Alternatives

If not Latitude, then what?

Latitude has a strong public record — published outcome figures, academic affiliations, no complaint cluster. Families still search for alternatives, and almost always off one of five walls: every office sits in California or New York, the program fee runs $4,000–$5,000+ by patient reports, OIT build-up means frequent in-person visits, the history is high-risk enough to want sublingual treatment with a physician in the room, or the family wants a different treatment philosophy entirely. Different walls, different doors.

Short answer

Pick by the wall you hit. Geography (all ~12 Latitude offices are in California or New York): the fully at-home route — Curex, the only fully at-home food allergy program, treating in every state at $199 a month with environmental allergy plans from $79 — or a local OIT allergist, calling practices directly since the FAST directory lists clinics in only 35 states. The program fee ($4,000–$5,000+ by patient reports, not covered by insurance): at-home treatment, which typically saves $10,000+ over a course, or local OIT with standard billing. The cadence (frequent up-dosing visits, then lifelong maintenance): at-home sublingual treatment — gentler milligram doses that more patients finish, on a schedule that survives work and school. A high-risk history, or wanting sublingual treatment with a physician in the room: Allergy Associates of La Crosse, the in-person sublingual clinic in Wisconsin since 1970, which explicitly treats anaphylaxis history and uncontrolled asthma. Philosophy (wanting the most aggressive personalized program regardless of cost): Food Allergy Institute's TIP — 2.5–4 years, $979–$1,079/month published. Xolair sits alongside all of these: FDA-approved severity protection, no desensitization. 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

Credit first

What Latitude gets right

Latitude Food Allergy Care is the polished end of in-person food allergy treatment: roughly twelve offices across Northern California, Southern California, and the New York metro area, affiliations with UCSF Benioff, Weill Cornell, and Children's Hospital Los Angeles, and oral food challenges — the gold standard for confirming or ruling out an allergy — offered as a core service. It publishes outcome figures, which most clinics do not: 94% of patients of all ages achieved desensitization with oral immunotherapy, 98% of patients under four (internal data, 2026), and an AAAAI 2025 abstract with Weill Cornell reported that about 5% of doses among 1,000+ OIT patients caused any reaction, the overwhelming majority mild. Average time to maintenance dosing: about 8.4 months.

Its third-party record is clean. BBB shows no complaints, the New York practice holds 276 Zocdoc reviews with strongly positive text, and there is no skepticism cluster — no petitions, no scam threads, nothing like the record around some other programs. Diagnostics and visits are typically covered in-network with Aetna, Cigna, UnitedHealthcare, and the Blue plans across all three regions.

So the search for alternatives is rarely about doubt. It is about five walls. Geography: every Latitude office sits in California or New York. Money: the one-time OIT program fee is a non-covered service, unpublished, reported by patients at $4,000–$5,000+ depending on region. Cadence: OIT build-up means frequent supervised up-dosing visits for months, then lifelong maintenance dosing. Risk: some histories — anaphylaxis, uncontrolled asthma — want the gentler sublingual treatment with a physician in the room. Philosophy: some families want the most aggressive program money can buy, others the gentlest one that survives ordinary life. Different walls open different doors.

The walls

Why families look elsewhere, in numbers

Latitude offices — every one of them in California or New York: ~12Latitude offices — every one of them in California or New York
patient-reported OIT program fee, not published and not covered by insurance: $4,000–$5,000+patient-reported OIT program fee, not published and not covered by insurance
states with no OIT clinic listed in the FAST directory (self-registered, so call locally): 15 + DCstates with no OIT clinic listed in the FAST directory (self-registered, so call locally)
of patients offered commercial peanut OIT declined it; time burden was the top reason at 28.5%: 52%of patients offered commercial peanut OIT declined it; time burden was the top reason at 28.5%

Sources: latitudefoodallergycare.com locations and FAQ; patient reports (Bay Area Reddit, ~$4,000; New York Atly review, over $5,000); FAST clinic directory; Leef et al., JACI: In Practice 2022.

The map

Six doors, by the wall you hit

Match the alternative to the constraint that actually sent you searching. Each door trades something for something.

