Professional Documents
Culture Documents
Unless otherwise noted, all information in this backgrounder comes from the Global Burden of
Asthma Report. The Report was commissioned by GINA and written by Richard Beasley,
Matthew Masoli, Denise Fabian, and Shaun Holt, of the Medical Research Institute of New
Zealand and the University of Southampton in the UK. For more information about the unmet
needs of asthma, and an explanation of the regions mentioned in this backgrounder, download
the full Report from www.ginasthma.org.
1
documents ample evidence that, in many regions around the world, this goal is
often not met:
Declining asthma mortality rates over the last 10 years have been
attributed to the increased use of inhaled corticosteroid therapy in
areas including Scandinavia, the UK/Republic of Ireland, Western Europe,
and Argentina. In Northeast Asia, increased use of inhaled
glucocorticosteroids has led to a reduction in asthma severity.
National asthma campaigns in Finland and other Scandinavian
countries, the UK, Australia, New Zealand, and elsewhere have reduced
asthma morbidity and mortality. These programs often include
educational components for both health professionals and the general
public.
A strategy for achieving and maintaining asthma control is set out in the GINA
Global Strategy for Asthma Management and Prevention. The strategy requires
four interrelated components of therapy:
wakingatnightwithcoughing,wheezing,shortnessofbreathoratightchest
increasedshortnessofbreathonwakingupinthemorning
needingmoreandmorerelievertreatmentoriftherelieverdoesnotseemtobe
workingwelloritseffectislastinglessthanfourhours
youcannotkeepupwithyourusuallevelofactivityorexercise.
If you experience any of these symptoms, then you should see your doctor or asthma
nurse.
Readmore:
http://www.netdoctor.co.uk/diseases/facts/asthmamedication.htm#ixzz2wT0a4Q5Z
Diette. "One way or the other, however, the people who are overusing it need more
attention."
Inhaled corticosteroids, taken one or two times daily, quiet the inflammation of the lungs,
reduce the likelihood of an asthma attack before it begins and help change the course of
the disease. Underuse of these drugs increases the chances that you will have an attack if
you encounter an asthmatic trigger such as dust, cockroaches, pets, perfume or pollution.
For years, researchers have known that asthmatics misuse their drugs, but they haven't
known which people were more apt to do so. Investigators assumed, however, that those
with quality health care would be more likely to use medications properly.
To fill the knowledge gap, Diette and his colleagues launched the Managed Health Care
Association Outcomes Management System Asthma Project. The doctors gathered and
analyzed information from 6,612 sicker-than-average asthmatic individuals on their
gender, race, education, asthma symptom severity, medication usage, health care access
and satisfaction, and physician speciality. These individuals, employees and dependents
of some of the largest U.S. companies, had health insurance coverage through managed
care.
The researchers weren't too surprised at the overuse statistics, but they were shocked,
they said, at the amount of underuse. "We now know that the magnitude of corticosteroid
underuse is huge," says Diette. In addition to being male, overusers of beta-agonists were
more likely to have frequent symptoms, use inhaled corticosteroids or visit a doctor other
than an allergist. In addition to being female, underusers of corticosteroids were more
likely to be younger, nonwhite or getting care from a nonspecialist.
The researchers say doctors need to question their patients, especially those most at risk,
about their medication usage. In addition, the findings could have implications for doctor
choice or training. "Where there are advantages to specialists, the question is how do you
narrow the gap between specialist and generalist physicians," said Diette. "It may be
worth considering referring more patients to specialists for evaluation and management."
Between 12 million and 15 million people, including close to 5 million children, in the
United States have asthma. Asthma is a chronic disease through which airflow in and out
of the lungs may be blocked by muscle squeezing, swelling and excess mucus. In 1997,
more than 30.5 million prescriptions were filled for asthma medication, and patients had
approximately 1.2 million emergency room visits and 445,000 hospitalization days.
