Lower Use of Biologics for the Treatment of Asthma in Publicly Insured Individuals.
Asthma
Benralizumab
Drug utilization
Dupilumab
IQVIA's National Disease and Therapeutic Index
Mepolizumab
Monoclonal antibody
NAMCS
NDTI
National Ambulatory Medical Care Survey
Omalizumab
Pharmacoepidemiology
Reslizumab
Journal
The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
28
08
2020
revised:
23
12
2020
accepted:
25
01
2021
pubmed:
9
2
2021
medline:
15
12
2021
entrez:
8
2
2021
Statut:
ppublish
Résumé
Despite bearing a disproportionate burden of poorly controlled asthma, publicly insured individuals are less likely to receive biologics. To assess biologic use by payer among individuals with asthma. We used IQVIA's National Disease and Therapeutic Index, a nationally representative, all-payer audit of ambulatory care in the United States, to describe the patterns of use by payer. Asthma treatment visits in which a biologic product was reported increased from approximately 0.1% of asthma-related visits in 2003 to 1% in 2015 and doubled to 2% by 2019. Omalizumab use initially increased from 2003 to 2006 and plateaued till 2015 when its use declined modestly, coinciding with the release of additional biologic products. In 2019, omalizumab accounted for 37% of biologic treatment visits, mepolizumab 21%, benralizumab 27%, dupilumab 15%, and reslizumab <1%. Biologic treatment visits were higher for privately insured individuals (28.3 per 1000 visits) compared with publicly insured individuals (16.3 per 1000 visits). This difference persisted after accounting for age, sex, and race using nationally representative estimates. White patients accounted for a disproportionate amount of biologic treatment visits among the publicly insured (80%) despite accounting for only 60% of publicly insured asthma treatment visits. No biologic treatment visits were observed for individuals who were uninsured. Half of dupilumab visits were for publicly insured patients, compared with 22% of mepolizumab/benralizumab and 27% of omalizumab visits. Biologics were uncommonly used among patients with asthma, and the basis for disproportionately lower use of biologics among the publicly insured, where the burden of uncontrolled asthma is greatest, merits further investigation.
Sections du résumé
BACKGROUND
Despite bearing a disproportionate burden of poorly controlled asthma, publicly insured individuals are less likely to receive biologics.
OBJECTIVE
To assess biologic use by payer among individuals with asthma.
METHODS
We used IQVIA's National Disease and Therapeutic Index, a nationally representative, all-payer audit of ambulatory care in the United States, to describe the patterns of use by payer.
RESULTS
Asthma treatment visits in which a biologic product was reported increased from approximately 0.1% of asthma-related visits in 2003 to 1% in 2015 and doubled to 2% by 2019. Omalizumab use initially increased from 2003 to 2006 and plateaued till 2015 when its use declined modestly, coinciding with the release of additional biologic products. In 2019, omalizumab accounted for 37% of biologic treatment visits, mepolizumab 21%, benralizumab 27%, dupilumab 15%, and reslizumab <1%. Biologic treatment visits were higher for privately insured individuals (28.3 per 1000 visits) compared with publicly insured individuals (16.3 per 1000 visits). This difference persisted after accounting for age, sex, and race using nationally representative estimates. White patients accounted for a disproportionate amount of biologic treatment visits among the publicly insured (80%) despite accounting for only 60% of publicly insured asthma treatment visits. No biologic treatment visits were observed for individuals who were uninsured. Half of dupilumab visits were for publicly insured patients, compared with 22% of mepolizumab/benralizumab and 27% of omalizumab visits.
CONCLUSION
Biologics were uncommonly used among patients with asthma, and the basis for disproportionately lower use of biologics among the publicly insured, where the burden of uncontrolled asthma is greatest, merits further investigation.
Identifiants
pubmed: 33556592
pii: S2213-2198(21)00169-0
doi: 10.1016/j.jaip.2021.01.039
pmc: PMC8549114
mid: NIHMS1747924
pii:
doi:
Substances chimiques
Anti-Asthmatic Agents
0
Biological Products
0
Omalizumab
2P471X1Z11
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3969-3976Subventions
Organisme : NIMHD NIH HHS
ID : K99 MD015767
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL139426
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
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