Alleviating Oral Corticosteroid Burden in Mild Asthma: Reynold Panettieri Jr, MD

Alleviating the corticosteroid burden on patients with mild asthma is a major reason for the high value of the combination of albuterol/budesonide, said Reynold Panettieri Jr, MD, vice chancellor for translational medicine and science director, Rutgers Institute for Translational Medicine and Science. However, this value could drive up cost and make accessibility difficult for those who need the treatment.

This transcript has been lightly edited for clarity; captions are auto-generated.

Transcript

What are the biggest barriers to shifting providers and patients toward albuterol/budesonide?

Right now, the major guidelines in the world, GINA [Global Initiative for Asthma] and the NAEPP [National Asthma Education and Prevention Program] guidelines have said we shouldn't be using albuterol alone. Yet in the United States, that's the predominant, if not exclusive, rescue inhaler. Our data is supporting the notion and the guidelines that we should abandon albuterol therapy in lieu of using a combined inhaled corticosteroid/albuterol combination. It aligns with the guidelines, we now have data in mild asthma: It's helpful. So you asked, why aren't we all doing that right now? Well, there's an access issue. Cost is always an issue. Albuterol is incredibly inexpensive, but it's not as good as the other drug. So what we have to understand is, how do we improve access? Because improving access to this drug is going to be transformative in asthma.

How might the findings from BATURA inform future updates to asthma treatment or payer coverage decisions?

I'm excited, because it's these kinds of studies that give the critical evidence necessary to make the switch. Is it necessarily going to cost more money? That's a complex, complex question. How do you value? What's the value proposition of the side effects of oral prednisone? Because that's what people get if they're only using albuterol. That has a price. In my mind's eye, the value proposition is to embrace this new approach, which aligns with the guidelines to decrease the consequences of (A) exacerbations and (B) oral corticosteroid burden.