Characterizing the severe asthma population in the United States: claims-based analysis of three treatment cohorts in the year prior to treatment escalation

AbstractObjectives: Little is known about the disposition of severe patients prior to treatment escalation. To classify patients by treatment step using pharmacy data and describe their economic and healthcare utilization, insurance status, and sociodemographic characteristics in the year prior to escalation to Global Initiative for Asthma (GINA) steps 4 and 5. Methods: This was a retrospective claims cohort study of asthma patients (age 12–75 years) newly initiated on “stable therapy” (three consecutive months of therapy) with omalizumab, high intensity corticosteroids (HICS; ≥1000 µg/d inhaled fluticasone equivalent or oral prednisone), or high-dose inhaled corticosteroid (HDICS; ≥500–<1000 µg/d fluticasone equivalent) from 2002 to 2011. Other asthma treatments were compared as a reference. Results: Of 25 297 patients, 856 initiated omalizumab, 6926 initiated HICS, and 11 445 initiated HDICS. In the year prior to treatment escalation to omalizumab, HICS, and HDICS, respectively, individuals had high ann...