Only 46% of pediatric asthma caregivers agree that biologics are safe
Click Here to Manage Email Alerts
Key takeaways:
- Researchers captured how caregivers view biologics for pediatric asthma via survey.
- When presented with the statement, “biologics decrease the frequency of asthma flares,” only 54% expressed agreement.
BOSTON — Among caregivers of children with asthma, 54% did not “strongly agree” or “agree” that biologics are safe, according to a poster presented at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.
This poster was presented by the Allergy & Asthma Network.
“As a practicing allergist, we need to recognize the barriers that exist for all patients and families with regards to access to these medications,” Vivian Hernandez-Trujillo, MD, allergy/immunology division director and fellowship program director at Nicklaus Children’s Hospital and owner of Allergy and Immunology Care Center of South Florida, told Healio. “We also need to educate about the safety of biologic medications used in the treatment of asthma.”
Using online survey results, Hernandez-Trujillo, who also serves as a Healio Women in Allergy Peer Perspective Board Member, and colleagues evaluated responses from 128 U.S. caregivers (63% aged 18 to 39 years; 61% women; 59% white; 17% Hispanic; 64% with at least a bachelor’s degree) of a child with asthma prescribed a biologic to uncover how they view this treatment option.
Biologics were defined and named in the survey, according to the poster.
Notably, these caregivers were derived from a larger pool of 500 caregivers of children with asthma who answered survey questions about oral corticosteroid use.
“Children of this racially-diverse caregiver population continue to have a high prevalence of uncontrolled asthma and received frequent oral corticosteroid prescriptions, despite available safer treatment options,” Hernandez-Trujillo told Healio.
Within the categories of caregiver race, caregiver household income, child age and child asthma control status, the poster noted specific groups with higher likelihoods for having a biologic prescription: Black race, income of at least $60K annually, child aged 6 to 11 years and uncontrolled asthma status.
Nearly one-third (32%) of caregivers reported a dupilumab (Dupixent; Sanofi, Regeneron) prescription, making it the most reported biologic of the five with U.S. approval for pediatric asthma.
In terms of length of use, 6.5 months was the overall average, according to researchers.
When presented with the statement, “biologics decrease the frequency of asthma flares,” 54% expressed agreement via scores of 4 or 5 on a scale of 1 (strongly disagree) to 5 (strongly agree).
The idea that this treatment type reduces the need for oral corticosteroids was agreed upon by 52% of caregivers, and this same proportion of caregivers gave a score signaling agreement to the statement saying biologics “would allow my child to participate in sports or activities without fearing an asthma attack.”
Of note, only 46% expressed agreement for the statement, “biologics are safe,” according to the poster.
“I was disappointed to see that approximately half of caregivers are not convinced of the efficacy and safety of biologics for their child,” Hernandez-Trujillo told Healio.
Researchers wrote that all but eight caregivers reported that their child used a biologic. The most frequently reported benefits of biologics highlighted on the poster included fewer asthma flare-ups (53%); less use of quick/rescue reliver inhaler medication (45%); fewer visits to the doctor, urgent care or ED (37%); no bad side effects (34%); and sleeping through the night (30%).
Despite decent proportions of caregivers reporting the above benefits, some experienced the oppositive and reported no improvement in asthma condition/flare-ups (16%), too much time spent in the doctor’s office/infusion center (26%), too many visits to the doctor/infusion center (18%) and bad side effects (23%) as drawbacks of biologics.
Other drawbacks were related to money (27% said co-pays or out-of-pocket costs are too expensive; 20% said insurance no longer covers the biologic) and the child’s well-being (27% said child developed fear of needles), according to the poster.
Based on insurance type, researchers observed more caregivers with private insurance vs. Medicaid reported coverage of their child’s biologic (53% vs. 45%).
Per month, $1,302 was the overall average out-of-pocket cost for biologics, but among Black caregivers, this cost went up to $1,773. Additionally, caregivers with an annual income of $100,000 or higher spent $1,530 out-of-pocket on biologics per month, according to the poster.
“Future studies are needed to evaluate other factors that may contribute to these barriers, including other social determinants of health and access to materials in a patient’s primary language and at their literacy level,” Hernandez-Trujillo told Healio.
For more information:
Vivian Hernandez-Trujillo, MD, can be reached at vivian.hernandez-trujillo@nicklaushealth.org.
De De Gardner, DrPH, RRT, RRT-NPS, FAARC, FCCP, chief research officer at Allergy & Asthma Network, can be reached at dgardner@allergyasthmanetwork.org.