Earlier Dupilumab Use Cuts Asthma Costs: Nicola Hanania, MD

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Earlier initiation of dupilumab in patients with asthma who experienced a severe exacerbation was associated with lower overall medical costs compared with those who received delayed initiation of the treatment.¹

These findings were presented at the European Respiratory Society (ERS) 2026 International Congress, underscoring the importance of starting treatment earlier to potentially reduce downstream health care resource utilization.¹ The study also highlights the importance of confirming an accurate asthma diagnosis, ensuring patient adherence, and prioritizing shared decision-making—all of which ultimately affect treatment costs, Nicola Hanania, MD, lead study author, associate professor of medicine in the section of pulmonary and critical care medicine, and director of the American Lung Association Airways Clinical Research Center (ACRC) at Baylor College of Medicine, said in an interview with The American Journal of Managed Care^®.

"It's not always that patients who have an exacerbation, who are already on controller therapy, and need to go right away to a biologic," he said. "We have to do the checklist, and my checklist comes back to confirming the diagnosis."

Hanania mentioned numerous factors that contribute to the decision of whether to start biologics for patients but noted that shared decision-making should remain a priority. Patients deserve to know what the treatment will do for them and should receive timely updates on any symptoms that occur, Hanania said.

"Because it takes a few months after starting a biologic for them to get to feel it, to see an impact," he said. "Ideally, right now, guidelines suggest at least 3 months of treatment before you decide to switch or stop."

Lastly, he emphasized associated health care costs and how that should also be included in shared decision-making.

"I think that's something that can inform the message, not only for the patient but also for the health care system and the payers, who sometimes are hesitant to reimburse patients," Hanania said. "And we have to get through hoops to get approvals for most of these biologics."

References

1. Hanania NA, DuCharme M, Shams M, et al. Asthma-related healthcare resource utilization and associated costs of timely versus delayed initiation of dupilumab following a severe asthma exacerbation. Presented at the ERS 2026 International Congress; September 5-9, 2026; Barcelona, Spain.