Uncontrolled Severe  Asthma Of

Clinical and Economic Burden

ABSTRACT

Uncontrolled Severe Asthma

Goals: 

To quantify the clinical and economic burden of patients suffering from severe asthma and low blood eosinophil count (BECs) that are not being treated by biologics.

Study Plan: 

A retrospective cohort study in the IBM MarketScan claims database.

Uncontrolled Severe Asthma

Techniques

Participants aged 12 and over with severe asthma and BEC data were identified from January 1st, 2013 between June 30, 2018, and January 1, 2013. (the date that was the most current BEC is used to determine the index). The criteria for inclusion were (1) the presence of a BEC results from a laboratory test,

(2) continuous enrollment during the 12 months preceding and up to the date of the index, and (3) meeting the Healthcare Effectiveness Data and Information Set definition of persistent asthma, (4) meeting the Global Initiative for Asthma definition of severe asthma and (5) the absence of treatment with biologics and other respiratory diagnoses or malignancies in the 12 months prior and after the date of the index. Asthma flare-ups and levels of disease control and all-cause asthma-related healthcare cost were reported in the 12 months post-index period for those with a BEC lower than 300 cells/mcL.

The results: 

The sample included 8073 patients suffering from severe asthma. 78 percent (n is 6260) had a BEC lower than 300 cells/mcL. The median (SD) for the group is 54.8 (14.2) years. 64% of them were female. The majority of patients had an asthma exacerbation. 19% were either suffering from poorly controlled or uncontrolled asthma,

based on the frequent hospitalizations related to asthma and emergency department visits or prescriptions for corticosteroids.

All-cause and asthma-related healthcare costs totaled $25,845 and $2802 in the respective years. Patients who suffer from suboptimal control and asthma that is not controlled spent an additional $1471 and $3872 in relation to claims related to asthma as compared to those with asthma that is controlled.

Conclusions

Among people suffering from asthma severe, with low eosinophils and not being treated by biologics, there is an elevated incidence of disease in those with suboptimal control of the disease, indicating the need for more extreme asthma treatments.

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