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Biologics are a new class of drugs that fight disease at the source. Instead of attacking symptoms, these drugs target diseases like asthma at a molecular level.

These newer types of drugs are more expensive than older medicines. That is prompting public discussion on how to pay for them. The cost of caring for patients with the most severe forms of asthma represents a majority of asthma healthcare spending. In addition, asthma is a leading cause of missed time from work and school.

Last fall, the Food and Drug Administration approved Nucala® (generic name: mepolizumab, an expensive biologic) for the treatment of severe asthma. Nucala is cleared for patients 12 and older who have a history of severe asthma, even while taking their regular asthma medicine.

A doctor gives Nucala once a month, by injection, in a medical office. Nucala reduces severe asthma attacks by blocking a protein called interleukin 5, which leads to reduced levels of blood eosinophils. Eosinophils are a type of white blood cell involved in asthma.

Nucala is the second biologic on the market. The other is Xolair® (generic name: omalizumab). Xolair is approved for moderate to severe persistent allergic asthma and chronic hives (chronic idiopathic urticaria).

In February, the Institute for Clinical and Economic Review (ICER) is holding a public meeting about the cost and benefit that Nucala provides to asthma patients. The price of Nucala is about $32,500 a year.

ICER is an independent, nonprofit research institute. Last year, it began a grant-funded project on a “value-based” measure of the economic and financial impact of new drug prices. The reports take into account not only the impact on effectiveness on health, but also healthcare spending.

The reviews have caught the eye of health plans and insurance regulators, who must decide whether to pay for the latest treatments.

The Asthma and Allergy Foundation of America (AAFA) provided public comments on the ICER Nucala report, as AAFA works to ensure that patients have access to affordable and innovative treatments for asthma. AAFA is urging the research institute, in this and other analyses of “value,” to:

  • Use, and encourage others to use, measures that look at patients’ quality of life when considering the value of new medicines. The voice of asthma patients must be included in any assessment of “value.”
  • Consider costs—not only as insurance companies or government healthcare payers see them—but also as patients perceive them, when assessing the “value” of new therapies.
  • Spell out the value not only of new therapies like Nucala, but the value that may be associated with improving the use of therapies that we already have. These current therapies are not always available or accessible to patients.

The last point may be especially important. “If we could find ways to make lower-cost treatments more available to those who will benefit from them, we may find the dollars to pay for these new high-cost medications for the relatively small number of people who most need them,” said Dr. Cary Sennett, AAFA’s President and Chief Executive Officer. "For example, investing in preventive services, such as assessment and the elimination of asthma triggers in the home, could reduce hospitalizations and emergency room visits and generate savings that could be used for those who really need these new biologics."

What do you think about these issues? How does drug pricing and access to new medications affect your family? Connect with other patients about these issues on AAFA’s Asthma Support Community Forum.

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