Abstract
Combination inhalers are one of the five most expensive drug groups in the UK. Expenditure may rise further following the launch of several new combinations for asthma, chronic obstructive pulmonary disease (COPD), or both. Despite clear advice, healthcare professionals (HCPs) often prescribe combination therapies inappropriately, which potentially undermines efficacy, increases costs, and may contribute to asthma mortality. Nevertheless, health care professionals need a diverse formulary to tailor treatment to each patient, and address the related issues of poor adherence and poor inhaler technique—both of which undermine outcomes and drive up costs. Meanwhile, commissioning groups seem to be missing several opportunities to reduce expenditure on drugs for asthma, while maintaining or improving outcomes.
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