You hit…	First door	The trade
Geography — no clinic in your state	Fully at-home SLIT (Curex, in every state) or a local OIT allergist (call practices directly)	At-home is gentler and generally a bit slower; directories are incomplete
The program fee	At-home SLIT at $199/month, environmental allergy plans from $79/month; or local OIT with standard billing	$10,000+ typical savings over a course; or less network polish
The visit cadence	At-home SLIT	Speed traded for a schedule that survives work and school — and that more patients finish
A high-risk history, or wanting sublingual treatment in person	Allergy Associates of La Crosse (Onalaska, Wisconsin)	One in-person first visit ($750–850 typical), then drops at about $2.20/day with rechecks every 3–6 months in person or virtual; 3–5 years
Wanting maximum aggression	Food Allergy Institute's Tolerance Induction Program	2.5–4 year arc, $979–$1,079/month published, self-reported outcomes, travel
Wanting FDA-approved and insurance-billed	Xolair	Reduces reaction severity on accidental exposure; does not desensitize; avoidance continues

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

The at-home door

Where Curex stands on this list

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. 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. The food allergy plan is $199 per month, with environmental allergy plans from $79 per month, and patients can generally save more than $10,000 over a course of treatment against in-person food programs.

It is the first choice for families outside the coastal metros, families who move or travel, working parents and shift workers, adults, children in sport, and anyone a harsher protocol would not survive. 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.

The core trade

Speed in clinic, sustainability at home

Every alternative on this page sits somewhere on one axis. The head-to-head evidence puts numbers on both ends (randomized peanut OIT vs SLIT trial in children, PMID 25528358); what each protocol asks of a week is at the daily-life comparison.

The speed case: supervised OIT

Latitude, local allergists, FAI

141-foldPeanut reaction-threshold increase at 12 months of OIT in the head-to-head pediatric trial — versus about 22-fold for SLIT in the same study. Supervised OIT desensitizes faster.
~8.4 monthsLatitude's published average time to maintenance dosing, with 6–12 months typical — then lifelong maintenance.
A physician in the roomEvery up-dose is observed, and reactions are managed on site. For anaphylaxis histories and severe asthma, this is not a preference — it is the required route.
Biologic pairingSome protocols add Xolair so patients tolerate significant doses during build-up. The biologic protects during treatment; the immunotherapy modifies the disease.

The sustainability case: at-home food SLIT

Curex at home; Allergy Associates of La Crosse in person

Fewer withdrawalsThe same head-to-head trial recorded significantly more adverse reactions and more dropouts on OIT than on SLIT. Gentleness is what keeps people in treatment for the 3–5 years a full course takes.
≤4 mg under the tongueHeld for 1–2 minutes, absorbed through the sublingual mucosa. The same dose swallowed would be ineffective — this is a different mechanism from OIT's swallowed doses, not a smaller copy of it.
Lighter daily rulesGenerally no post-dose rest window and no clinic calendar — the reasons families report it is easier to stay on for the full course.
Graduation, and the long-course evidenceMore patients finish because side effects rarely force them off. Over a longer course, in NIH-funded studies at UNC, 67–70% of children on extended peanut SLIT could tolerate 750–800 mg or more of peanut protein, a quarter to a third passed a full 5,000 mg challenge, and toddlers started at ages 1–4 reached a median 4,443 mg after three years against 143 mg on placebo — with no dose in any of the three studies requiring epinephrine (PMIDs 31493887, 36828080, 37815782).

The in-person sublingual door

Allergy Associates of La Crosse

Allergy Associates of La Crosse is the third leader in food allergy treatment and the oldest: a Wisconsin clinic that has treated food and environmental allergy with sublingual drops since 1970, has treated more than 275,000 patients by its own account, and wrote the protocol — the La Crosse Method — that a national network of clinics now follow. Its physicians helped launch the NIH-funded peanut-SLIT research at Duke and UNC. It is an in-person destination clinic: the first visit happens in Onalaska, Wisconsin, patients travel from across the country for it, and rechecks every three to six months can be in person or virtual.

The first visit is in person in Onalaska — allow 2–4 hours — at a typical $750–850, or $1,000–1,400 for complex cases; return visits run about half that. Food allergy drops cost about $2.20 a day, patient-pay. A course runs 3–5 years, with rechecks every 3–6 months in person or virtual. It treats infants through adults, and explicitly treats anaphylaxis history and uncontrolled asthma, in person. No single success-rate figure is published; the clinic cites an independent Validation Institute review of its outcome data.

La Crosse is the right alternative for a family that wants the gentler sublingual treatment with a physician in the room — above all for a high-risk history — and can make one trip to Wisconsin, with rechecks by video after. It is also where the at-home door leads back to: the same kind of treatment, two ways in.

