Real-World Impact of Tezepelumab on Asthma Exacerbations, Healthcare Resource Utilization, and Costs in US Patients with Severe Asthma: CROSSROADS-1

Abstract

Purpose Asthma affects 26 million individuals in the US, with severe cases driving high healthcare use and costs. TezspireTM (tezepelumab) has shown benefits in a Phase 4 real-world study, but real-world claims-based evidence is limited. This study evaluated the real-world effectiveness of tezepelumab by assessing changes in asthma exacerbations, healthcare use, and costs among persistent users. Methods This retrospective cohort study used IQVIA’s PharMetrics Plus claims database linked with Prognos and Quest data (12/17/2020 – 5/31/2024). Patients aged ≥12 years with severe asthma were included if they had continuous 12-month pre- and post-index medical and pharmacy enrollment, and ≥10 tezepelumab claims during 12-month follow-up. The index date was the first tezepelumab claim. Outcomes were compared pre- and post-index and included annualized asthma exacerbation rate (AAER), exacerbation-related healthcare resource utilization (HCRU), and costs. Subgroup analyses were conducted by prior biologic use, blood eosinophil count (BEC), serum IgE, and comorbidities. Results Among 337 patients (mean age: 50.8 years; 78.0% female), 44.8% were biologic-naive and 55.2% were biologic-experienced. AAER decreased by 49.1% (95% CI: 43.5% to 54.2%; p<0.0001) following tezepelumab initiation, with greater reductions among biologic-naïve patients (55.7% [95% CI: 47.6% to 62.6%]; p<0.0001) and those with high pre-tezepelumab BEC (87.1% [95% CI: 63.5% to 95.5%] for ≥300 cells/µL; p<0.0001). Exacerbation-related healthcare use decreased, with mean inpatient, ED, and outpatient visits per patient declining from 0.14, 0.67, and 3.23 in the pre-index to 0.05, 0.37, and 1.63 in the post-index, respectively (p<0.0001 for all). Associated mean costs per patient were reduced: inpatient from $2,171 to $551 (p=0.0003), ED from $755 to $356 (p=0.0002), and outpatient from $933 to $477 (p<0.0001). Conclusion Findings from this observational, retrospective analysis show substantial reductions in AAER, exacerbation-related HCRU and costs among patients treated with tezepelumab, with greater improvements observed among patients who were biologic-naive or with high BEC.