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Healthcare costs and resources utilization in children with difficult-to-control asthma treated with biologic
Matteo Monzio Compagnoni1,2, Claudia Conflitti1,2, Veronica Capuano3,4
1National Centre for Healthcare Research & Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy.
Insights
Biologic therapies significantly reduced hospitalizations and medication use in children with severe asthma. While overall costs increased due to drug expenses, healthcare savings were noted in reduced respiratory admissions and emergency room visits.
Area of Science:
- Pediatric Pulmonology
- Pharmacoeconomics
- Real-World Evidence
Background:
- Childhood asthma presents variable severity, with biologics improving severe cases.
- Real-world data and cost-effectiveness studies on pediatric asthma biologics are limited.
- This study evaluates biologics' impact on healthcare utilization and costs in children with asthma.
Purpose of the Study:
- To assess the impact of biologic therapies on healthcare service utilization in pediatric asthma.
- To analyze the associated healthcare costs of biologic treatments in a real-world setting.
- To provide data on the effectiveness and economic impact of biologics for severe childhood asthma.
Main Methods:
- Retrieved data from the Lombardy region Healthcare Utilization database (Italy).
- Identified a cohort of 46 children (6-11 years) treated with dupilumab, mepolizumab, or omalizumab (2017-2021).
- Compared healthcare resource use and costs between baseline and follow-up periods post-treatment initiation.
Main Results:
- Hospitalizations and ER visits for asthma exacerbations decreased by 75.0% and 85.7%, respectively.
- Biologics (omalizumab, mepolizumab, dupilumab) reduced oral corticosteroids and other asthma medication use.
- Overall costs rose due to biologic agents, but hospital admission costs for respiratory causes significantly decreased.
Conclusions:
- Real-world data show biologics reduce respiratory hospital admissions and anti-asthma drug use in children.
- Biologic therapies demonstrate potential for improved outcomes and reduced healthcare burden related to asthma exacerbations.
- Long-term sustainability and cost-effectiveness require further in-depth assessment.
Introduction:
Asthma is one of the most common diseases in children, with a variable range of severity. In recent years, treatment for severe asthma has been largely improved by the availability of targeted biologic therapies. Nevertheless, studies reporting real-world data and cost-effectiveness analyses are lacking. The aim of this study was to evaluate, on a population-based cohort of children with asthma, the impact of the treatment with biologics on healthcare service utilization and associated costs.
Methods:
Data were retrieved from Healthcare Utilization database of Lombardy region (Italy). A cohort of 46 asthmatic children aged 6-11 in treatment with dupilumab, mepolizumab or omalizumab was identified during 2017-2021. We compared healthcare resources use between the year before ("baseline period") and the year after the treatment initiation ("follow-up period"). Average 1-year healthcare costs were also calculated.
Results:
Comparing the baseline with the follow-up period, the number of patients with at least one exacerbation-related hospitalization and ER access decreased by 75.0% and 85.7%, respectively. The use of biologic agents, namely omalizumab, mepolizumab and dupilumab, significantly reduced oral corticosteroids (OCS), short-acting β2-agonists and the association inhaled corticosteroids/long-acting β2-agonists use. ER admissions for non-respiratory causes were also significantly reduced, while discontinuation rate was low (6.5%). The overall costs increased, due to the costs of the biologic agents, but the hospital admission-related costs due to respiratory causes reduced significantly.
Conclusions:
Our real-world investigation suggests that biologic agents reduced hospital admissions for respiratory causes and use of anti-asthmatic drugs, including OCS. However, long-term healthcare sustainability still needs more in-depth assessments.
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