The high-conviction door

Food Allergy Institute's Tolerance Induction Program

FAI in Long Beach, California is the destination program: a proprietary protocol that starts patients on structurally similar non-allergenic proteins before the allergen itself, built from an extensive diagnostic workup and combining SLIT and OIT, with an endpoint the clinic calls food freedom — unrestricted eating plus lifelong maintenance. The published terms: $979–$1,079 per month depending on age with a six-month minimum, 2.5–4 years typical (complex cases longer; one parent reports being told 6–8), ages 15 months to 50 years, and 4–6 in-person visits per year. More than half of its patients travel from outside California — families describe flying in from Florida, Texas, New York, and abroad every 8–12 weeks — and its first office outside Southern California opens in New Jersey on September 15, 2026.

The claims are big and the scrutiny has been real. FAI advertises a 99% success rate after completing TIP and a sub-1% reaction rate; a 2021 Undark investigation quoted academic allergists doubting those figures, and noted the main supporting study covered 51 patients, retrospectively, with no control group. A July 2021 Change.org petition (312 signatures) asked the clinic to publish safety and outcome data and to disclose financial relationships with its affiliated labs. BBB rates the business C+ with one unanswered complaint. None of this proves the program doesn't work — a substantial cluster of families report graduated children eating freely — but it means the outcome figures are self-reported, not independently verified.

FAI is the right alternative for a family that wants maximum personalization and aggression, can spend at the level of its own first-year estimates ($11,748–$15,425 on its cost page, with patient reports running to about $15,000 all-in), and can sustain a multi-year travel commitment. The full cost breakdown itemizes what the subscription excludes — food dosing replacements, SLIT materials, some labs, and a patient-reported annual maintenance fee of about $4,000 after remission that several families say was not disclosed upfront.

The insurance door

Xolair: protection without desensitization

Since Palforzia's withdrawal from the US market on July 31, 2026, Xolair (omalizumab) is the only FDA-approved food allergy medication — which also means every immunotherapy program in this market, clinic and at-home alike, is prescribed off-label. Off-label is not the same as unsafe; it is the regulatory status of the entire field right now.

Xolair's trial numbers are worth knowing precisely. In OUtMATCH (n=168, FDA figures), 68% of participants tolerated at least 600 mg of peanut protein versus 6% on placebo; egg came in at 67% versus 0%, milk 66% versus 11%, cashew 42% versus 3%. But 17% of participants saw no significant change, and the drug does not desensitize — it reduces the severity of reactions to accidental exposure while strict avoidance continues. It is an injection every 2–4 weeks, approved for ages 1 and up, billed to insurance, and available through prescribers far from any specialty center, which makes it the alternative that requires no program at all. For families who want disease modification rather than a safety net, it is a complement to immunotherapy, not a substitute — the distinction the treatment options overview walks through in full.

Side by side

Every door, one table

Option	Where you go	Cost (published or reported)	Timeline	Evidence base
Latitude	~12 offices, CA + NY; up-dosing visits in clinic	Visits/diagnostics typically in-network; program fee $4,000–$5,000+ (patient-reported; not published)	~8.4 months average to maintenance, then lifelong dosing	94% all ages / 98% under 4 desensitized (internal data, 2026); AAAAI 2025 abstract
Local OIT allergist	Clinics listed in 35 states; call directly — the directory is incomplete	Varies; often standard insurance billing	Build-up over months, then lifelong maintenance	Published OIT literature; ~141-fold threshold gain at 12 months in the pediatric peanut trial
FAI (TIP)	Long Beach + Vista, CA; New Jersey opens 9/15/2026; 4–6 visits/year, >50% travel from out of state	$979–$1,079/month, 6-month minimum; first-year estimates $11,748–$15,425 (clinic's own page)	2.5–4 years typical; complex cases longer	Self-reported 99%; 51-patient retrospective study; questioned by academic allergists (Undark, 2021)
Allergy Associates of La Crosse	One clinic, Onalaska, WI; first visit in person, rechecks every 3–6 months in person or virtual	First visit $750–850 typical ($1,000–1,400 complex); returns about half; food drops ~$2.20/day, patient-pay	3–5 years	In use since 1970, 275,000+ patients by its own account; independent Validation Institute review cited
Xolair	Any prescriber; injection every 2–4 weeks	Insurance-billed biologic	Ongoing; protection, not desensitization	OUtMATCH: 68% tolerated ≥600 mg peanut vs 6% placebo; 17% no significant change
Curex (at-home SLIT)	Fully remote, in every state; labs local, at-home, or by kit	$199/month plan; environmental allergy plans from $79/month; $10,000+ typical savings over a course	Gentler and generally a bit slower; a full immunotherapy course typically takes 3–5 years	No Curex food outcome data yet (its study is environmental); rests on the NIH/UNC peanut-SLIT trials (PMIDs 31493887, 36828080, 37815782)

Ranges reflect conflicting public reports shown as ranges. All food immunotherapy is currently off-label; Xolair is the only FDA-approved food allergy medication.

