(403) Real-World Primary Non-Adherence to Biologic Therapies in Moderate-to-Severe Asthma: A Retrospective Claims Analysis

Background: : Severe asthma affects 3-5% of patients but accounts for ≥50% of total asthma-related costs, with annual U.S. estimate exceeding $30 billion. These patients experience frequent exacerbations and 2-6 times higher healthcare utilization than those with mild disease. Biologic therapies can reduce exacerbations and hospitalizations by over 50%, yet primary non-adherence, which is defined as failure to initiate therapy after a prescription is sent to the pharmacy, remains common (14-40%). Improving primary adherence is crucial to reducing exacerbations, preventing hospitalizations, and ensuring biologics achieve their intended health and economic impact.

Objective: : The primary objective was to evaluate the rate of primary non-adherence of biologics in patients with severe asthma. Secondary objectives were to compare initiation patterns by medical versus pharmacy benefit and assess secondary adherence among patients who initiated therapy.

Methods: : Members aged ≥ 6 years with at least one diagnostic code for asthma were identified using medical and pharmacy claims from a regional health plan in New York state. The index date was defined as the prior authorization (PA) approval date for an asthma biologic between January 1, 2022, to December 31, 2024. Primary adherence was defined as evidence of a biologic fill or administration within 180 days of the index date. A total of 6 asthma biologics were included: benralizumab, dupilumab, mepolizumab, omalizumab, reslizumab, and tezepelumab.

Results: : Data collection and analysis are in progress; results will be available at the time of presentation. Preliminary findings, pending validation, suggest a very low rate of primary non-adherence.

Conclusions: : Final results will provide insights into primary non-adherence to asthma biologics and may highlight the influence of payer policies, clinical support programs, and specialty pharmacy services on treatment initiation.

Sponsorship:: None