Healthcare costs associated with short-acting β₂-agonists in asthma: observational UK SABINA study

Background Poor asthma control is associated with high short-acting β₂-agonist (SABA) use.

Aim Assess asthma-related healthcare resource utilisation (HCRU) and medication costs associated with high versus low SABA prescriptions in the United Kingdom (UK).

Design & setting Analysis of SABINA I (SABA use INAsthma), a retrospective longitudinal study using UK electronic health records (Clinical Practice Research Datalink GOLD 2008−2019 and Hospital Episode Statistics database).

Method Eligible patients were ≥12 years old with SABA prescriptions in the past year. SABA prescriptions (canisters/year) were defined as high (≥3) or low (1–2). Association of SABA prescriptions with HCRU was assessed by negative binominal model adjusted for covariates. The UK unit costs from the National Health Service were applied to estimate total healthcare costs (2020). Medication costs were based on annual average number of canisters/year per patient.

Results Overall, 186,061 patients with SABA prescriptions were included, of whom 51% were prescribed high SABA. Total annual average costs (HCRU and medication) were 52% higher in the high- versus low-SABA group (£2,256,091/1,000 versus £1,480,640/1,000 patients/year). Medication costs accounted for the majority of asthma-related costs. Across both groups, most HCRU costs were for non–exacerbation-related primary care/hospital outpatient visits. The annual average HCRU cost difference for high- versus low-SABA was greatest for hospitalisations (+230%; £15,521/1,000 versus £4,697/1,000 patients/year) and exacerbation-related primary care visits (+162%; £18,770/1,000 versus £7,160/1,000 patients/year). Asthma-related HCRU extrapolated to the broader UK asthma population was £108.5 million/year higher with high- versus low-SABA.

Conclusion High- versus low-SABA prescriptions are associated with higher asthma-related HCRU costs.