Developments in Asthma Treatment

David Lang, MD, a professor of medicine and chair of the department of allergy and clinical immunology and co-director of the asthma center at the Cleveland Clinic, presented on the newest developments in asthma treatment during the NAMCP 2016 Fall Managed Care Forum population health management track session.

His presentation, entitled “Key Advances in the Treatment & Management of Asthma,” sought to educate attendees on recent clinical data on the efficacy and safety of current and emerging asthma treatment options.

His presentation also aimed to update managed care professionals on the latest evidence for asthma monitoring tools, medication adherence strategies, and options for improving asthma control.

Dr Lang cited research which showed that uncontrolled asthma contributes to the asthma cost burden at more than double the cost of properly controlled asthma. Research showed that, in a multicenter, prospective, observational study, the total mean cost of uncontrolled asthma was $14,212 compared to controlled asthma at $6452. He also noted that patients with controlled asthma used less sick days at work and used fewer health care resources than patients with uncontrolled asthma at all periods during the 24-month study.

Dr Lang discussed how in 25.7 million Americans reported having asthma compared with only 20 million in 2001. He stated that the estimated per-patient per-year cost of asthma in the United States is $3300, with an annual overall (medical and nonmedical) cost of $56 billion. He also noted that 3630 Americans die from asthma-related complications annually.  

 According to Dr Lang’s presentation, the most reliable tools to assess asthma control are the Asthma Control Questionnaire, Asthma Control Test, and the Asthma Therapy Assessment Questionnaire.  

Dr Lang stated the patient population varies widely for asthma. According to his presentation, the asthma prevalence rate among black patients was 47% higher compared to white patients. He also noted that 1 in 6 black pediatric patients have asthma and that the rate of asthma-related emergency department visits is 330% higher among black patents. Dr. Lang emphasized that these disparities are significantly linked to poverty, urban air quality, indoor allergens, and inadequate access to proper medical care. 

Among suggested treatment strategies, Dr Lang highlighted personalized care through targeting specific biomarkers to determine asthma pharmacotherapy. He stated that patients with moderate to severe persistent asthma, positive perennial skin tests, and IgE levels of 30 to 77 IU/mL are candidates for Xolair (omalizumab; Genentch). Other treatments highlighted by Dr Lang included Nucala (mepolizumab; GlaxoSmithKline) and Cinqair (reslizumab; Teva). —David Costill