ATS Field Report 2: Brinsupri Symptom Relief; KOL Sees Strong Tolerability

Research evidence excerpt

ATS Field Report 2: Brinsupri Symptom Relief; KOL Sees Strong Tolerability

densome symptoms.

On dosing and durability, the KOL is predominantly using the 25mg high dose, and plans to

assess clinical benefit, as measured by symptom relief, at 1 year. Persistence also appears

strong thus far. The KOL noted that the company-reported ~30% discontinuation rate is difficult

to reconcile with his experience, suggesting that the company reported rate may be driven

more by patient-perceived lack of efficacy rather than tolerability. This will be an important

dynamic to monitor as use expands into broader, less-selected populations and community

settings.

Access Dynamics are Beginning to Evolve As Uptake Continues

While early launch adoption has been relatively smooth, our KOL recently experienced his first

Brinsupri denial, signaling that payer scrutiny may be increasing. However, our KOL noted

payers often define an exacerbation as any worsening of symptoms that leads to antibiotic

use, creating a key, deployable pathway for access. As a result, when patients present with

symptoms such as cough, congestion, fatigue, or increased sputum, our KOL will frequently

treat with a course of antibiotics as deems appropriate, and document the episode as an

exacerbation. This can then be used to satisfy payer requirements (≥2 exacerbations per year).

Notably, patients with pseudomonas infection (~25% of the bronchiectasis population) are

typically more straightforward to approve, as their higher exacerbation risk and frequent

antibiotic use more easily satisfy payer criteria.

This dynamic effectively allows physicians to align real-world symptom worsening with payer-

defined criteria, even if real-world clinical and trial definitions of exacerbations differ. While this