Dr William "Andy" Nish on Considering Adherence When Prescribing Biologics to Patients With Asthma

Switching patients with asthma to a biologic medication purely because that patient is not adherent to inhaled medications gets in the way of a physician's goal of being good stewards of patient care and finances, said William "Andy" Nish, MD.

William "Andy" Nish, MD, is a medical director and provider with a specialty in allergy and immunology at Northeast Georgia Physicians Group in Gainesville, Georgia.


If nonadherence with inhaled corticosteroids has been a factor for the patient, should that influence whether the patient should move to a biologic?

Certainly, we would want them to be adherent as the most important thing. Partially because if we're going to be good stewards of care and finances and somebody is not going to take their basic medicine and they're going to switch to a medicine that's $20,000 or $30,000 a year just because they're not taking their inhaler, I have a hard time with that. So, definitely adherence or compliance with their routine medicines should come first. And, in an ideal world, to put them on such an expensive medicine as a biologic just because they won’t take their inhaled steroid is something I would struggle with.