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; 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 the only fully at-home food allergy program in the US.

Medically reviewed by Dr. Neeta Ogden, MD, FACAAI · Last reviewed September 2026

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.

Why families board planes for Long Beach

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.

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.

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.

New Jersey changes the map — for one coast

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.

When distance decides

Which route fits which family

What they offer

What this provider is known for, from the public record.

  • Clinic oral immunotherapy

    Faster, larger threshold rise

    In the one head-to-head peanut trial in children, oral immunotherapy raised the reaction threshold roughly 141-fold at 12 months against roughly 22-fold for sublingual drops (with more side effects and withdrawals).

    Source: Narisety 2015, PMID 25528358

  • Food Allergy Institute

    Supervised pace

    In-person supervision at 4–6 visits a year permits a pace no at-home program should attempt; the clinic publishes typical completion in 2.5–4 years.

    Source: foodallergyinstitute.com

  • Food Allergy Institute

    Food challenges built in, complex cases

    Supervised food challenges and introductions are part of the program rather than referred out, for ages 15 months to 50 years, including complex multi-allergen cases.

    Source: foodallergyinstitute.com

How food allergy drops are regulated

Personalized allergy drops are compounded for each individual patient. Such formulations are not reviewed by the FDA. However, they remain common practice for allergists and ENT allergists because they provide a convenient alternative to allergy shots. Allergy drops are the standard of care in many EU countries.

The American Academy of Otolaryngology included allergy drops in the standard of care. The FDA has approved four sublingual tablets for single allergens; allergy drops are compounded, target multiple allergies at once, and remain off-label.

Has the FDA written to Curex about allergy drops? Once, in 2021: an untitled letter about how the drops were marketed. Curex changed its website, responded in April 2021, and has had no FDA correspondence about allergy drops since.

Does the 2025 FDA warning letter concern allergy drops? No. The September 2025 warning letter concerned marketing language for compounded GLP-1 weight-loss products; Curex made the requested changes.

Every letter and response: Curex and the FDA. The short version: Is Curex legit?

The practical next step

Frequently Asked Questions

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.

Ready to treat your allergies at the source?

Take the free allergy quiz to find out if immunotherapy is right for you and get started with personalized treatment today.

Take Free Allergy Quiz