The Biologics Balancing Act in Asthma

Meera MontanPublished on 2022-05-04

The introduction of monoclonal antibodies, commonly referred to as biologics, has been a game changer for people with severe asthma. For those with severe asthma, avoiding triggers and using traditional asthma medications are not enough. Biologics offer a solution to frequent exacerbations and unpredictable days. Unfortunately, it can be difficult to determine the difference between those that truly need and would benefit from biologics and those that may just need support with adhering to traditional therapies. With the cost of biologics hovering around $30,000 per person per year in the US, the need to assess appropriate therapy has a significant economic impact on all those involved.

Assessing medication adherence, supporting right diagnosis, and providing continuous health education and evaluation are crucial to provide optimal care and treatment and avoid unneeded costs.

Medication Adherence

Medication adherence in the asthma population is well known to be suboptimal. It’s estimated that only 30-50% of those with asthma are regularly using medications as prescribed (1). Studies have also shown that only about 30% of people are using inhalers correctly (2). Without data on adherence to care plans with traditional therapies, it can be difficult to diagnose severe asthma and determine if biologics are needed.

Supporting Diagnosis

While there are approximately 24 million people in the US with asthma, only 5% of that population is estimated to have severe asthma. Misdiagnosis or over/under diagnosis of asthma can lead to well meant, but unnecessary treatment. Of those with severe asthma, around 85% will benefit from biologics. A diagnosis alone may not necessitate biologics, as many cases can be controlled with adherence to traditional inhalers using proper inhaler technique.

Health Education

Physicians have little time to educate people with asthma during appointments and asthma educators are not available to all. Physicians also often have limited and varied skills and resources to provide formal asthma education, especially in primary care settings. It’s widely accepted that providing asthma education around understanding one’s condition, triggers and medications can lead to fewer exacerbations, yet most people living with asthma do not receive adequate education. As with most conditions, improved health literacy supports individuals to better self-manage their health and improves adherence to treatments.

Follow-up & Evaluation

If biologics are determined to be the best treatment for a person with asthma, follow-up to ensure efficacy and adherence is key to success. Every person responds differently to biologics, meaning that there may be a need to switch biologics to find the most effective solution or provide additional support for those not taking medication as prescribed. It’s also important to see longitudinal data over time, which enables deteriorations to be detected early.

NuvoAir is ready to assist health plans and providers to ensure biologics are prescribed appropriately for those with asthma. Our respiratory therapist-led program works with people with asthma to help them navigate their individual care plan, ensure medication adherence, gather remote data, and provide education on their condition. Armed with spirometry, inhaler adherence, inhaler technique feedback, and self-reported data, physicians will have a full understanding of what’s going on outside of their office, giving them the reassurance they need to prescribe.

If you’d like to learn more about how NuvoAir can assist with qualifying biologics and improving outcomes for people with asthma in the US, please reach out to


Bidwal M, Lor K, Yu J, Ip E. Evaluation of asthma medication adherence rates and strategies to improve adherence in the underserved population at a Federally Qualified Health Center. Res Social Adm Pharm. 2017 Jul-Aug;13(4):759-766. doi: 10.1016/j.sapharm.2016.07.007. Epub 2016 Aug 3. PMID: 27595427.

Sanchis J, Gich I, Pedersen S; Aerosol Drug Management Improvement Team (ADMIT). Systematic Review of Errors in Inhaler Use: Has Patient Technique Improved Over Time? Chest. 2016 Aug; 150(2):394-406. doi: 10.1016/j.chest.2016.03.041. Epub 2016 Apr 7. PMID: 27060726.