Asthma ICs prescriptions in primary care in France and the United Kingdom: Are they similar?

Abstract

<b>Aim:</b> Even if international guidelines are developed to align routine care to best current evidence, differences may arise from health system specific factors. ASTROLAB, a FP7 European project assessing the safety of long acting β2-agonists (LABA), included a cohort of persistent asthma patients in France and in the United Kingdom (UK) based on 4 therapy patterns: LABA without inhaled corticosteroid (IC), IC without LABA, LABA and IC as separate inhalers or LABA/IC fixed-dose combinations (FDC). In this analysis, we compared IC therapy patterns and cotherapies between the two national IC without LABA cohorts. <b>Method:</b> Patients (6-40 years) were selected from prescribed LABA and/or IC ≥6 months with the same therapy pattern initially described during the 12 months selection period. THIN prescription data were used for the UK and claims data for France. <b>Results:</b> Among eligible UK (n=29,812) and French (n=2,048) patients, more UK patients received IC without LABA (63.0% vs 23.4%), while the FDC group was predominant in France (64.4% vs 33.3%). In the IC without LABA group, patients received similar numbers of IC prescriptions (UK) or dispensations (France) over 12 months (4.3 vs. 4.0, p=0.12). However, IC canisters with lower IC dosages/inhalation were more frequent in the UK. More French patients received leukotriene-receptor antagonists (18.6% vs 8.3%, p&lt;0.0001) and oral corticosteroids (51.9% vs 15.5%, p&lt;0.0001). Conversely, most patients in both countries received short-acting beta-agonists (94.6% vs 90.7% p=0.0651). <b>Conclusion:</b> Marked differences in asthma therapy patterns appeared between France and the UK, among IC-treated patients. <b>Acknowledgment:</b> Project funded by the EC (GA n°282593).