Lower Use of Biologics for the Treatment of Asthma in Publicly Insured Individuals.
Lower Use of Biologics for the Treatment of Asthma in Publicly Insured Individuals.
复制标题
DOI：
10.1016/j.jaip.2021.01.039
复制
发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Alexander GC
中科院分区：
文献类型：
--
作者：
Akenroye AT;Heyward J;Keet C;Alexander GC
尽管承受着控制不佳的哮喘的不成比例的负担，但公共保险个人接受生物制剂的可能性较小。评估付款人在哮喘患者中使用生物制剂的情况。我们使用 IQVIA 的国家疾病和治疗指数（一项具有全国代表性、对美国门诊护理进行的所有付款人审计）来描述付款人的使用模式。报告使用生物制品进行哮喘治疗的就诊次数从 2003 年约占哮喘相关就诊的 0.1% 增加到 2015 年的 1%，到 2019 年翻了一番，达到 2%。奥马珠单抗的使用量最初从 2003 年到 2006 年有所增加，并保持稳定，直到 2015 年其使用量略有下降，与其他生物制品的发布同时发生。 2019 年，奥马珠单抗占生物治疗就诊次数的 37%，美泊利珠单抗占 21%，贝那利珠单抗 27%，杜匹单抗 15%，瑞利珠单抗 <1%。与公共保险个人（每 1000 次就诊 16.3 次）相比，私人保险个人的生物治疗就诊次数（每 1000 次就诊 28.3 次）更高。使用具有全国代表性的估计来考虑年龄、性别和种族后，这种差异仍然存在。尽管白人仅占公共保险哮喘治疗就诊人数的 60%，但在公共保险参保人中，接受生物治疗的人数却过高 (80%)。对于没有保险的个体，没有观察到生物治疗就诊。一半的 dupilumab 就诊针对的是公共保险患者，而美泊利单抗/贝那利珠单抗的这一比例为 22%，奥马珠单抗的则为 27%。生物制剂在哮喘患者中很少使用，而公共保险人群中生物制剂的使用率不成比例地较低，而不受控制的哮喘负担最大，值得进一步研究。
Despite bearing a disproportionate burden of poorly controlled asthma, publicly insured individuals are less likely to receive biologics. To assess biologic use by payer among individuals with asthma. We used IQVIA’s National Disease and Therapeutic Index, a nationally representative, all-payer audit of ambulatory care in the United States, to describe the patterns of use by payer. Asthma treatment visits in which a biologic product was reported increased from approximately 0.1% of asthma-related visits in 2003 to 1% in 2015 and doubled to 2% by 2019. Omalizumab use initially increased from 2003 to 2006 and plateaued till 2015 when its use declined modestly, coinciding with the release of additional biologic products. In 2019, omalizumab accounted for 37% of biologic treatment visits, mepolizumab 21%, benralizumab 27%, dupilumab 15%, and reslizumab <1%. Biologic treatment visits were higher for privately insured individuals (28.3 per 1000 visits) compared with publicly insured individuals (16.3 per 1000 visits). This difference persisted after accounting for age, sex, and race using nationally representative estimates. Whites accounted for a disproportionate amount of biologic treatment visits among the publicly insured (80%) despite accounting for only 60% of publicly insured asthma treatment visits. No biologic treatment visits were observed for individuals who were uninsured. Half of dupilumab visits were for publicly insured patients, compared with 22% of mepolizumab/benralizumab and 27% of omalizumab visits. Biologics were uncommonly used among patients with asthma, and the basis for disproportionately lower use of biologics among the publicly insured, where the burden of uncontrolled asthma is greatest, merits further investigation.
登录
查看更多内容
影响因子：
9.6
作者：
Cabana, Michael D.;Lara, Marielena;Shannon, Jay
通讯作者：
Shannon, Jay
影响因子：
3.1
作者：
Hasegawa, Kohei;Stoll, Samantha J.;Camargo, Carlos A., Jr.
通讯作者：
Camargo, Carlos A., Jr.
影响因子：
14.2
作者：
Apter, AJ;Boston, RC;Feldman, HI
通讯作者：
Feldman, HI
影响因子：
1.5
作者：
Fu, Teresa;Keiser, Elizabeth;Tang, Jean Y.
通讯作者：
Tang, Jean Y.
影响因子：
24.3
作者：
Chung, Kian Fan;Wenzel, Sally E.;Teague, W. Gerald
通讯作者：
Teague, W. Gerald