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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 commitment, the Accelerated Access Collaborative (AAC) selected asthma biologics as a Rapid Uptake Product (RUP). These are medicines approved by NICE but that are not yet integrated into everyday practice.

Asthma biologics are an innovative group of medicines that offer an important treatment option for people with severe asthma. Severe asthma is a specific type of asthma which is difficult to control, even with optimised inhaled asthma medication. It is a complex condition which may be driven by different inflammatory pathways, but typically severe asthma patients face a substantial burden of illness, marked reductions in quality of life and require a significant amount of health resource.

Many people with severe asthma live with poor asthma control typified by emergency trips to hospital, intensive care and regular doses of strong oral corticosteroids. These oral steroids may stop the asthma symptoms, but they can have devastating side effects on physical and mental health, from kidney and bone damage to insomnia, anxiety and depression.

Severe asthma is associated with very high healthcare costs due to medication use, unscheduled healthcare utilisation and management of oral steroid-related adverse events. These costs have been shown to be four times higher for uncontrolled severe asthma patients than the general asthma population.

Asthma biologics work in a targeted way by disrupting pathways causing airways inflammation, helping to manage symptoms, reduce relapses and may also reduce reliance on other medicines such as oral steroids. Currently there are four NICE approved biologics for severe asthma: omalizumab, mepolizumab, reslizumab and benralizumab. They are given as an injection or infusion (depending on which biologic is being taken), either regularly in hospital or self-injected by patients at home.

The decision to start a biologic treatment for severe asthma is made by specialist severe asthma multi-disciplinary teams based in severe asthma centres. People receiving biologics are closely monitored to ensure that they are receiving the right treatment to help manage their symptoms.

It is estimated that in England over 60,000 patients currently suffering with severe asthma would benefit from an asthma biologic. However, prescribing data suggests that only 8-10,000 of these patients are currently able to access these treatments. The AAC asthma biologics programme aims to support improvements in pathways and practices to ensure more patients are able to receive specialist care for their severe asthma and access asthma biologics.