OBJECTIVES: Many patients with asthma have coexisting chronic obstructive pulmonary disease (COPD). Benralizumab has been shown to be effective in reducing asthma exacerbations in a real-world setting. However, the impact of benralizumab on exacerbation-related healthcare resource utilization (HRU) and costs among patients with asthma and concomitant COPD is unknown.

METHODS: Using data from a large US claims database (11/2016-6/2020), a retrospective pre-post study was conducted. Included patients had ≥2 records of benralizumab, ≥1 asthma and ≥1 COPD diagnoses pre-benralizumab initiation (index), ≥1 COPD exacerbation pre-index, and were aged ≥12 years. Asthma and COPD exacerbations were defined separately by claims-based algorithms. Costs and rates per person-year (PPY) of exacerbation-related HRU were summarized and compared in the one year pre- and post-index among all patients and among patients with≥2 COPD exacerbations pre-index.

RESULTS: Among the 797 patients with ≥1 COPD exacerbation pre-index, the rate of asthma exacerbation-related inpatient stays decreased 57% (0.35 PPY pre-index vs. 0.15 PPY post-index) and the rate of emergency department (ED) visits decreased 51% (0.25 vs. 0.12) (both p<0.001) after benralizumab initiation. Similarly, rates of COPD exacerbation-related HRU also decreased: 49% lower inpatient rates (0.54 PPY pre-index vs. 0.28 PPY post-index) and 59% lower ED visits (0.54 vs. 0.22) (both p<0.001). The total asthma exacerbation-related costs were reduced by $1,814 ($3,407 pre-index vs. $1,593 post-index) and COPD exacerbation-related costs were reduced by $1,884 ($5,531 vs. $3,648) (both p<0.001). The population with ≥2 COPD exacerbations pre-index (N=379) had similarly large reductions in exacerbation-related HRU (asthma: inpatient 60% reduction, ED 51% reduction; COPD: inpatient 48% reduction, ED 60% reduction) and reductions in exacerbation-related costs (asthma: $2,391 reduction; COPD: $2,768 reduction) (all p<0.001).

CONCLUSIONS: Significant and consistent reductions in asthma and COPD exacerbation-related HRU and costs were observed in the 12 months after benralizumab initiation among patients with asthma and comorbid COPD.