TY - JOUR
T1 - Prescribing trends of inhaler treatments for asthma and chronic obstructive pulmonary disease within a resource-constrained environment in the Scottish national health service
T2 - findings and implications
AU - McCabe, Holly
AU - Godman, Brian
AU - Kurdi, Amanj
AU - Johnston, Katie
AU - MacBride-Stewart, Sean
AU - Lennon, Janey
AU - Hurding, Simon
AU - Bennie, Marion
AU - Morton, Alec
N1 - Funding Information:
The production of this paper was facilitated by a grant to Alec Morton by the University of Strathclyde under the university’s New Professors‘ Fund.
Publisher Copyright:
© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019/7/3
Y1 - 2019/7/3
N2 - Background: There is an increasing prevalence of asthma and chronic obstructive pulmonary disease (COPD) worldwide, leading to increased inhaler use. However, there are concerns with inhaler compliance resulting in different patented inhalers and longer-acting formulations. As a result, inhalers are now among the highest expenditure items in ambulatory care in Scotland leading to multiple initiatives to keep within budget without compromising care. Method: This study assesses inhaler utilization and expenditure between 2001 and 2017 alongside health authority initiatives. Results: There was an increase by 137% in inhaler utilization between 2001 and 2017, and a two-fold increase in expenditure, driven by the increasing use of patented combination inhalers to address concerns. This is very different to the oral markets where expenditure on proton pump inhibitors, statins, and antihypertensives have fallen considerably recently despite increased volumes due to the increasing use of low-cost generics. However, inhaler expenditure has started to fall with an increasing use of lower cost combinations and initiatives to reduce the steroid burden alongside monitoring patient care. Conclusion: Challenges with using and changing inhalers has meant this market has not followed other high-volume drug classes following patent loss. This is starting to change, with the situation monitored to enhance efficient prescribing alongside continued good quality care.
AB - Background: There is an increasing prevalence of asthma and chronic obstructive pulmonary disease (COPD) worldwide, leading to increased inhaler use. However, there are concerns with inhaler compliance resulting in different patented inhalers and longer-acting formulations. As a result, inhalers are now among the highest expenditure items in ambulatory care in Scotland leading to multiple initiatives to keep within budget without compromising care. Method: This study assesses inhaler utilization and expenditure between 2001 and 2017 alongside health authority initiatives. Results: There was an increase by 137% in inhaler utilization between 2001 and 2017, and a two-fold increase in expenditure, driven by the increasing use of patented combination inhalers to address concerns. This is very different to the oral markets where expenditure on proton pump inhibitors, statins, and antihypertensives have fallen considerably recently despite increased volumes due to the increasing use of low-cost generics. However, inhaler expenditure has started to fall with an increasing use of lower cost combinations and initiatives to reduce the steroid burden alongside monitoring patient care. Conclusion: Challenges with using and changing inhalers has meant this market has not followed other high-volume drug classes following patent loss. This is starting to change, with the situation monitored to enhance efficient prescribing alongside continued good quality care.
KW - Asthma
KW - COPD
KW - Scottish NHS
KW - drug utilisation
KW - expenditure
KW - inhalers
KW - reforms
UR - http://www.scopus.com/inward/record.url?scp=85067554144&partnerID=8YFLogxK
U2 - 10.1080/17476348.2019.1624528
DO - 10.1080/17476348.2019.1624528
M3 - Article
C2 - 31189394
AN - SCOPUS:85067554144
SN - 1747-6348
VL - 13
SP - 679
EP - 689
JO - Expert Review of Respiratory Medicine
JF - Expert Review of Respiratory Medicine
IS - 7
ER -