Access to inhaled corticosteroids is key to improving quality of care for asthma in developing countries

Abstract

Asthma is a worldwide public health problem affecting about 300 million people. The majority of persons living with asthma are in the developing world where there is limited access to essential drugs. The financial burden for persons living with asthma and their families, as well as for healthcare systems and governments, is very high. Inadequate treatment and the high cost of medications leads to disability, absenteeism and poverty. Despite the existence of effective asthma medications and international guidelines, and progress made in the implementation of such guidelines over the last decade, the high cost of essential asthma medications remains a major obstacle for patient access to treatment in developing countries. The International Union Against Tuberculosis and Lung Disease has evaluated this problem and created an Asthma Drug Facility (ADF) so that countries can purchase affordable, good quality essential drugs for asthma. The ADF uses pooled procurement along with other purchasing and supply strategies to obtain the lowest possible prices. Accompanied by the implementation of standardized asthma management, the increased affordability of drugs provided by the ADF should bring rapid and significant health and cost benefits for patients, their communities and governments.

The unbearable cost of severe asthma in underprivileged populations

“…Because of economic obstacles, a majority of the population of low-and middle-income countries lack access to basic asthma treatment such as ICS (9). The challenge we must face was to provide global access to core asthma medications, particularly ICS, at affordable prices, to improve implementation of treatment guidelines and to encourage better health care provider and patient education (20).…”

“…Previous publications estimate that families spending 50% or more of their nonfood expenditure fit in this category (17,18). Recent surveys have shown that the proportion of individuals with persistent asthma reporting use of inhaled corticosteroids (ICS), the cornerstone of treatment, is very low in various continents (19)(20)(21). The cost of regular treatment is unaffordable to families in low-resource settings (9), resulting in considerable higher proportion of uncontrolled asthma, which is associated with greater economic burden to families and health systems, loss of productivity and deterioration in quality of life (22).…”

Prioritised research agenda for prevention and control of chronic respiratory diseases

“…Resources are limited and fragmented. 3) Facilities for diagnosis and monitoring as well as essential medicines for treating CRDs are not available and/or affordable in many LMICs [8,9]. 4) Strategies for CRD prevention and health promotion are often absent or rudimentary.…”

Management of asthma in Benin: the challenge of loss to follow-up

“…1,2 Unfortunately, management of asthma is suboptimal for a substantial proportion of asthma patients worldwide, [3][4][5] and most have limited access to affordable inhaled corticosteroids. [6][7][8] A comprehensive lung health project funded by the World Bank and implemented through collaboration between the International Union Against Tuberculosis and Lung Disease (The Union) and partners in Benin, China and Sudan, included as one of its aims to reduce the burden of lung disease through improvement of case management of patients with persistent asthma. 9,10 A situation analysis was performed to evaluate asthma management practice in China.…”