Value-Based Care in Type 2 Airway Disease: Real-World Evidence, Health Economics, and Sustainability of Biologic Therapies

Type 2 inflammatory disease, spanning severe asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), allergic rhinitis, and their frequent co-occurrence, represents one of the most clinically complex and economically significant challenges facing respiratory and allergy medicine today. The emergence of targeted biologic therapies over the past decade has fundamentally altered the treatment landscape. Dupilumab, mepolizumab, benralizumab, omalizumab, and tezepelumab have each demonstrated robust efficacy in randomised controlled trials, reducing exacerbations, improving lung function, shrinking polyp burden, and restoring quality of life in patients who previously had few options beyond high-dose corticosteroids or surgery. Regulatory approvals have followed, and biologics are now embedded in international guidelines across multiple type 2 indications.Yet the translation of trial efficacy into sustainable real-world practice remains incomplete. Healthcare systems worldwide face mounting pressure to justify the cost of biologic therapies, define which patients derive the greatest benefit, and design reimbursement frameworks that are both equitable and fiscally durable. These are not peripheral concerns: biologic therapies for type 2 airway disease represent some of the highest per-patient drug expenditures in respiratory medicine, and their uptake is accelerating. Health technology assessment bodies, payers, integrated care commissioners, and clinical decision-makers urgently need a richer evidence base; one that goes beyond phase III trial populations to capture real-world heterogeneity, long-term durability, comparative effectiveness across agents, and the full economic value of disease modification, including the often-overlooked savings from surgical avoidance, hospitalisation reduction, and corticosteroid-sparing.This Research Topic invites contributions from clinicians, health economists, health services researchers, real-world data scientists, and outcomes researchers that interrogate the value, sustainability, and comparative performance of biologic therapies across the type 2 airway disease spectrum. Submissions addressing a single agent, a specific indication, or cross-indication and cross-agent comparisons are equally welcome, provided they engage with the core questions of real-world evidence, health economics, or healthcare system sustainability.Suitable themes for manuscripts include, but are not limited to:- Health technology assessment (HTA) and cost-effectiveness analyses of biologic therapies in severe asthma, CRSwNP, and comorbid type 2 disease- Budget impact modelling and long-term reimbursement sustainability of biologics across healthcare systems and payer environments- Real-world effectiveness of approved biologics (dupilumab, mepolizumab, benralizumab, omalizumab, tezepelumab) in type 2 airway disease: single-agent and comparative studies- The clinical and economic value of surgical avoidance and hospitalisation reduction as outcomes of biologic therapy in CRSwNP and asthma- Health outcomes in patients with comorbid type 2 conditions: asthma and CRSwNP, allergic rhinitis, atopic dermatitis, and eosinophilic oesophagitis- Biomarker-guided patient selection and stratification for biologic therapy: blood eosinophils, FeNO, total IgE, periostin, and emerging predictors- Comparative effectiveness and head-to-head real-world data across biologic agents and mechanisms of action- Patient-reported outcomes, quality-of-life measures, and shared decision-making in biologic-treated type 2 airway disease- Treatment persistence, adherence, switching, and the determinants of long-term biologic continuation- Value-based care pathways and multidisciplinary models for the integrated management of united airway disease- Health system disparities, access inequities, and the real-world impact of reimbursement barriers on biologic uptake and outcomes- Long-term safety, post-market surveillance, and extended real-world follow-up of biologic therapies- Paediatric and adolescent perspectives on biologic therapy in type 2 airway disease- Novel economic modelling methodologies and data sources including registry data, claims data, and electronic health records applied to biologic therapy evaluationAll article types accepted by Frontiers in Allergy are welcome. Topic editors: Antonio Moffa, Manuele Casale Source: https://www.frontiersin.org/research-topics/83754/value-based-care-in-type-2-airway-disease-real-world-evidence-health-economics-and-sustainability-of-biologic-therapies