The Burden of Patients With Severe Asthma: A Comparison Between Patients Treated With and Eligible for Monoclonal Antibodies Through a Retrospective Observational Analysis of Italian Real-World Data
Author(s)
Letizia Dondi, BS1, Giulia Ronconi, PharmD1, Leonardo Dondi, BS1, Silvia Calabria, PharmD1, Irene Dell'Anno, PhD1, Immacolata Esposito, PhD2, alice addesi, BS2, Giorgio Walter Canonica, PharmD3, Nello Martini, BS1, Carlo Piccinni, PhD1.
1Fondazione Ricerca e Salute (ReS) - Research and Health Foundation, Roma, Italy, 2Drugs & Health, Roma, Italy, 3Department of Biomedical Sciences, Humanitas University, Milano, Italy.
1Fondazione Ricerca e Salute (ReS) - Research and Health Foundation, Roma, Italy, 2Drugs & Health, Roma, Italy, 3Department of Biomedical Sciences, Humanitas University, Milano, Italy.
OBJECTIVES: To retrospectively describe patients with severe asthma (SA) treated with or eligible for monoclonal antibodies (mAbs) and assess one-year asthma exacerbations, healthcare resource utilization (HCRU) and related costs directly charged to the Italian National Healthcare Service (SSN).
METHODS: From an Italian administrative database of 4.6 million inhabitants, among patients with asthma in 2022 (index date), those with SA were identified by mAbs dispensation (cohort A) and continuous treatment with medium/high-dose inhaled corticosteroid (ICS) and long-acting-beta-agonist (LABA) and occurrence of moderate/severe exacerbation (cohorts B and C), namely patients eligible for mAbs. Exacerbations, HCRU and related direct costs during one-year follow-up were assessed.
RESULTS: Patients with asthma in 2022 were 128,621. Patients with SA were identified as cohorts A (3046; 2.4%), B (3517; 2.7%) and C (7621; 5.6%). Compared to cohort A, cohorts B/C were significantly older and more affected by comorbidities (≥2 comorbidities in 39.9% vs 51.65%/46.0%, respectively), mainly cardio-metabolic diseases. During follow-up, compared to cohort A, cohorts B/C significantly (p<0.05) experienced more exacerbations (70.9%/57.3% vs 46.7%), received more concomitant drugs and were hospitalized more frequently, while underwent less local outpatient specialist services (81.9%/76.8% vs 88.4%). Most patients received concomitant drugs and drugs for asthma; >50% cohort A still received mAbs, while <1% cohorts B/C initiated a mAb. Compared to cohort A, cohorts B/C On average, the SSN yearly spent € 7512, € 2911 and € 2351 per patient of cohort A, B and C, respectively. Of the total costs, for cohorts B and C, concomitant drugs, hospitalizations and outpatient specialist services accounted for higher proportions.
CONCLUSIONS: Although patients with severe asthma eligible for mAbs were significantly more complex than patients treated with mAbs, and continued to experience moderate exacerbations, <1% of them received mAbs during follow-up, suggesting the need for preventive strategies including the change of pharmacological approach.
METHODS: From an Italian administrative database of 4.6 million inhabitants, among patients with asthma in 2022 (index date), those with SA were identified by mAbs dispensation (cohort A) and continuous treatment with medium/high-dose inhaled corticosteroid (ICS) and long-acting-beta-agonist (LABA) and occurrence of moderate/severe exacerbation (cohorts B and C), namely patients eligible for mAbs. Exacerbations, HCRU and related direct costs during one-year follow-up were assessed.
RESULTS: Patients with asthma in 2022 were 128,621. Patients with SA were identified as cohorts A (3046; 2.4%), B (3517; 2.7%) and C (7621; 5.6%). Compared to cohort A, cohorts B/C were significantly older and more affected by comorbidities (≥2 comorbidities in 39.9% vs 51.65%/46.0%, respectively), mainly cardio-metabolic diseases. During follow-up, compared to cohort A, cohorts B/C significantly (p<0.05) experienced more exacerbations (70.9%/57.3% vs 46.7%), received more concomitant drugs and were hospitalized more frequently, while underwent less local outpatient specialist services (81.9%/76.8% vs 88.4%). Most patients received concomitant drugs and drugs for asthma; >50% cohort A still received mAbs, while <1% cohorts B/C initiated a mAb. Compared to cohort A, cohorts B/C On average, the SSN yearly spent € 7512, € 2911 and € 2351 per patient of cohort A, B and C, respectively. Of the total costs, for cohorts B and C, concomitant drugs, hospitalizations and outpatient specialist services accounted for higher proportions.
CONCLUSIONS: Although patients with severe asthma eligible for mAbs were significantly more complex than patients treated with mAbs, and continued to experience moderate exacerbations, <1% of them received mAbs during follow-up, suggesting the need for preventive strategies including the change of pharmacological approach.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH229
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Public Health
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)