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Introduction Shared decision-making and patient preferences are often overlooked in severe asthma biologic selection, with very little published literature to help guide clinicians on patient preferences. This study aims to lend a voice to patients‘ views on biologic treatment frequency, especially as we proceed into a new era of an upcoming biannually administered asthma biologic.Methods Quantitative data was collected via a questionnaire from a consecutive sample of adult severe asthmatics who were either about to commence their first biologic or already receiving biologic treatment between January and March 2025.Results A total of 180 patient responses were collected and categorized into biologic-naïve (n = 95) and biologic-experienced (n = 85) groups. The demographic characteristics were consistent with those typical of a severe asthma population ( table 1). Regarding treatment frequency preferences, 35% of biologic-naïve patients favoured monthly injections, whilst 39% had no preference, and 10% preferred a twice-yearly biologic regimen. Among biologic-experienced patients, a similar distribution was observed: 33% preferred monthly treatment, 28% had no preference, and 12% favoured a 6-monthly option. With regard to transitioning to a 6-monthly biologic, 48.5% of biologic-experienced patients expressed interest, 27.5% were not interested, and 24% had no preference. Biologic-naïve patients showed comparable responses, with 44% expressing an interest, 33% stating no interest, and 23% reporting no preference.Across the entire sample, 41% of patients expressed concern about treatment response with a 6-monthly dosing schedule, compared to 28% for monthly biologic therapy. Concerns related to side effects, cost, and appointment accessibility were more frequently associated with monthly treatment.Abstract P131 Table 1Conclusion This study provides a previously unknown insight into severe asthma patient views on their preferred frequency of biologic administration and seems to suggets an appetite for engagement with an upcoming 6-monthly biologic Depemokimab.