B32-51 Real-world Impact of Dupilumab on Healthcare Resource Utilization and Costs in Patients With Moderate-to-Severe Asthma: A US Claims Database Analysis

Rationale

Dupilumab is indicated for moderate-to-severe asthma with eosinophilic phenotype in the United States (US). Following the 2018 approval, dupilumab has gained marketing authorization in other type 2 inflammatory diseases, transforming the treatment paradigm. Therefore, updated real-world evidence on dupilumab’s impact on healthcare resource utilization (HCRU) and costs is essential for informing current clinical practice.

Methods

This retrospective cohort study used claims from the Healthcare Integrated Research Database (HIRD®), a large US commercial insurance database maintained by Carelon Research. Inclusion criteria were: patients aged ≥12 years with asthma diagnosis (≥2 outpatient or ≥ 1 inpatient diagnosis in lifetime lookback period, and ≥1 asthma diagnosis [inpatient or outpatient, any position] during the pre-index period) who initiated dupilumab (index date) between October 2021 and July 2024; had at least one medium- or high-dose inhaled corticosteroid fill in the 12-month pre-index period; and continuous enrolment for 12 months before and after the index date. Asthma-related HCRU, both associated and not associated with exacerbations, was analyzed. Healthcare costs evaluated included exacerbation-related costs, pharmacy costs, and total asthma-related costs and are reported in 2024 US dollars. Biologic medication costs were excluded from cost measures. Outcomes were compared 12 months before and after dupilumab initiation.

Results

A total of 3,018 patients met the inclusion criteria and were included in the analysis. A reduction in asthma-related HCRU was observed between 12 months before and 12 months after dupilumab initiation. More specifically, the proportion of patients with at least one asthma-related hospitalization decreased from 11.1% to 6.8%, with the mean number of hospitalizations per person per year (PPPY) reduced by 35.7% (0.14 to 0.09). Mean asthma-related emergency department visits were reduced by 44% (0.27 to 0.15 PPPY), mean asthma-related outpatient encounters were reduced by 28% (7.6 to 5.5 PPPY) and mean asthma-related outpatient office visits by 26% (4.6 vs 3.4 PPPY). Mean annual healthcare cost associated with asthma exacerbations decreased by 66.4% ($1,269 [standard deviation; SD: $5,409] to $427 [SD: $2,828]. In addition, total asthma-related medical costs decreased by 36% (mean: $8,305 vs $5,276). Overall asthma-related costs (medical & pharmacy) decreased by 29% following dupilumab initiation (mean: $12,034 to $8,493).

Conclusion

In this real-world US claims analysis, reductions in asthma-related HCRU and costs, excluding biologic medications, were observed within one year after dupilumab initiation. This observation warrants further research to better understand the clinical and economic benefits of dupilumab in managing moderate-to-severe asthma.

This abstract is funded by: Sanofi and Regeneron Pharmaceuticals Inc.