[Care for uncontrolled asthma in Germany - with focus on Magdeburg and Mannheim regions].

Objective: Description of treatment and prescription patterns among asthma patients in the regions of Magdeburg (MD) and Mannheim (MA) compared nationwide. Methods: We analyzed IQVIATM LRx data 1 from the period of July 2022 to June 2023. The prescription database LRx covers about 80% of prescriptions for patients in the statutory health insurance in Germany. A machine learning model was used to assign the indication of asthma to patients with ≥ 1 redeemed GKV prescription for respiratory diseases. Results: In this analysis, 2992487 patients with asthma were identified in Germany ( MD 20692; MA 55302), of which 30% were assigned to GINA stage 4 (MD 33%; MA 30%) and 4% to GINA stage 5 (MD 5%; MA 5%) (GINA: Global Initiative for Asthma 2). Only 27% of the patients had ≥ 1 prescription from pulmonologists (MD 37%; MA 28%). Among all patients, 13% showed signs of uncontrolled asthma (MD 12%; MA 13%). Of these, 21% were eligible for biologics (Bx) (MD 22%; MA 20%), of which 16% received ≥ 1 Bx prescription (MD 18%; MA 18%). Only 11% of patients with uncontrolled asthma had no acute oral corticosteroid (OCS) prescriptions (MD 10%; MA 9%), whereas among patients continuously treated with biologics, 58% had no OCS prescriptions (MD 68%; MA 75%). Nationwide nearly 24% of continuously with Bx treated patients (MD 24%; MA 31%) redeemed prescription of low to medium dose inhaled corticosteroids (ICS). Conclusion: Patients with severe asthma or signs of uncontrolled asthma require additional care from pulmonologists. Despite all observed regional differences in care, identifying patients with uncontrolled asthma and promptly referring them to pulmonologists is an important approach for improvement. In real-world care, treatment of severe uncontrolled asthma with biologics has the potential to reduce the use of oral and inhaled corticosteroids.