Data analysis shows: In Western Europe, English and Finnish severe asthma patients are least likely to receive biologics treatment
International Comparison report on Biologics Uptake shows the relative uptake of biologics treatments for severe asthma in ten European countries.
Amsterdam, 9 October 2023 – Today, healthcare analytics provider LOGEX is launching a report on the uptake of biologics in the treatment of severe asthma in ten different European countries. The report, sponsored by AstraZeneca, demonstrates that countries across Europe have varying uptake of asthma biologics ranging from as low as 5% to as high as 60%. Germany has a relatively high biologics uptake in the severe asthma population, while the biologics uptake for severe asthma in England and Finland is lagging behind substantially compared to the other countries.
The impact of severe asthma
Asthma affects in excess of 262 million people globally in 2019[1] and has a substantial impact on individuals and healthcare services. Severe asthma can be thought of as one extreme end of the spectrum of the disease. Despite severe asthma being estimated to make up only five percent of the overall asthma burden, it accounts for 50 percent of the economic expenditure of asthma [2].
Biologics treatments
Oral corticosteroids are most commonly used in the treatment of uncontrolled severe asthma. In more recent years, more treatment options in the form of biologics have entered the market and have shown efficacy for severe asthma management. Although prescribing is shifting from oral corticosteroids to biologics steadily across Europe, wide variations between countries exist in terms of the speed and scale of this shift. This is the reason why LOGEX with financial sponsorship of AstraZeneca studied the extent to which biologics are being used in Belgium, Denmark, England, Finland, France, Germany, Italy, The Netherlands, Norway and Sweden. LOGEX commissioned the Dutch Institute for Rational Use of Medicine (IVM) to help with the collection and analysis of the data. The uptake is determined based on publicly available data, supplemented with market insights.
Main findings
For most of the included countries, the percentage of the severe asthma population using biologics was between 15 percent and 30 percent in 2019 and increased to between 30 percent and 45 percent in 2021. Uptake was highest in all years in Germany. It is noteworthy that the uptake in Sweden more than doubled within two years.
England and Finland have a significantly lower biologics uptake for severe asthma, with less than ten percent of the severe asthma population using biologics. The biologics uptake increased only slightly over the years.
Contributing factors
The report reflects some potential contributing factors to the development of the uptake of biologics. These were put forward by the industry experts who were consulted for the second part of the report. Some of these factors can be condensed to the inconsistency in defining severe asthma, the policy efforts countries have in place to speed up the process of new medicines diffusing in their healthcare system, variation in timelines for local approval of specific new biologics, differences in guidelines as to who is authorised to prescribe biologics to patients, and varying reimbursement schemes of biologics. Many of these factors might be relevant for England and Finland, where the uptake is relatively low. Zooming in on England, the National Institute for Health and Care Excellence (NICE) identified capacity in specialist centres as a potential barrier to initiating treatment [3]. Biologics cannot be initiated by most healthcare professionals (HCPs). Only HCPs from a specialist asthma clinic are generally allowed to assess and initiate[4]. Furthermore, these specialist centres are not evenly distributed geographically, leading some areas to be under-represented and patients in these areas to have to travel long distances to receive diagnosis and treatment.
Good learning opportunity
This report offers a good opportunity for specialists and policymakers to see how their own efforts rank objectively within Europe. Lower and middle-ranked countries, like Finland and the UK, have a chance to draw lessons from efforts from countries that rank higher with their biologics uptake, like Germany and Sweden.
- Annotations
- [1] Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle. http://ghdx.healthdata.org/gbd-results-tool. [Online]
- [2] Current and emerging treatments for severe asthma. Al Efraij K, FitzGerald JM. s.l. : J Thorac Dis. 2015 , Nov;7(11):E522-5. . doi: 10.3978/j.issn.2072-1439.2015.10.73. PMID: 26716048; PMCID: PMC4669299.
- [3] Excellence, National Institute for Health and Care. Ashtma Biologics Adoption Barriers and Suggested Solutions. [Online] 2021. https://www.oxfordahsn.org/wp-content/uploads/2021/11/Asthma-Biologics-Adoption-Report-final.pdf.