How I help my asthma patients overcome bio-hesitancy

By Kara Wada, MD | Fact-checked by MDLinx staff
Published September 26, 2024

Key Takeaways

  • Biologics can improve symptom control, reduce the frequency and severity of asthma exacerbations, enhance lung function, and decrease reliance on oral corticosteroids, ultimately leading to a better quality of life for patients with severe asthma.

  • Despite the benefits, many of your patients may be hesitant to try a biologic therapy, but by fostering open communication and providing clear, evidence-based information, you can help them overcome these often-unfounded concerns.

  • Physicians can highlight the importance of biologics even for patients who feel their asthma is well-controlled, emphasizing the potential for reduced exacerbations and improved lung function. A proactive approach is key.

The burden of severe asthma on patients' lives is immense. While traditional therapies such as inhaled corticosteroids and bronchodilators can provide relief, they are not always enough. 

Biologics, a revolutionary class of medications, offer targeted treatment and improved symptom control for severe asthma patients. However, many patients hesitate to embrace this innovative treatment option due to various concerns and misconceptions. 

Let's delve into the common reasons behind bio-hesitancy and how physicians can address them to foster collaborative decision-making.

The roots of bio-hesitancy

The fear of needles and injections

The mode of administration remains a significant barrier for some. Biologics are usually administered subcutaneously or intravenously, which can trigger anxiety in patients with needle phobia or those who've had unpleasant experiences with injections.

However, we can help alleviate this fear. Many patients find that utilizing devices like shot blockers or buzzing devices significantly reduces injection pain. These simple tools can make a world of difference in their comfort level and willingness to consider biologic therapy.

Concerns about side effects

As with any medication, side effects are a legitimate concern. Patients may worry about experiencing adverse reactions, from mild injection site issues to more serious systemic effects like anaphylaxis.

Patients who have had adverse reactions to medications in the past, especially those sensitive to side effects, may approach new medications with caution, including biologics. The long duration of action of biologics, staying in the system for weeks to months, can amplify this concern.

Although biologics for asthma generally have a favorable safety profile, the fear of the unknown or information found online can contribute to hesitancy. 

Concerns about long-term safety

Biologics are relatively new compared to other asthma medications, and some patients worry about their long-term safety and the prospect of lifelong treatment. This concern is particularly pronounced in younger patients or those planning to start a family.

Addressing these concerns requires acknowledging the ongoing research and post-marketing surveillance that continue to monitor the long-term effects of biologics. It's also essential to explain that treatment duration is individualized and reassessed periodically based on the patient's response.

Distrust of the pharmaceutical industry

Some patients harbor a general distrust of the pharmaceutical industry, which can affect their view of biologics. Addressing this involves transparency, providing patients with information about clinical trials, and openly discussing any potential conflicts of interest.

High prices and insurance pains

Biologics tend to be expensive, and concerns about cost and insurance coverage are a significant barrier for many patients. Even with insurance, out-of-pocket costs, deductibles, and co-pays can be substantial.

Some patients are hesitant to initiate treatment when unsure about their ability to afford it in the long term. Financial concerns are particularly challenging for patients with limited income or inadequate insurance coverage. The situation is further compounded for patients with Medicare due to limitations on their ability to utilize rebate programs.

Perceived lack of need

Some patients may not believe they need biologic treatment, particularly if their symptoms seem controlled with current medications.

Explaining the benefits of biologics, even in seemingly well-controlled asthma, such as reducing exacerbations and preventing long-term lung damage, is crucial.

What you can do

Addressing bio-hesitancy necessitates open dialogue, active listening, and providing clear, evidence-based information.

Patients should be encouraged to express their fears and concerns, and physicians should address them with empathy and patience. Educational materials, patient decision aids, and visual resources can help patients understand the benefits and risks of biologics.

It's also vital to involve patients in the decision-making process. Discussing their treatment goals, preferences, and concerns allows for a personalized approach. Sharing success stories of other patients who have benefited from biologics, while respecting confidentiality, can also be incredibly impactful.

What this means for you

Biologics represent a significant advancement in the treatment of severe asthma. By proactively addressing concerns, providing comprehensive education, and involving patients in the decision-making process, physicians can empower patients to overcome bio-hesitancy and make informed choices about their treatment. It's a collaborative journey towards better asthma control and improved quality of life.

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