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An Unhappy New Year for Asthma Patients

Health economists have put a damper on asthma patients’ hopes for better disease management in 2022.

In mid-December, an organization called the Institute for Clinical and Economic Review released its final report about tezepelumab, a new drug for severe asthma. ICER’s underestimation of the drug’s value – even before it earned federal approval – could make the medication harder for patients to access.

A New Option

In clinical trials, tezepelumab was found to be more effective than traditional medications at reducing exacerbations in patients with severe, uncontrolled disease.

The drug works differently than most asthma medications. That makes it a valuable new alternative, especially for people who haven’t had good options. Even ICER acknowledges this.

The organization also touted findings from an independent appraisal committee, who found the new medication demonstrates “a net health benefit.”

ICER’s Opinions and Access

Even after admitting the drug’s benefits, ICER gave tezepelumab a mediocre rating, citing “uncertainties” about its effect in younger patients and “questions” about clinical trial results as they pertain to Black Americans.

The underwhelming mark wasn’t entirely unexpected, however, given ICER’s history of dismissing novel asthma therapies. In 2018, ICER found another biologic called dupilumab wasn’t cost effective – then undermined an entire class of asthma drugs. To this day, access to dupilumab is limited by prior authorization.

Despite its harsh approach to pricing, ICER pointed out – rightfully – that all treatment options that use different mechanisms of action should be available to patients without subjecting them to step therapy. The tactic would force patients to try and fail on other older, and likely less expensive, medications before earning the right to try tezepelumab.

For the sake of patient access, advocates hope insurers follow this positive recommendation – and overlook ICER’s criticism of the newest innovative medication for severe asthma.

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