Medical Necessity of Tezspire for Severe Persistent Asthma

Patient Selection Criteria

The American College of Allergy, Asthma, and Immunology recommends tezepelumab for patients with severe persistent asthma who are ≥12 years old, have uncontrolled asthma despite high-dose inhaled corticosteroids plus additional controller medications, and have documented frequent exacerbations or poor asthma control, with evidence of inadequate response to conventional therapy 1
Patients should have daily symptoms throughout the day, requiring rescue inhaler use multiple times per week, and a documented history of frequent exacerbations requiring oral corticosteroids 1
The Asthma Control Test (ACT) score should indicate uncontrolled asthma despite maximal conventional therapy, and current treatment should include high-dose inhaled corticosteroids plus at least one additional controller medication 1

The National Asthma Education and Prevention Program recommends a stepwise approach for asthma management, with Step 4 therapy consisting of high-dose inhaled corticosteroids plus long-acting beta-agonists 2
Step 5-6 therapy involves the addition of oral corticosteroids or biologic agents when Step 4 fails, and consultation with an asthma specialist is recommended for all patients with severe persistent asthma 2, 3, 4

The American College of Allergy, Asthma, and Immunology recommends follow-up visits every 1-3 months initially to assess treatment response, with Asthma Control Test (ACT) scores and documentation of rescue medication use frequency and exacerbation rates at each visit 1
Spirometry should be performed at baseline and periodically to assess lung function improvement, and attempts should be made to step down other asthma medications once control is achieved 1, 3, 4