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There is a significant burden of asthma in the UK

In the UK, ~5.4 million people are currently being treated for asthma, and progress on outcomes has stalled, with rates of hospital admission and mortality for adult asthma in the UK amongst the worst in Europe.1,2

The foundation of asthma care is anti-inflammatory treatment with inhaled corticosteroids (ICS)3, however, short-acting beta agonists (SABAs) which have no inherent anti-inflammatory pharmacological properties4, are the most widely prescribed inhaler treatment in the UK.5

The level of SABA use in the UK is amongst the highest in Europe5 - ~38% of asthma patients are potentially over-reliant on SABAs (prescribed 3 inhalers or more each year).6

Over-reliance on SABA can have serious consequences for patients and the environment:

Patients prescribed 3 or more SABA inhalers per year are at increased risk of severe exacerbation, emergency department attendance, and premature death.8-10
SABA inhalers (all devices) contribute to ~70% of the total carbon footprint of all inhaler devices in the UK.5 In asthma, 83% of SABA inhalers are prescribed for patients already using 3 or more SABA inhalers a year.5

Data in 2021 from the UK shows that poorly controlled asthma is associated with 3-fold higher greenhouse gas emissions than well-controlled asthma.11

Reducing SABA over-reliance and optimising anti-inflammatory treatments could improve outcomes for asthma patients while achieving carbon savings aligned to the NHS Net Zero ambitions.12-14


  1. Asthma UK. Asthma facts and statistics. Available from (Accessed November 2021)
  2. European Lung White Book. European Respiratory Society Sheffield; 2019. Available from (Accessed November 2021)
  3. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention 2021. Available from
  4. Kaplan, A et al. J Clin Med 2020; 9(4): 921
  5. Wilkinson, AJK et al. BTS Oral Abstract No: S26. Available from (Accessed November 2021)
  6. Janson, C et al. Adv Ther 2020; 37: 1124-1135
  7. AstraZeneca Data on File. REF-77186. August, 2020
  8. Bloom, CI et al. Adv Ther. 2020; 37(10): 4190-4208
  9. Schatz M, et al. J Allergy Clin Immunol. 2006;117:995-1000
  10. Nwaru BI et al. Eur Resp J. 2020 55: 1901872; doi: 10.1183/13993003.01872-2019
  11. Wilkinson A. et al. Greenhouse gas emissions associated with asthma care in the UK: results from SABINA CARBON. Abstract presented at European Respiratory Society (ERS) International Congress, 2021; Sep 5-8: Abstract no. OA76
  12. National Health Service (NHS). Delivering a ‘Net Zero’ National Health Service. October 2020. Available from (Accessed November 2021)
  13. NHS England. Annex B – Investment and Impact Fund: 2021/22 and 2022/23. August 2021. Available from (Accessed November 2021)
  14. National Health Service (NHS). The NHS Long Term Plan, January 2019. Available from (Accessed November 2021)

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