@article{93812035f548468a9f0c0e008712780b,
title = "Omalizumab Treatment Patterns Among Patients with Asthma in the US Medicare Population",
abstract = "Background: Asthma in older adults is associated with high rates of morbidity and mortality; similarly, asthma can be severe enough among younger adults to warrant disability benefits. Reasons for poor outcomes in both groups of patients may include discontinuation and lack of adherence to controller therapies. Objective: To examine characteristics and treatment patterns of US Medicare patients initiating omalizumab for asthma, and factors associated with its discontinuation and adherence. Methods: A retrospective claims database analysis of Medicare beneficiaries with asthma initiating omalizumab treatment was carried out. The primary outcomes were omalizumab discontinuation (gap in use ≥90 days) and adherence (proportion of days covered ≥0.8) over a 12-month follow-up. Multivariable regressions were used to examine factors associated with omalizumab discontinuation and adherence. Results: Of the 3058 Medicare patients initiating omalizumab for asthma (mean age, 62.7 years), 36.9% discontinued omalizumab and 60.6% were adherent. Discontinuation rates were 32.7% and 42.8%, and adherence rates were 65.4% and 53.9%, for disabled and older Medicare patients, respectively. Patients aged 65 to 69 years and 70 to 74 years had significantly lower odds of discontinuation (odds ratios [95% CI], 0.66 [0.46-0.93] and 0.62 [0.43-0.89], respectively) and higher odds of adherence than did patients aged 80 years or older. Compared with patients receiving low-income subsidy, patients not receiving low-income subsidy had lower odds of discontinuation (0.66 [0.52-0.83]) and higher odds of adherence (1.52 [1.20-1.93]). Greater numbers of preindex evaluation and management physician visits and comorbid rhinitis were associated with lower odds of discontinuation and higher odds of adherence. Conclusions: More than 60% of Medicare patients with asthma continued and were adherent to omalizumab over a 12-month follow-up. Patient age, low-income subsidy status, and the numbers of evaluation and management physician visits were among factors associated with treatment adherence and discontinuation.",
keywords = "Adherence, Asthma, Disabled, Discontinuation, Medicare, Older adults, Omalizumab, Treatment patterns",
author = "Pengxiang Li and Abhishek Kavati and Puckett, {Justin T.} and Jordan Jahnke and Paula Busse and Hanania, {Nicola A.} and Benjamin Ortiz and Doshi, {Jalpa A.}",
note = "Funding Information: Financial support for the conduct of the research and preparation of this article was provided by Novartis Pharmaceuticals Corporation, East Hanover, NJ. Authors employed by Novartis Pharmaceutical Corporation were involved in the study design, interpretation of data, writing of the report, and the decision to submit the article for publication. Authors received editorial support for this article from Claire Lavin and Jessica Donaldson-Jones of Fishawack Communications Ltd., funded by Novartis Pharmaceuticals Corporation, East Hanover, NJ.Conflicts of interest: P. Li has received consulting fees from Avalon Health Economics, Bob Ohsfeldt LLC, and HealthStatistics, all unrelated to the content of this article. A. Kavati and B. Ortiz are employees and stockholders of Novartis Pharmaceuticals Corporation. P. Busse has received honorarium/consulting fees from Biocryst, CSL Behring, CVS Health, Novartis, Pearl Therapeutics, AstraZeneca, Pharming, and Shire; has acted as a legal expert for the law offices of Levin, Riback, Adelman, and Flangel; and their institution has received grant monies from Shire, all unrelated to the content of this article. N. A. Hanania has received consulting fees from AstraZeneca, Boehringer Ingelheim, Genentech, GlaxoSmithKline (GSK), Novartis, and Sanofi Genzyme; and their institution has received grant monies from AstraZeneca, Boehringer Ingelheim, and GSK, all unrelated to the content of this article. J. A. Doshi has received grant monies from Novartis for activities related to the work under consideration for publication; reports serving as an advisory board member or consultant for Allergan, Ironwood Pharmaceuticals, Janssen, Kite Pharma, Merck, Otsuka, Regeneron, Sarepta, Sage Therapeutics, Sanofi, and Vertex; has received research funding from Abbvie, Biogen, Humana, Janssen, Novartis, Pfizer, PhRMA, Regeneron, Sanofi, and Valeant; and reports her spouse holding stock in Merck and Pfizer, all unrelated to the content of this article. The rest of the authors declare that they have no relevant conflicts of interest. Funding Information: Financial support for the conduct of the research and preparation of this article was provided by Novartis Pharmaceuticals Corporation , East Hanover, NJ. Authors employed by Novartis Pharmaceutical Corporation were involved in the study design, interpretation of data, writing of the report, and the decision to submit the article for publication. Authors received editorial support for this article from Claire Lavin and Jessica Donaldson-Jones of Fishawack Communications Ltd., funded by Novartis Pharmaceuticals Corporation , East Hanover, NJ. Publisher Copyright: {\textcopyright} 2019 The Authors",
year = "2020",
month = feb,
doi = "10.1016/j.jaip.2019.07.011",
language = "English",
volume = "8",
pages = "507--515.e10",
journal = "Journal of Allergy and Clinical Immunology: In Practice",
issn = "2213-2198",
publisher = "Elsevier",
number = "2",
}