Disease Severity and Baseline Characteristics of Patients Receiving Mepolizumab or Omalizumab in Employer Claims Database: A real-world experience

RATIONALE: The clinical efficacy of mepolizumab and omalizumab has been established; however, less is known about real-world use of these biologics prescribed to treat severe asthma. We examine baseline demographic, clinical and healthcare utilization characteristics in patients 12 months prior to first mepolizumab or omalizumab administration in an employer medical claims database.

METHODS: Patients with commercial insurance and a diagnosis of asthma treated with mepolizumab (with no prior omalizumab treatment) or omalizumab between November 1, 2015-March 31, 2017 with 12 months of continuous enrollment prior to administration were identified from a large, geographically diverse employer claims database. Descriptive statistics were used for all comparisons between cohorts.

RESULTS: The cohorts included 413 mepolizumab and 5320 omalizumab patients, age 49.5 vs. 45.6yr, 59% vs. 67% female, and comorbid conditions of allergic rhinitis (69.7% vs. 75.4%, p=0.010), atopic dermatitis (2.2% vs. 6.8%, p<0.001), sinusitis (35.4% vs. 25.4%, p<0.001), and nasal polyps (19.1% vs. 6.6%, p<0.001), respectively. In the 12 months prior to treatment initiation, higher percentages of the mepolizumab vs. omalizumab population had exacerbations (88.4% vs. 68.7%, p<0.001) with mean rates of 2.9 vs. 1.9 exacerbations/year (p<0.001). Asthma-related utilization was higher for ED visits (24.4% vs. 17.1%, p<0.001), outpatient visits (97.3% vs. 92.1%) and hospitalizations (7.8% vs. 4.7%, p=0.004), respectively. Asthma-related hospitalization, ED, and outpatient costs were also higher among patients prior to mepolizumab vs. omalizumab treatment.

CONCLUSIONS:

Prior to receiving mepolizumab, patients have higher disease severity and disease burden manifested by increased exacerbations, specific comorbidities, healthcare utilization and cost compared with patients receiving omalizumab.