OBJECTIVES: Allergic asthma (AA) patients comprise over 93% of severe/difficult to treat cases in the US and patients face a lifelong treatment course. A dearth of real world information exists on the use of effective and approved treatments, particularly among adolescents. This study examined medication treatments for AA patients and incorporated treatment intensity (HighTx), consistent with NHLBI treatment guidance (steps 5-6), as a severity proxy. METHODS: This retrospective, observational study used MarketScan claims to identify newly diagnosed AA patients (10/2009 – 9/2012). Two cohorts were established: adolescents (12-17); adults (18-64). Index was the date of first AA diagnosis. Continuous enrollment was required for 12 months before and after index. Demographics and comorbidities were measured at baseline. Asthma medication use was observed in the 12 months after index. HighTx was characterized for patients with high dose inhaled corticosteroid/long-acting beta agonist (ICS/LABA) combination treatment and having > 30 days supply in any continuous treatment period in 12 months after index. RESULTS: Gender distribution differed across age cohorts (adolescents: >50% female; adults: >65% male). Acute illness drove comorbidity burden: more adolescents experienced acute respiratory infections (37.9% vs. 24.5% adult); more adults reflected acute sinusitis (20.6% vs. 25.2% adult).  Treatment patterns (full sample): more adolescents received short-acting beta agonist (35.5% vs. 30.2% adults); fewer received ICS/LABA (22.6% vs. 34.5% adults) and monoclonal antibodies (0.3% vs. 1.1% adults). Treatment pattern (HighTx): more patients received ICS/LABA (adolescents 98.9%; adults 99.3%); days on therapy did not exceed 160 (ICS/LABA) for either HighTx age cohort. Twice as many HighTx adults received monoclonal antibodies as adolescents (2.5% vs. 5.1% adults). CONCLUSIONS: In light of similar disease burden, AA diagnosis, and availability of effective treatments, fewer AA adolescents received targeted therapies than adults.  This disparity highlights the opportunity to incorporate targeted therapies as a treatment option, particularly for adolescent AA patients.