OBJECTIVES: Severe asthma is a critical subset of asthma, known for escalating the risk of asthma-related symptoms. This study aims to assess the treatment pattern and disease burden in adults with severe asthma.

METHODS: This observational, retrospective cohort study with a one-year follow-up was conducted using a healthcare claims database spanning 2018 through 2020, from Tianjin, China. Patients diagnosed with asthma, who had ≥2 prescriptions for medium to high doses of inhaled corticosteroids (ICS) along with additional controllers under diagnosis of asthma, were identified to represent severe asthma population in China. For the treatment pattern, this study mainly focused on adherence to medication, proportion of inhaled corticosteroid/long-acting β₂ (ICS/LABA) and oral corticosteroids (OCS), and duration of OCS. For the disease burden, this study mainly focused on frequency of asthma exacerbation, and the asthma-related cost.

RESULTS: 2,418 patients with severe asthma were included, representing severe asthma population of China, with a mean (SD) age of 56.15 (14.39) years, male 55.62%, 94% using ICS/LABA, 10.75% using OCS. Mean (SD) duration of OCS administration was 82.73 (108.64) days, with 19.62% over 180 days. No patients used biologic treatment. The mean (SD) medication adherence was 0.44 (0.36). Eleven percent of patients experienced ≥ 1 exacerbation, with mean (SD) frequency of annual exacerbations 0.21 (0.98). The mean (SD) asthma-related annual cost was CNY 2846.08 (CNY 4677.92), with medication costs more than 90%. The mean (SD) cost for per exacerbation was CNY 1441.83 (CNY 4098.38), which may led to high medical cost.

CONCLUSIONS: This study shows the treatment pattern that ICS/LABA is widely used and the less use of biologic treatment in China. The high medication cost, poor adherence to medication regimen, and high exacerbation frequency and cost reveal an unmet need to more effective management and treatment.