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

Santiago Zuluaga Sanchez,1 Jessica K DeMartino,2 Magdaliz Gorritz,3 Christopher S Ambrose,4 Rifat Tuly,3 Jean-Pierre Llanos,5 Chi-Chang Chen,3 Andrew W Lindsley,6 Lee Baylis,5 Weily Soong,7 Laren Tan81Health Economics, Amgen Ltd, Uxbridge, UK; 2Respiratory and Immunology, AstraZeneca, Wilmington, DE, USA; 3Real World Country Solutions, IQVIA Inc, Wayne, PA, USA; 4BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA; 5Global Medical Affairs, Amgen, Thousand Oaks, CA, USA; 6US Medical Affairs, Amgen, Thousand Oaks, CA, USA; 7Allergy and Immunology Department, AllerVie Health and Clinical Research, Birmingham, AL, USA; 8Department of Medicine, Loma Linda University Health, Loma Linda, CA, USACorrespondence: Rifat Tuly, Real World Country Solutions, IQVIA Inc, 650 E Swedesford Rd Suite 400, Wayne, PA, USA, Tel +1 213-210-1532, Email rifat.tuly@iqvia.comPurpose: 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.Keywords: severe asthma, tezepelumab, real-world evidence, health insurance claims, asthma exacerbations, healthcare resource utilization