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Supplements Therapeutic Advances in the Management of Type 2 Inflammatory Disease

The Clinical Relevance of IL-4/IL-13 Inhibition in Atopic Disease - A Q&A With Aiden A. Long, MD

AJMC®: What are the broader treatment implications of the availability of a drug that is so effective in type 2 inflammatory conditions?

Long: In asthma, the use of IL inhibitors is limited mainly by cost and the perceived cost-effectiveness. The ICER study that came out last fall suggested that these drugs would need to have cost reductions of about 60% to 70% to be cost-effective. Additionally, many physicians are forced to buy and bill a lot of these drugs, and the practices may actually lose money by doing that.

Lack of cost-effectiveness, reported by independent analysis, is limiting for these agents as a class. [Yet] atopic dermatitis is a chronic debilitating skin disease. It causes a very much impaired quality of life. I don’t quite know how one can optimally assess that from a cost-effectiveness standpoint. I do know that in my entire career, we haven’t had much to treat atopic dermatitis very effectively, and now we have a drug that offers dramatic results. As an individual prescriber, you feel very positively about trying to help your patients that way.

IL-4/IL-13 agents may be extremely beneficial in interrupting these diseases early, preventing the consequences of poorly treated disease. Scientifically, it makes sense to use these drugs very broadly. They could change the whole paradigm by which we treat type 2 diseases if cost were not in the equation, but unfortunately it is. As a physician, I know there’s a financial risk to me prescribing these, under current coverage and reimbursement arrangements. 

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