Categorization of asthma patients by Global Initiative for Asthma (GINA) 2018 guidelines using a US administrative claims database

Abstract

Introduction: GINA steps are defined based on reliever and controller medications used to treat asthma. Administrative claims data offer a novel means to describe the distribution of asthma patients by GINA 2018 step based on their real-world use of asthma medications, and assess the use of newer asthma treatments such as biologics. Methods: Retrospective analysis of IBM®Watson MarketScan® claims data from Jan 2015 to Dec 2018 was conducted. Patients were aged ≥12 years, had asthma diagnosis, short-acting beta-agonist prescription indexed from Jan 2016 to Dec 2017, and 1-year continuous insurance plan enrolment pre- and post-index date. Patients with comorbid respiratory conditions were excluded. Results: Of 7,746,127 patients with available data, 579,955 were included in the analysis. Overall, 54.3% were classified as Step 1, 14.6% as Step 2, 10.2% as Step 3, 20.5% as Step 4 and 0.4% as Step 5 (Table). Average patient age was greater in the higher GINA steps. Across all GINA steps, 62–66% of patients were female. Conclusions: These findings describe real-world medication use by GINA step among insured US asthma patients. Administrative claims data offer a novel means of assessing the practical adoption of treatment guidelines. These data provide framework for future research evaluating clinical and health resource outcomes by GINA step and evolving treatment strategies.