All 5 biologic therapies that are currently available in the United States for asthma related to type 2 inflammation may reduce asthma exacerbation and modestly improve quality of life, according to a summary published in the Journal of Managed Care & Specialty Pharmacy.1

Approximately 20.4 million Americans aged 18 years and older and an additional 6.1 million children have asthma.2,3 About half of all patients with asthma have “allergic” asthma, whereas others may have eosinophilic asthma, both of which are associated with type 2 inflammation with increases in T helper 2 cells.4 There are currently 5 biologic therapies approved by the US Food and Drug Administration that are available that affect the inflammatory pathways involved in the allergic and eosinophilic phenotypes of asthma.1

The Institute for Clinical and Economic Review conducted a systematic literature review of omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab as add-on therapy for patients with uncontrolled moderate to severe asthma, and reviewed their clinical effectiveness, cost-effectiveness, and policy discussion with key stakeholders regarding the overall value of these therapies. They found that all 5 therapies reduce asthma exacerbations, modestly improve quality of life, and appear to be relatively safe. However, the evidence is insufficient to distinguish the overall clinical benefits and safety among these therapies. In the long-term, all 5 therapies have high incremental cost-effectiveness ratios, representing low monetary value for their labeled indications.

The authors concluded that, “Further efforts are needed to help align the prices of these treatments with their demonstrated benefits in order to ensure sustainable access to high-value care for all patients.”1

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References

  1. Tice JA, Campbell JD, Synnott PG, et al. The effectiveness and value of biologic therapies for the treatment of uncontrolled asthma. J Manag Care Spec Pharm. 2019;25(5):510-514.
  2. Centers for Disease Control and Prevention, National Center for Health Statistics. Faststats: asthma. https://www.cdc.gov/nchs/fastats/asthma.htm. Updated January 19, 2017. Accessed April 16, 2019.
  3. Centers for Disease Control and Prevention. Asthma facts: CDC’s National Asthma Control Program grantees. https://www.cdc.gov/asthma/pdfs/asthma_facts_program_grantees.pdf. July 2013. Accessed April 16, 2019.
  4. Schatz M, Rosenwasser L. The allergic asthma phenotype. J Allergy Clin Immunol Pract. 2014;2(6):645-648.