Race/Ethnicity and Insurance Biases Limit Asthma Biologic Prescription, Use

Race/ethnicity and insurance status inequities in biologic adherence among adults receiving outpatient care for asthma may prevent some individuals from getting optimal benefit from biologics, according to study findings presented at the American Academy of Allergy, Asthma and Immunology (AAAAI) 2023 Annual Meeting, held in San Antonia, Texas, February 24 to 27.

Investigators sought to determine biologic prescription rates and adherence in relation to prescribing among adults receiving care for asthma.

The researchers conducted a retrospective, observational cohort study using electronic health care data over a 5-year period from 9147 adults with asthma treated by an allergist or pulmonologist at Penn Medicine, a Philadelphia-area health system. Through multivariable regression, the investigators identified patient factors associated with receiving a new biologic prescription after the first specialist visit; whether a dose of biologic was administered or filled; biologic days covered; and the reduction in oral corticosteroid bursts in the 12 months following the prescription date.

The researchers found that 3.7% of patients received a new biologic prescription and that men were more likely to receive prescriptions. Medicaid was associated with fewer biologic days covered than was commercial insurance. The researchers further found that Black patients with Medicaid insurance were less likely to receive at least 1 dose, primarily because of patient preference (50%), loss to follow-up (22%), and insurance denial (22%).

Patients with Medicaid or Medicare insurance were more likely to receive prescription for oral corticosteroid bursts than patients with commercial insurance, after adjusting for days covered. Patients’ use of oral corticosteroid bursts decreased after receiving a biologic prescription.

“Prescription of biologics is beneficial in the outpatient specialist setting, but inequities in biologic adherence according to race/ethnicity and insurance status may prevent some patients from achieving a full benefit,” investigators concluded.

This article originally appeared on Pulmonology Advisor.