Severe asthma biologics use in England: a need to increase use and reduce inequity (ID 535)
University Hospital Southampton NHS Foundation Trust
Funding: This abstract was funded by AstraZeneca
Abstract
Background: Severe asthma (SA) is often debilitating, disruptive and life-limiting. Biologic treatments improve SA control and are steroid sparing. In England, patients are referred to and undergo systematic assessment in a specialist centre prior to biologic initiation.Aim: Evaluate the degree of regional variation in biologic prescribing across England to assess the need for interventions to improve accessibility.
Method: Data (BlueTeq: national recording system) on the initiation of biologic treatments in eligible patients (based on regional asthma prevalence) in England between 2016 and 2023 were obtained for all 42 Integrated Care Boards (ICBs). Future use based on current initiation rates was calculated using an arbitrary target of 50% of biologic-eligible patients actually receiving biologics.
Results: SA biologic prescribing in England varied widely by ICB. The median of all eligible patients who received biologics was 16% (range 2% to 29%). Nationally there was up to a 15-fold difference in biologic prescribing between ICBs (Figure). Based on current initiation rates (lowest of 2%), modelling indicates that it will take 37 years (until December 2061) for 50% of eligible patients to receive biologic therapy.
Conclusion: In England, biologics are under-used among eligible SA patients, with considerable regional variability. It has been shown that proactive identification of patients with SA using primary care search tools increased biologic initiation 3-fold in one region.1 At the other end of the patient journey, accelerating transfer to home care in appropriate patients can increase capacity and reduce time to start biologics.2 Additionally, integrating care between specialist centres and primary care can support more timely and higher biologic initiation. System-wide, nationally driven policy change and implementation are needed to reduce variation in care and ensure patients receive this treatment in a timely manner.
1. Damery et al. npj Primary Care Respiratory Medicine 2024
2. Whitfield et al. BTS 2023;P38
This abstract has been submitted to ERS and BTS, therefore under embargo and cannot be published at acceptance, until we hear notification of BTS.
Conflicts of interest: Hitasha Rupani has received advisory board and speaker fees from GSK, Chiesi, AstraZeneca, Sanofi and Boehringer Ingelheim; conference support from AstraZeneca and grant funding to her institution from AstraZeneca and GSK.
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