Comparative Review of Asthma Biologics and Anti-Inflammatories Coverage Across 3 Major Health Plans

As the asthma treatment landscape evolves, payers must navigate the balance between broad access to foundational therapies and tight controls on high-cost biologics. Our latest Formulary Frontlines analysis compares how Blue Cross Blue Shield, Cigna, and UnitedHealthcare manage coverage across key anti-inflammatory drug classes—revealing striking differences in tiering, utilization tools, and access strategies.

Key Insights

• BCBS provides the broadest generic access, with Tier 1 placement for cornerstone agents like budesonide, fluticasone, and montelukast, while still covering branded options in higher tiers.
• Cigna applies the strictest barriers, escalating foundational ICS and leukotriene modifiers into higher tiers and layering on prior authorization (PA), quantity limits (QL), and non-extended day supply (NDS) restrictions—especially for biologics.
• UnitedHealthcare takes a hybrid stance, favoring allergy-related corticosteroids in lower tiers but assigning asthma-specific ICS, ICS/LABA combinations, and biologics to higher tiers with consistent QL and dispensing limits.

What You'll Gain

• Side-by-side formulary comparisons across 5 anti-inflammatory asthma classes, including ICS, ICS/LABA combinations, leukotriene modifiers, and biologics targeting IgE and IL-5 pathways.
• Clear visibility into payer strategies, showing how tiering, PA, QL, and dispensing limits affect patient access and out-of-pocket costs.
• Strategic insights to guide formulary design, highlighting where payers diverge in balancing affordability, clinical necessity, and cost-containment.

Download the full report to benchmark your asthma formulary strategy in a specialty market where generics remain accessible, but biologics face steep access hurdles.