EOSINOPHIL LEVELS, EXACERBATIONS, RESOURCE UTILIZATION AND COSTS AMONG MODERATE-TO-SEVERE ASTHMA PATIENTS

Abstract

Introduction In the US, ∼900,000 patients (≥12 years) have uncontrolled moderate-to-severe asthma despite using available treatments. Elevated eosinophils (EOS) are a marker of Type-2 asthma; however, their association with asthma exacerbations, healthcare resource utilization (HCRU) and costs has not been well described in a real-world setting. Methods Patients with diagnosis codes for asthma (ICD-9 493, 493.9, 493.92, or ICD-10 J45.40, J45.41, J45.50, J45.51, J45.998) were identified from the Geisinger Health System electronic health records (EHR). Patients with ≥1 EOS measurement within 90 days of an inhaled corticosteroid and long-acting beta-2 agonist (ICS/LABA) prescription from 01/01/2010–11/01/2016 were identified. Date of EOS result was the index date (ID); patients had continuous EHR enrollment for 12 months before and after ID. Patients were stratified by baseline EOS. Baseline demographics, comorbidities, HCRU and costs during 12 months before ID were compared across baseline EOS levels using ANOVA or chi-square tests. Results 491 patients were categorized into four EOS levels: –299 (n=168), 300–499 (n=87), and ≥500 (n=64) cells/uL. Overall, top three diagnosed Type-2 comorbidities were allergic rhinitis, chronic sinusitis, and eczema. Over 75% of patients experienced ≥1 exacerbation in the past year across all baseline EOS levels. HCRU, cost, and asthma exacerbations were not significantly different across baseline EOS levels (Table 1). Conclusions A large proportion of moderate-to-severe asthma patients experienced exacerbations, while HCRU and costs were high irrespective of baseline EOS level. The results demonstrate a high unmet need among patients across all EOS levels. Table 1. Baseline characteristics (during 12 months prior to index date). *P-values represent results of chi-square tests or ANOVA. †Asthma exacerbations were defined as either an asthma-related hospital admission or emergency department visit, or a prescription order for an oral or injectable corticosteroid.