Presentation (CTI)

OBJECTIVES: Biologic therapies are increasingly used in the management of moderate-to-severe asthma; however, real-world evidence describing treatment persistence, healthcare resource utilization (HCRU), and costs remains heterogeneous. This targeted literature review summarized real-world treatment patterns, HCRU, and economic outcomes among patients with asthma receiving biologic therapy.
METHODS: A targeted literature search of PubMed and publicly available conference proceedings was conducted for studies published between January 2015 and January 2026. Eligible studies included observational real-world designs (administrative claims, registries, or retrospective clinical cohorts) evaluating asthma biologics and reporting at least one outcome of interest, including treatment persistence or discontinuation, switching, HCRU, and/or costs. Findings were synthesized qualitatively due to heterogeneity in study populations, follow-up durations, and outcome definitions.
RESULTS: Across real-world data sources, treatment persistence varied substantially. In a large U.S. claims analysis, approximately 64% of patients remained on biologic therapy for at least 6 months, and 45% remained persistent at 12 months. Registry and cohort studies reported treatment discontinuation and switching driven primarily by lack of effectiveness or clinical factors, with switching frequently occurring between anti-IL-5 or IL-5 receptor-targeted therapies. Economic evaluations consistently demonstrated a high-cost burden among biologic-treated patients, largely attributable to pharmacy costs. Claims-based pre/post analyses reported reductions in hospitalizations and oral corticosteroid use following biologic initiation, accompanied by increases in total healthcare costs due to biologic therapy acquisition. Studies evaluating severe asthma populations reported substantially higher asthma-related costs compared with less severe disease.
CONCLUSIONS: Real-world evidence suggests variable treatment persistence and frequent therapy changes among patients with asthma receiving biologics, with substantial economic burden driven primarily by pharmacy costs despite potential reductions in select healthcare utilization measures. Additional standardized and comparative real-world studies are needed to inform payer and health system decision-making.