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Published on: August 25, 2020
Trends and Disparities in Asthma Biologic Use in the United States
Jonathan W Inselman1, Molly M Jeffery2, Jacob T Maddux3
1Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minn.
Insights
Asthma biologic use remains low in the US, with only 3 in 1000 individuals using these advanced treatments. Disparities in access exist, highlighting a need for equitable distribution of biologic therapies for asthma.
Area of Science:
- Pulmonology
- Pharmacology
- Health Services Research
Background:
- Limited biologic approvals for moderate to severe asthma occurred between 2003 and 2015.
- The US Food and Drug Administration (FDA) approved four new asthma biologics since 2015.
Purpose of the Study:
- To analyze trends in asthma biologic utilization in the United States.
- To identify disparities in access to asthma biologic medications from 2003 to 2018.
Main Methods:
- Retrospective cohort analysis using the OptumLabs Data Warehouse.
- Identification of prevalent and incident asthma biologic users.
- Regression analysis to compare users and nonusers; description of clinician prescribing patterns.
Main Results:
- Biologic medication use in asthma patients remains infrequent, peaking at 0.3% in 2006.
- Factors associated with increased biologic use include middle age, higher income, commercial insurance, and specialist access.
- A majority of clinicians (65%) prescribed only one type of biologic.
Conclusions:
- Overall utilization of asthma biologics is low.
- Significant disparities in access to these crucial asthma treatments are evident.
Background:
From 2003 to 2015, only 1 biologic was approved for the treatment of moderate to severe asthma in the United States. Since 2015, 4 new asthma biologics were approved by the US Food and Drug Administration.
Objective:
To describe trends and disparities of asthma biologic use in the United States from 2003 to 2018.
Methods:
We conducted a retrospective analysis using a cohort developed from the OptumLabs Data Warehouse. Prevalent and incident asthma biologic users were identified, and characteristics of users and nonusers were analyzed using regression analysis. Clinician prescribing behavior was described.
Results:
Use of biologic medications remains uncommon among individuals with asthma, with prevalence peaking in 2006 at 3 in 1000 individuals with asthma. Several factors are associated with a higher likelihood of asthma biologic use: middle age, higher income, commercial insurance, and access to a specialist. Most clinicians (65%) in the cohort prescribed only 1 biologic.
Conclusions:
We report low overall use of asthma biologics and evidence of disparities in access to asthma biologics.
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