With a large and growing patient population, asthma is one of the most lucrative drug markets in the pharmaceutical industry. Maintenance treatments for persistent asthma include inhaled corticosteroids (ICSs), which act as anti-inflammatory agents in the lungs and bronchodilators; and long-acting beta2 agonists (LABAs), which ease airway bronchoconstriction. Among the blockbuster drugs in this market are the LABA/ICS fixed-dose combinations, which combine both drug mechanisms into one convenient inhaler.

This report uses national patient-level claims data to explore the position of the leading maintenance therapies in the treatment of newly diagnosed asthma patients with a quantitative analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. The report also quantifies a drug’s source of business among recently treated asthma patients compared with its competitors and details which drugs precede others through an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.

Questions Answered in This Report:

  • Newly diagnosed patients: Approximately 42% of asthma patients begin treatment with a key therapy within a year of their initial diagnosis. What percentage of these patients progress to a second- or third-line drug within the first year? Which products capture the most patient share in the first, second, and third lines of treatment? How often is combination therapy used in each line of therapy?

  • Recently treated patients: Leukotriene inhibitors and LABA/ICS fixed-dose combinations are the mostly widely prescribed agents for the treatment of asthma among recently treated patients. How has use of the leukotriene inhibitors been impacted by the market entry of generic formulations? When do patients progress from one therapy to the next in asthma, and how does this pattern differ among key drugs? Are the most recently treated patients for each key brand coming from new (adds/switches) or continuing business?

  • Pathways to key therapies: Longitudinal claims data reveal that ICSs are the most common drug class used as a first-line therapy in asthma. Which therapies do patients most commonly switch/add-on to ICS therapy? Which therapies have experienced market growth or decline over the key therapy periods studied? To what extent are key therapies prescribed concomitantly to recently treated patients? What has been the impact of recently approved drugs for asthma? Which drug classes have the highest discontinuation rates, and to which drugs are those patients switching?

Scope:

Primary patient-level data: This report provides quantitative findings from our analysis of data covering approximately 40 million lives and provides the most representative sample of U.S. treatment practice for Medicare and commercially insured patients. This report is delivered as a key findings slide deck and a dashboard that can be accessed using the internet and presents claims that are less than six months old at the time of publication.

Patient Sample:

Patients who are continuously enrolled for the complete two-year study period must meet the following condition: at least two claims with a diagnosis code for asthma (International Classification of Diseases, Ninth Revision [ICD-9] diagnostic codes 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.81, 493.82, 493.90, 493.91, 493.92) during the study period.

Quantified lines of therapy analyses show exact share of each agent in each line of therapy, including rate of progression between lines and length of time patients are on each line.

Newly Diagnosed Patients:

- Patient share by drug class and key products across three lines of therapy, within one year of diagnosis.

- Patient flowchart through one year of treatment for all first-line products, including progression rates and add/switch behavior.

- Polypharmacy and key concomitant therapies by line of therapy.

- Quarterly trends in patient share by line of therapy.

Recently Treated Patients:

- Quarterly snapshot of patient share by drug class and key products.

- Pathway to key therapy flowcharts tracking the preceding therapy patterns for all key therapies, including add/switch behavior.

- Brand source of business, including share for continuing, new (switches/adds), and new (initial therapy) business.

- Polypharmacy and key concomitant therapies.

- Drug persistence and compliance.

- Quarterly trends in patient share for all key therapies.


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