If not Latitude, then what?

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 food-program pricing requires a current quote, and no food-program savings amount is confirmed. [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 — Curex food-plan rates, client commercial terms as of 2026-10-12: Food Allergy Drops: $199/month or $1,990/year. Unlimited number of foods, as clinically prescribed; plus insurance copay for each video consultation. Environmental + Food Allergy Drops: $259/month or $2,590/year. Two treatment sets, with unlimited number of allergens as clinically prescribed; plus insurance copay for each video consultation. Food Drops Self-Pay Plan: $249/month or $2,490/year. Food allergy drops; consultations included without a consultation copay. Environmental + Food Drops Self-Pay Plan: $299/month or $2,990/year. Environmental and food allergy drops; consultations included without a consultation copay. For the listed allergy plans, the annual subscription costs the equivalent of 10 monthly payments instead of 12: two months of subscription fees saved, or 16.7% compared with paying monthly for a year. This is subscription savings, not a discount on testing, copays or your total medical bill. Other products have their own payment terms; GLP-1 annual rates are shown separately. Treatment fees are self-pay. Insurance benefits are verified during onboarding. Each video consultation has a plan-dependent specialist copay, normally $35, which can be lower or higher depending on your plan. Deductibles and coinsurance may also affect your responsibility. The subscription covers compounded allergy drops and non-insured clinic services, including shipping, asynchronous consultations and care management. Insurance-category subscriptions add a copay for each video consultation. The environmental, food and combined self-pay drops plans and the environmental allergy shots plan include consultations without a consultation copay. Certain self-collection tests are not insurance-covered and are priced separately. Allergy IgE, celiac and Alpha-Gal tests may be covered by insurance, depending on your plan. IgG food sensitivity testing is not covered by insurance; the laboratory bills the patient directly. Verify coverage and the laboratory estimate before ordering. See /learn/curex-pricing and confirm eligibility, testing costs and a personalized written quote. 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, 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.