Even With Biologics, Asthma Not Well Controlled in Most Patients With Severe Disease

Nearly two-thirds of patients with severe asthma experienced an asthma exacerbation, usually requiring an outpatient visit and systemic corticosteroids, within a year of initiating a biologic, findings show.

“Biologic therapies are effective in reducing exacerbations, but a substantial proportion of US severe asthma patients treated with biologics have residual disease, suggesting a remaining unmet need,” researchers wrote.

To investigate the clinical and economic burden in real-world patients with severe asthma treated with biologics, researchers analyzed claims and laboratory data for 2122 patients 12 and older who initiated a biologic.

Within the first year of biologic use, 64% of patients had an asthma exacerbation, primarily resulting in outpatient visits requiring systemic corticosteroids, the study found. In the 971 patients with 12 months or more months of follow-up data, 52% had uncontrolled asthma and 26% had suboptimally controlled asthma the year after biologic initiation. Researchers considered asthma uncontrolled if patients had an asthma-related hospitalization or 2 or more outpatient visits and corticosteroid prescriptions. Asthma was considered suboptimally controlled if patients had one outpatient visit and corticosteroid prescription or 4 or more prescriptions for short-acting beta-agonists.

Total all-cause health care costs averaged $67,968, with asthma-related costs accounting for 71%, the study found. Some 46% of the total asthma costs were for outpatient prescriptions.

“Patients with uncontrolled/suboptimally controlled disease had higher health care costs (uncontrolled: all-cause $78,897 and asthma-related $54,129; suboptimally controlled: all-cause $65,266 and asthma-related $45,377)” researchers wrote, “than patients with controlled disease (all-cause $57,501; asthma-related $43,255).”

Reference:
Jo H, Kilpatrick K, Ambrose C, et al. Clinical and economic burden of severe asthma treated with biologics in the United States. J Manage Care Spec Pharm. 2022;28(3a):S58.