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Asthma biologics overview

Improving outcomes for patients with respiratory disease is a clinical priority in the NHS Long Term Plan. To support delivery of this part of the NHS Long Term Plan, the Accelerated Access Collaborative (AAC) has selected Asthma biologics as a Rapid Uptake Product (RUP). These are medicines approved by NICE which support the NHS Long Term Plan’s key clinical priorities but are not yet integrated into everyday practice.

Asthma biologics are an innovative group of medicines used by specialists to treat people with severe asthma. They provide a treatment option for people with severe asthma who continue to experience asthma attacks despite taking usual treatments (such as inhaled steroids). Currently there are four NICE approved biologics for severe asthma (omalizumab, mepolizumab, reslizumab and benralizumab).

Biological therapies can transform patients’ lives by reducing long-term side-effects of other treatments (e.g. oral corticosteroids) and can also reduce the number of exacerbations and life-threatening asthma attacks. The aim of this innovation will be to improve patient care and outcomes by providing a better treatment option for patients with severe asthma.

Asthma biologics work in a targeted way by affecting the natural immune response that causes lung inflammation, helping to manage symptoms, reduce relapses and may also reduce reliance on other medicines such as steroids. It is given as an injection regularly in hospital or at home.

Less than 50% of severe asthma patients have eosinophil-driven disease (Wenzel, 2005). Biologics are designed to control the number of eosinophil cells (Asthma UK). Only 11% of eligible severe asthma patients have access to biologic medicines in the UK.

Increasing the use of biologics appropriately would reduce use of oral corticosteroids (OCS) which are associated with negative side-effects and exacerbations, causing 75,000 annual UK hospital admissions, each costing £1,500.

The four asthma biologics on the RUP programme are currently procured through specialised commissioning and recommended by NICE. The majority of eligible patients (>60%) remain hidden in primary care without access to specialist care or are managed in a sub-optimal way.

The programme aims to improve care for patients with severe asthma, raise awareness of the medicines and improve pathways to reduce exacerbations, identify patients with poorly controlled asthma and reduce overuse of OCS.

We will improve the current pathway by proactively identifying patients hidden in primary care, risk stratification tools, inclusive policies for timely diagnosis, inhaler technique assessment and referral to specialist hubs. This will improve quality standards and efficiency.

We will work with the respiratory leads across primary care, secondary care, primary care commissioning and Severe Asthma Centres in Oxfordshire, Buckinghamshire, East Berkshire, Berkshire West and Milton Keynes.