Healthcare costs associated with short-acting β2-agonist use in asthma: an observational UK study from the SABINA global programme

Clinical Research Results Abstract Introduction: Patients with asthma increase their use of short-acting β2-agonists (SABAs) with worsening symptoms. We examined asthma-related healthcare resource use (HCRU) and medication costs associated with SABA use in the United Kingdom (UK).Methods: SABINA I (SABA use IN Asthma) is a retrospective longitudinal study using UK electronic health records (CPRD GOLD; 2008−2019). Eligible patients with asthma were aged ≥12 years with SABA prescriptions in the past year. Baseline SABA use (canisters/year) was defined as high (≥3) or low (1−2). HCRU rates (from multivariable negative binominal model) and average medication costs (based on the average number of canisters/year/patient) were quantified across asthma treatment groups (British Thoracic Society steps); UK unit cost was applied to estimate total costs (2020).Results: Overall, 186,061 SABA users were included: 20% received no inhaled corticosteroids (ICS), and 37% received low-dose ICS prescriptions; 51% had high SABA use, which increased with severity. Patients in the high-SABA vs low-SABA group had 69% higher asthma-related HCRU costs (£474,794 vs £280,280/1,000 patients/year) and 48% higher medication costs (£1,781,297 vs £1,200,359/1,000 patients/year). The HCRU cost difference between the high- vs low‑SABA group was greatest for hospitalisations (+230%; £15,521 vs £4,697/1,000 patients/year) and exacerbation-related primary care visits (+162%; £18,770 vs £7,160/1,000 patients/year) (Figure 1). Across both SABA groups, most HCRU costs were for non–exacerbation-related primary care/outpatient visits. Total asthma-related costs extrapolated to the broader UK population with asthma were £108.5 million/year higher with high- vs low-SABA use, driven by medication costs. Discussion: High- vs low-SABA prescriptions were associated with higher asthma-related costs. Better asthma control through implementation of the latest evidence-based recommendations that recommend adding ICS when needed may minimise SABA use, thereby leading to lower asthma-related HCRU costs. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest The study was designed and funded by AstraZeneca. References and Clinical Trial Registry Information