The cost of asthma
Under a global strategy for asthma management and prevention, the World Health Organisation has prescribed international guidelines. These guidelines recommend the regular use of prophylactic inhaled medication along with inhaled bronchodilators. But do asthma patients in poor countries receive proper treatment?
A survey conducted in 24 African and Asian countries found that the treatment prescribed to most of the patients in these countries fell far short of international guidelines. Easy availability of oral drugs that are also cheap (98 per cent of the centres had oral medicines) forced many doctors to prescribe oral therapy rather than the recommend inhaled therapy. The cost of the beclomethasone 50mg inhaler was 20 per cent of average local monthly income of many of these poor people in these countries.
In comparison, the cost of oral drugs (90 salbutamol 4 mg tablets) was only 3.8 per cent of the average local monthly income. A survey of general practitioners in Punjab revealed overuse of ephedrine and an under-use of the inhaled drugs because steroids are cheaper and provide almost immediate relief.
The challenge of fighting asthma remains. It is time the pharmaceutical industry makes effective inhaled medication available at prices that are affordable.
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