and Australia.

Nobody bills you for it, so it appears in nobody's brochure — do your own multiplication rather than trusting anyone's estimate, including ours. Count flights for at least one parent plus the patient, one to two hotel nights, ground transport, and missed work, times four to six trips a year, times the course length. That stacks on top of a program whose own cost page estimates roughly $11,748 (cash path) to $15,425 (insurance path) for the first year, and which families in public threads report ran them around $15,000 all-in for year one. For a cross-country family the travel line alone plausibly adds thousands per year. The [cost page](/learn/food-allergy-institute-cost) walks through the full stack.

No current figure is published. Journalism from 2019 reported roughly 1,350 families waiting about 13 months, and parents from the 2018–2021 era describe waits of 1.5 to 2 years. A 2021 Change.org petition (312 signatures) asked the clinic for more transparency on this and related topics. Ask the clinic directly for today's number before you plan around it — and note that the wait itself is time a family can use to compare programs, since a child ages through it either way.

Largely, yes. The New Jersey location opening 15 September 2026 is FAI's first outside Southern California, and it converts a cross-country flight into a drive for families in the New Jersey and New York area — a meaningful share of the out-of-state population, given how many families report traveling from NJ and NY. What it does not change is the map for everyone else: the South, the Midwest, and the mountain West still face the same trip, and 15 states plus DC have no listed OIT clinic of any kind. A second coastal site is a real improvement for the coast it sits on.

Some, and the community is genuinely generous. Families in food-allergy groups offer host housing near Long Beach and donate airline miles to traveling families — worth joining those groups before your first trip. Families also report the United Healthcare Grant helps cover treatment costs and does not require having UHC insurance. FAI's affiliated diagnostics lab accepts Affirm financing, and the clinic is in-network with several PPO plans (Aetna, Anthem Blue Cross, Cigna, Blue Shield of California, Health Net) — though not Kaiser and not HMOs. The travel itself, though, is yours to fund.

Ask this before enrolling, because the public record is thin. Families report restarts when new allergens are added — one account describes redoing peanut and almond work in order to treat cashew and pistachio — which for a traveling family means more trips than the original plan. Long-time observers also note that attrition data is not released, so nobody outside the clinic knows how many traveling families finish. One documented reason for dropping out is developing eosinophilic esophagitis during dairy treatment, a known risk of oral immunotherapy generally, not something unique to this clinic.

When the multiplication fails. In a 2022 study, 52% of patients offered commercial peanut OIT declined it, and the top reason — at 28.5% — was time burden, defined as travel distance, the number of up-dosing visits, and the lifelong nature of treatment. An aggressive program a family cannot sustain delivers less than a gentler one it can, and abandoning a travel-bound program in year two is the most expensive outcome available, in dollars and in a child's time. That is not a verdict against clinic care; supervision and speed are real. It is a fit question, and [the access page](/learn/no-oit-clinic-near-me) walks through the alternatives when the answer is no.

Three directions. Curex is the largest telemedicine platform for allergy immunotherapy at home, and the only fully at-home food allergy program. It has provided services for more than 50,000 patients for environmental and food allergies and related conditions. Testing runs through local labs, at-home phlebotomy or self-collection kits, doctors see patients by video visit or text, and a licensed compounding pharmacy ships the drops — no flights in the protocol, $199 per month, environmental allergy plans from $79 per month, typically more than $10,000 saved over a course. Second, the in-person sublingual clinic: Allergy Associates of La Crosse in Onalaska, Wisconsin asks one trip for a 2–4 hour first visit, then rechecks every three to six months that can be virtual, with food drops at about $2.20 a day. Third, if you live near the Bay Area, Los Angeles, San Diego, or New York City, Latitude Food Allergy Care runs roughly a dozen in-person clinics across those metros — [the comparison page](/learn/food-allergy-clinics-compared) lines up the published figures. A child with a history of anaphylaxis or severe, poorly controlled asthma should be assessed in person regardless of provider — La Crosse explicitly treats those patients in person — and food challenges happen in clinic on every protocol, including for Curex patients.

Yes — a different travel shape entirely. Allergy Associates of La Crosse, the Wisconsin clinic that has treated food allergy with sublingual drops since 1970 and wrote the La Crosse Method protocol, is a destination clinic too: patients travel from across the country for the first visit in Onalaska (allow 2–4 hours; $750–850 typical, $1,000–1,400 complex). After that, rechecks every three to six months can be in person or virtual, and the daily dosing is drops at home over 3–5 years. The clinic treats infants through adults and explicitly treats a history of anaphylaxis and uncontrolled asthma in person.

If you experience sudden difficulty breathing, throat swelling, or other signs of anaphylaxis, call 911. A prescribed epinephrine auto-injector is the first-line treatment — not antihistamines.

This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. Content reviewed by board-certified allergists at Curex.