Other authors include Albert Wu, Elizabeth Skinner, Rebecca Clark, Michael Huber and
Donald Steinwachs from Johns Hopkins; Leona Markson from Merck & Company;
Robert McDonald from Anthem Blue Cross and Blue Shield and the Indiana University
School of Medicine; and Joseph Healy from Harvard Pilgrim Health Plan. The study was
funded by the Managed Health Care Association and Merck & Co., Inc.
http://esgweb1.nts.jhu.edu/press/1999/DEC99/991213.HTM
HighCostofAsthmaMedsPuttingLivesatRiskPriceReviewNeeded
Asthma Foundation NSW is calling on the Federal Government to review the cost
of asthma medications following the publication of a new survey. It shows that
many consumers are struggling with the cost of vital asthma medication, having
to reduce or go without medication, resulting in asthma attacks that need urgent
medical treatment.
Our survey not only confirms that price is a major barrier to the control of
asthma, but directly results in people either skimping on medication to make it go
further or skipping prescriptions altogether, said Michele Goldman, CEO of
Asthma Foundation NSW.
This will come as no surprise to the government as a 2009/10 report by the
Council of Australian Governments (COAG) Reform Council revealed that more
than a million people were put off buying their prescribed medicine because of the
price.
Over 400 Australian asthmatics die each year and there has been a recent spike in
the number of child deaths, so asthma control can be, literally, a matter of life and
death.
A review of the PBS system, with a view to reducing the disparity between the
cost of asthma reliever and preventer medication for non-concession card holders,
is clearly needed.
The on-line survey, conducted by Asthma Foundation NSW during April 2012
collected information about 859 adults with asthma. The survey asked if the cost
of medications affected them and if they had experienced any medical
emergencies as a result. The headline results showed:
o
o
o
85%ofrespondentshadanissuewiththecostoftheirmedication,with
38%findingitisusuallyoralwaysanissue.
49%ofrespondentsadmittedtotakinglessmedication,orgoingwithout
entirely,becauseofthecost.
Whenpeoplewereskippingmedications,81%werenottakingpreventer
medication,26%nottakingrelieverand7%nottakingrespiratorymeds
suchasoralsteroids.
Over75%ofpeoplewhosaidtheyalwaysorusuallywentwithout
medicationsduetocostreportedthattherehadbeenanasthmaattackasa
result.Inmorethanhalfofthesecases,urgentmedicalhelp(GPor
hospital)wasrequired.
itisahugestruggleandIdeliberatelyputmyselflastsomychildren
getwhattheyneed.Iendeduphavingamajorasthmaattackandwas
rushedtohospitaltheyclaimedmylungshadclosedupsomuchifIhad
leftitanylongertheywouldnothavebeenabletoreopentheairways,I
spent6daysinhospitalandseveralweeksaftertogetbacktonormal
health.
Consideringweneedthismedicationtobe'healthy'andsurvive,Idon't
seewhyweshouldhavetopaysomuchforthemedication.Especially
whentherearethe3ofusin1familyneedingthemedicationtostayalive.
It'snotfair.
Ifthepreventermedicationsforasthmawerecheaperthenmorepeople
wouldtakethemandtherewouldbelesschanceofpeoplehavingattacks.
Iknowofmanyasthmaticswhoonlytakepreventersseasonallywhenthey
shouldbetakingthemallyearroundduetothecost.Itcostsme$72a
monthjustformypreventermedication.Thenontopofthatisthecostof
Ventolinandallergymedications.
Chronic conditions like asthma cant be cured, you have it for life. Drug therapy
is the cornerstone of asthma treatment, enabling people to prevent and reverse
inflammation of the airways, said Ms Goldman.
We believe that having asthma is stressful enough and making medications more
affordable will enable people to better control their asthma and stay well, reduce
pressure on the health system and result in less days off work and school.
Its clear that some sort of relief is needed and we believe that either a stepped
reduction in co-payments or giving people with a chronic condition, who need
regular medications, a concession card would provide that.
It is a proposal not without precedent. Currently, prescription medications are free
in Northern Ireland, Scotland and Wales.
Claims that free or cheaper prescription medication would lead to a blow-out in
PBS costs is not been supported by figures from Wales where the use of
medications has increased by 3.9 to 6% year on year, said Ms. Goldman.
Five years into the experiment the Welsh Minister for Health and Social Services
has reported a reduction in the financial burden on consumers and the health
system with a drop in the numbers being admitted to hospital.
Are you having trouble controlling your asthma? Sign up for Asthma Assist today.
Call 1800 645 130 or register here.
Media Enquiries: Nick Bleszynski 0403 931 291