Due diligence

Five questions to ask any program — including us

The same short list works on Latitude, its alternatives, and Curex. The answers separate programs faster than any marketing page.

Get the full fee in writing. Latitude's program fee is not published; patients report $4,000–$5,000+ by region. FAI's subscription excludes food dosing replacements, SLIT materials, and some labs, and several families describe a roughly $4,000 annual fee after remission they say was not disclosed upfront. Ask specifically what is not included.
Ask where the outcomes are published. Latitude cites internal 2026 data plus an AAAAI abstract; FAI's 99% rests on a 51-patient retrospective study; La Crosse cites an independent review rather than a single rate. 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. Ask everyone, us included.
Count the hours, not just the dollars. Of 67 patients offered commercial peanut OIT in one study, 52% declined, and the top reason at 28.5% was time burden — travel distance, up-dosing visits, lifelong treatment. Map the visit calendar against your actual work and school year before you sign.
Ask what happens if you move or travel. A destination program means flights every 8–12 weeks; a metro program means staying in the metro for the build-up year and maintenance beyond it. An at-home program moves with you. Multi-year treatments should survive a job change.
Ask who handles a reaction, and where. An anaphylaxis history or severe, poorly controlled asthma routes to in-person assessment regardless of provider — Allergy Associates of La Crosse explicitly treats exactly these patients, on drops. And oral food challenges happen in a clinic on every protocol, including for Curex patients. Any program that waves this off is answering the wrong way.

Resolution

Where the map leaves most families

Run the geography first, because it decides for most of the country. Latitude's roughly twelve offices all sit in California and New York. FAI operates in Long Beach and Vista, with New Jersey opening September 15, 2026. La Crosse asks for one trip to Wisconsin, then rechecks that can be virtual. The FAST directory lists OIT clinics in 35 states, leaving 15 states plus DC with none listed, and in the Midwest the median distance to the nearest allergist of any kind is 57.3 miles. If you live inside one of the covered metros, the clinic door is genuinely open — and for anaphylaxis histories or uncontrolled asthma, an in-person door is the one to take: Latitude, a local allergist, or La Crosse, which treats exactly those patients on sublingual drops.

Then run the money and the time together, because they compound over a 3–5 year course. Clinic food allergy programs can exceed $10,000 per year: Latitude's patient-reported fee plus in-network visits at the low end, FAI's published $11,748–$15,425 first year at the high end. And in the study that asked why families offered peanut OIT said no, 52% declined, with time burden first at 28.5% and lifestyle modification second at 25%. The treatments work; the schedules are what break.

For the families those numbers describe, the at-home route is the first choice, not the door left over. 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. It requires no clinic within driving distance, runs $199 a month with environmental allergy plans from $79 a month, typically saves more than $10,000 over a course, and more patients finish it because side effects rarely force them out — the La Crosse treatment delivered at home, backed by the NIH-funded UNC peanut-SLIT trials above. Step by step: how Curex works and is Curex legit.

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

A standard OIT practice run by a board-certified allergist: the same modality, the same supervised up-dosing model, often plainer billing. The FAST directory lists OIT clinics in 35 states, but it is self-registered and incomplete, so call practices directly and ask specifically about your allergen — multi-allergen OIT and rarer foods are not universally offered. What you give up relative to Latitude is the network polish: twelve coordinated offices, published outcome figures, and affiliations with UCSF Benioff, Weill Cornell, and CHLA. What you may gain is proximity and, often, a lower program cost. [The state-by-state access picture](/learn/no-oit-clinic-near-me) shows what is actually within reach of your zip code.

Latitude's FAQ says diagnostics and visits are typically covered in-network with major carriers, but the one-time OIT program fee is a non-covered service whose amount is not published on its site. Patients report roughly $4,000 in the Bay Area and over $5,000 in New York, so treat it as a $4,000–$5,000+ range by region and year. Food Allergy Institute publishes $979–$1,079 per month with a six-month minimum; its own cost page estimates the first year at roughly $11,748 on the cash path and $15,425 through insurance. In-person food allergy programs in general can exceed $10,000 per year. Curex runs monthly plans from as low as $79/month on some treatment plans, and patients can generally save more than $10,000 over the course of treatment versus in-person programs. [The published-figures comparison](/learn/food-allergy-clinics-compared) lays the numbers side by side.

