RECENT TRENDS IN ON-DEMAND TREATMENT PRESCRIPTIONS FOR HEREDITARY ANGIOEDEMA: A US CLAIMS DATABASE ANALYSIS
Author(s)
Raffi Tachdjian, MD, MPH1, Sandra C. Christiansen, MD2, Timothy J. Craig, DO3, Daniel F. Soteres, MD4, Maeve O'Connor, MD5, Marc A. Riedl, MD6, Aditya Sehgal, BSc7, Paul K. Audhya, MD, MBA8, Alice Wang, MA8;
1University of California, Los Angeles, School of Medicine, Los Angeles, CA, USA, 2University of California, San Diego, La Jolla, CA, USA, 3Penn State University, Hershey, PA, USA, 4Asthma & Allergy Associates, Colorado Springs, CO, USA, 5Allergy, Asthma, & Immunology Relief of Charlotte, Charlotte, NC, USA, 6University of California San Diego, La Jolla, CA, USA, 7Pharmsight, Haryana, India, 8KalVista Pharmaceuticals, Framingham, MA, USA
1University of California, Los Angeles, School of Medicine, Los Angeles, CA, USA, 2University of California, San Diego, La Jolla, CA, USA, 3Penn State University, Hershey, PA, USA, 4Asthma & Allergy Associates, Colorado Springs, CO, USA, 5Allergy, Asthma, & Immunology Relief of Charlotte, Charlotte, NC, USA, 6University of California San Diego, La Jolla, CA, USA, 7Pharmsight, Haryana, India, 8KalVista Pharmaceuticals, Framingham, MA, USA
OBJECTIVES: With rising use of subcutaneous and oral long-term prophylaxis (LTP) treatments for hereditary angioedema (HAE), limited information exists regarding the impact on real-world utilization of on-demand (OD) treatments.
METHODS: Patients with ≥1 claims of HAE therapy were included from the IQVIA PharMetrics® Plus Closed Health Plan Claims Database (study period: January 1, 2021 - December 31, 2024). OD doses were calculated among patients with ≥1 claims of OD; a standardized OD dose was defined as one icatibant syringe, two rhC1INH vials, three ecallantide vials, or four pdC1INH vials. OD doses were aggregated each year. Total quantity of non-androgen LTP dispensed was indexed to 100 in 2021 to account for different formulations and strengths.
RESULTS: During the study period, 3,647 HAE patients had ≥1 claims of OD or LTP therapy (69% female, mean age 42y in 2024). Of those, 3,024 (83%) had ≥1 claims of OD. This sample represents an average of 22% of the HAE population in the US (6,715 overall with 5,987 with paid claims). Total OD doses per year remained stable, from 17,652 in 2021 to 17,658 in 2024; extrapolated to the full US HAE population using census data and 1:50K prevalence estimate would be an annual average of 83,724 doses during the study period. Mean OD dose per patient per year remained largely unchanged (mean 14.0). Average share of OD therapies was icatibant 72%, rhC1INH 16%, pdC1INH 8% and ecallantide 3%; yearly share remained generally constant. The proportion of patients with ≥1 claim for any LTP increased from 64% to 68%. Oral LTP quantity increased 134%, while intravenous and subcutaneous decreased 71% and 14%.
CONCLUSIONS: While overall LTP utilization increased and shifted somewhat toward oral therapy, on-demand treatment utilization remained constant. Current LTP strategies have not eliminated the need for acute intervention, highlighting the continued clinical importance of OD therapy.
METHODS: Patients with ≥1 claims of HAE therapy were included from the IQVIA PharMetrics® Plus Closed Health Plan Claims Database (study period: January 1, 2021 - December 31, 2024). OD doses were calculated among patients with ≥1 claims of OD; a standardized OD dose was defined as one icatibant syringe, two rhC1INH vials, three ecallantide vials, or four pdC1INH vials. OD doses were aggregated each year. Total quantity of non-androgen LTP dispensed was indexed to 100 in 2021 to account for different formulations and strengths.
RESULTS: During the study period, 3,647 HAE patients had ≥1 claims of OD or LTP therapy (69% female, mean age 42y in 2024). Of those, 3,024 (83%) had ≥1 claims of OD. This sample represents an average of 22% of the HAE population in the US (6,715 overall with 5,987 with paid claims). Total OD doses per year remained stable, from 17,652 in 2021 to 17,658 in 2024; extrapolated to the full US HAE population using census data and 1:50K prevalence estimate would be an annual average of 83,724 doses during the study period. Mean OD dose per patient per year remained largely unchanged (mean 14.0). Average share of OD therapies was icatibant 72%, rhC1INH 16%, pdC1INH 8% and ecallantide 3%; yearly share remained generally constant. The proportion of patients with ≥1 claim for any LTP increased from 64% to 68%. Oral LTP quantity increased 134%, while intravenous and subcutaneous decreased 71% and 14%.
CONCLUSIONS: While overall LTP utilization increased and shifted somewhat toward oral therapy, on-demand treatment utilization remained constant. Current LTP strategies have not eliminated the need for acute intervention, highlighting the continued clinical importance of OD therapy.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD42
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Rare & Orphan Diseases