Increased Adherence to Biologic Therapies Leads to Lower All-Cause and Asthma-Related (HCRU) Costs in Severe Asthma
Author(s)
Nijra L. Lugogo, MD1, B.D. Modena, MD2, Justin Kwiatek, PharmD3, Jiaxuan Wang, MSc4, Peter Howarth, MBBS, DN, FRCP, FFPM5, Riyad Al-Lehebi, MD, FRCPC6, Aungkana Vichiendilokkul, PharmD7, Urvee Karsanji, PhD8, Jeremiah Hwee, PhD9, Gerald Smith, MSc4, Riley Geason, MPH10, Arijita Deb, PhD11, Rafael Alfonso-Cristancho, MD11.
1Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA, 2Modena Health, La Jolla, CA, USA, 3Medical Affairs, GSK, Upper Providence, PA, USA, 4Cytel Inc., Vancouver, BC, Canada, 5Global Medical Affairs, Speciality Care, GSK, London, United Kingdom, 6Department of Pulmonology, King Fahad Medical City; College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia, 7Global Medical Affairs, GSK, Collegeville, CT, USA, 8Real World Analytics, GSK, London, United Kingdom, 9Global Epidemiology, GSK, Mississauga, ON, Canada, 10Real World Evidence, Cytel Inc., Boston, MA, USA, 11Global Real World Evidence & Health Outcomes Research, GSK, Collegeville, PA, USA.
1Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA, 2Modena Health, La Jolla, CA, USA, 3Medical Affairs, GSK, Upper Providence, PA, USA, 4Cytel Inc., Vancouver, BC, Canada, 5Global Medical Affairs, Speciality Care, GSK, London, United Kingdom, 6Department of Pulmonology, King Fahad Medical City; College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia, 7Global Medical Affairs, GSK, Collegeville, CT, USA, 8Real World Analytics, GSK, London, United Kingdom, 9Global Epidemiology, GSK, Mississauga, ON, Canada, 10Real World Evidence, Cytel Inc., Boston, MA, USA, 11Global Real World Evidence & Health Outcomes Research, GSK, Collegeville, PA, USA.
OBJECTIVES: This study evaluated the relationship between biologic adherence and healthcare resource utilisation (HCRU) costs in patients with severe asthma.
METHODS: This cross-sectional cohort study analysed US Optum Market Clarity data (2007-2023) of adults with an asthma diagnosis ≥12 months before biologic initiation and ≥12 months of follow-up. Adherence to each biologic was assessed using medication possession ratio (MPR). Distinct treatment-adherence clusters were identified using group-based trajectory modelling (GBTM). The relationship between adherence and HCRU costs per patient (excluding biologic administration costs) during 12-month follow-up was analysed descriptively.
RESULTS: Of the 10,088 patients included in the MPR analysis, 9553 without a biologic switch during follow-up were included in the GBTM analysis. Seven adherence clusters were identified (Cluster A-highest adherence; Cluster B-late-stage stopper; Cluster C-intermittent adherence; Cluster D-halfway stopper; Cluster E-fluctuating stopper; Cluster F-delayed stopper; Cluster G-lowest adherence). For all-cause events, mean (standard deviation) total costs were lowest in Clusters A ($5583 [13,959]) and B ($5527 [14,546]), increasing with decreasing adherence across Clusters C-G ($6813 [16,923]-$7545 [22,166]). Similarly, all-cause inpatient costs were lowest in Cluster A ($1337 [6485]), increasing to $2117 (9263)-$2518 (19,300) across Clusters B-G. All-cause outpatient costs were lowest in Cluster B ($4103 [8617]), followed by Cluster A ($4677 [11,771]), rising to $4950 (11,583)-$5459 (14,585) in Clusters C-G. For asthma-related events, total costs were lowest for Cluster A ($1377 [5887]) versus other clusters ($1645 [6287]-$2006 [8152]). Asthma-related inpatient costs were lowest in Cluster A ($765 [5017]) versus other clusters ($951 [9828]-$1430 [10,509]). Asthma-related outpatient costs were lowest in Cluster B ($826 [2840]), followed by Cluster A ($965 [4373]), increasing to $975 (3275)-$1086 (4297) across Clusters C-G.
CONCLUSIONS: Higher biologic adherence was consistently associated with lower HCRU costs in patients with severe asthma.
FUNDING: GSK (214570)
METHODS: This cross-sectional cohort study analysed US Optum Market Clarity data (2007-2023) of adults with an asthma diagnosis ≥12 months before biologic initiation and ≥12 months of follow-up. Adherence to each biologic was assessed using medication possession ratio (MPR). Distinct treatment-adherence clusters were identified using group-based trajectory modelling (GBTM). The relationship between adherence and HCRU costs per patient (excluding biologic administration costs) during 12-month follow-up was analysed descriptively.
RESULTS: Of the 10,088 patients included in the MPR analysis, 9553 without a biologic switch during follow-up were included in the GBTM analysis. Seven adherence clusters were identified (Cluster A-highest adherence; Cluster B-late-stage stopper; Cluster C-intermittent adherence; Cluster D-halfway stopper; Cluster E-fluctuating stopper; Cluster F-delayed stopper; Cluster G-lowest adherence). For all-cause events, mean (standard deviation) total costs were lowest in Clusters A ($5583 [13,959]) and B ($5527 [14,546]), increasing with decreasing adherence across Clusters C-G ($6813 [16,923]-$7545 [22,166]). Similarly, all-cause inpatient costs were lowest in Cluster A ($1337 [6485]), increasing to $2117 (9263)-$2518 (19,300) across Clusters B-G. All-cause outpatient costs were lowest in Cluster B ($4103 [8617]), followed by Cluster A ($4677 [11,771]), rising to $4950 (11,583)-$5459 (14,585) in Clusters C-G. For asthma-related events, total costs were lowest for Cluster A ($1377 [5887]) versus other clusters ($1645 [6287]-$2006 [8152]). Asthma-related inpatient costs were lowest in Cluster A ($765 [5017]) versus other clusters ($951 [9828]-$1430 [10,509]). Asthma-related outpatient costs were lowest in Cluster B ($826 [2840]), followed by Cluster A ($965 [4373]), increasing to $975 (3275)-$1086 (4297) across Clusters C-G.
CONCLUSIONS: Higher biologic adherence was consistently associated with lower HCRU costs in patients with severe asthma.
FUNDING: GSK (214570)
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR138
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
Biologics & Biosimilars, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)