When a family wants the most aggressive, most personalized in-person arc and accepts its terms: a proprietary protocol that starts with structurally similar non-allergenic proteins before the allergen itself, a typical 2.5-to-4-year course at $979–$1,079 a month, and 4–6 in-person visits a year in Long Beach or at the New Jersey office that opens September 15, 2026. More than half of FAI's patients travel from outside California — families describe flying in every 8–12 weeks — so the destination model demonstrably works for committed households. Weigh its self-reported figures with open eyes: the 99% success claim rests on a 51-patient retrospective study, and academic allergists publicly questioned it in a 2021 Undark investigation. [The full cost picture](/learn/food-allergy-institute-cost) itemizes what the subscription does and does not include.

It is the only FDA-approved food allergy medication since Palforzia's withdrawal on July 31, 2026. In the OUtMATCH trial, 68% of participants tolerated at least 600 mg of peanut protein versus 6% on placebo; the egg figure was 67%, milk 66%, cashew 42% — but 17% saw no significant change, and Xolair does not desensitize, so strict avoidance continues. It is an injection every 2–4 weeks, approved for ages 1 and up, billed to insurance, and available through prescribers far from any specialty center. Some clinic protocols pair it with immunotherapy during build-up: the biologic protects during treatment, and the immunotherapy modifies the disease.

That is the situation in a lot of the country: the FAST directory lists OIT clinics in 35 states, meaning 15 states plus DC have none listed at all, and a Midwest study found a median of 57.3 miles to the nearest allergist of any kind. Because the directory is self-registered, call allergists in your area before concluding no one offers OIT. If the answer is still no, the at-home route removes the map entirely: Curex, the only fully at-home food allergy program, treats in every state — local-lab or self-collection testing, video or text visits, drops shipped by a licensed compounding pharmacy — at $199 a month. Xolair through a local prescriber is the other geography-proof option. An anaphylaxis history or severe, poorly controlled asthma routes to in-person assessment first; Allergy Associates of La Crosse in Wisconsin explicitly treats those patients on drops. [The access geography page](/learn/no-oit-clinic-near-me) has the state grid.

Both halves are evidence. In the head-to-head pediatric peanut trial (PMID 25528358), OIT raised reaction thresholds about 141-fold at 12 months versus about 22-fold for SLIT — supervised OIT desensitizes faster — but OIT also produced significantly more adverse reactions and more withdrawals. Over a longer course, in NIH-funded UNC studies 67–70% of children on extended peanut SLIT could tolerate 750–800 mg or more of peanut protein and toddlers reached a median 4,443 mg against 143 mg on placebo, with no dose needing epinephrine (PMIDs 31493887, 36828080, 37815782). Food SLIT is gentler and generally somewhat slower, and more patients finish it. 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.

Mostly pediatric, with doors that open case by case. One 36-year-old peanut-allergic patient reported being accepted at Latitude "although they stated they don't normally treat adults," citing a peanut-component IgE threshold of 2.0 or greater and a 6–12 month path to maintenance. Food Allergy Institute publishes an age range of 15 months to 50 years, and patients describe teens and adults saving up to attend. Xolair is approved for ages 1 and up. Curex treats adults and children by telemedicine; candidacy is clinical everywhere — an evaluation decides whether you may be a candidate, not a website.

OIT protocols published by clinics run on rules: dose at the same time daily with food, no strenuous exercise or hot showers for about 2–3 hours afterward, hold doses during fever or illness, and call the clinic after three missed days; Latitude patients also mention avoiding alcohol for several hours after dosing. Food SLIT is lighter: a dose of no more than 4 mg of protein per allergen held under the tongue for 1–2 minutes, generally with no post-dose rest window — the dose works through the sublingual mucosa, and the same amount swallowed would be ineffective. Xolair asks the least day to day, an injection every 2–4 weeks, but the avoidance rules never relax because it does not desensitize. [The daily-life comparison](/learn/food-immunotherapy-daily-life) maps what each protocol asks of a normal week.

It is the third leader in food allergy treatment, and the in-person sublingual door: Allergy Associates of La Crosse in Onalaska, Wisconsin has treated food allergy with drops since 1970, has treated more than 275,000 patients by its own account, and wrote the La Crosse Method protocol. First visit in person ($750–850 typical, $1,000–1,400 complex), drops about $2.20 a day patient-pay, virtual rechecks every 3–6 months, 3–5 years; infants through adults, and it explicitly takes anaphylaxis history and uncontrolled asthma. The at-home route is the same kind of treatment with a different way in.

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.