A cost analysis on the pattern of asthma prescribing in the UK. R.G. Neville, M.G. Pearson,

ABSTRACT: There is a need to establish the proportion of adult asthmatics at each step of the recommended asthma management guidelines, the cost of their prescribed treatment, and a revised cost of treatment assuming patients who were suboptimally controlled were moved up a step. Actual prescription and cost figures and a theoretical projection of an ideal scenario was calculated from a sample of general practices in Great Britain from the Doctors Independent Network. They comprised 102 nationally distributed practices and 17,206 adult patients with a diagnosis of, and prescription related to, asthma recorded between October 1993 and March 1994. Ninety-one per cent of patients received treatment within a recognized step of the guidelines. Of these, 80 % were at steps 1 and 2. Employing excess inhaled beta-agonist use as a proxy for control of asthma, between 55 % and 69 % of patients at Steps 1–3 should receive treatment at a higher step. This could lead to an increased expenditure of up to £4.66 per adult patient per month. This would imply a rise in the annual UK cost of antiasthma prescriptions for adults from £388m to a possible £533m. The United Kingdom Government audit commission has suggested that current expenditure on asthma treatment appears to be insufficient. Using an entirely dif-ferent approach this study has confirmed that a significant increase in asthma pre-scribing costs is likely to be needed if optimal control of asthma is to be achieved