Article Text

Audit, research and guideline update
The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry
  1. Stephen O'Neill1,
  2. Joan Sweeney2,
  3. Chris C Patterson3,
  4. Andrew Menzies-Gow4,
  5. Rob Niven5,
  6. Adel H Mansur6,
  7. Christine Bucknall7,
  8. Rekha Chaudhuri8,
  9. Neil C Thomson8,
  10. Chris E Brightling9,
  11. Ciaran O'Neill1,
  12. Liam G Heaney2,
  13. on behalf of the British Thoracic Society Difficult Asthma Network
  1. 1JE Cairnes School of Business and Economics, National University of Ireland Galway, Galway, Ireland
  2. 2Centre for Infection and Immunity, Queen's University of Belfast, Belfast, UK
  3. 3Centre for Public Health, Queen's University of Belfast, Belfast, UK
  4. 4Royal Brompton Hospital, London, UK
  5. 5MAHSC, The University of Manchester & UHSM, Manchester, UK
  6. 6Severe and Brittle Asthma Unit, Birmingham Heartlands Hospital, Birmingham, UK
  7. 7Department of Respiratory Medicine, Royal Infirmary, Glasgow, UK
  8. 8Department of Respiratory Medicine, Division of Immunology, Infection and Inflammation, University of Glasgow and Gartnavel General, Glasgow, UK
  9. 9Department of Infection, Inflammation and Immunity, Institute for Lung Health, University of Leicester, Leicester, UK
  1. Correspondence to Professor Liam Heaney, Centre for Infection and Immunity, Queen's University of Belfast, Level 8, Belfast City Hospital, Lisburn Road, Belfast, Northern Ireland BT9 7AB, UK; l.heaney{at}


Severe refractory asthma poses a substantial burden in terms of healthcare costs but relatively little is known about the factors which drive these costs. This study uses data from the British Thoracic Society Difficult Asthma Registry (n=596) to estimate direct healthcare treatment costs from an National Health Service perspective and examines factors that explain variations in costs. Annual mean treatment costs among severe refractory asthma patients were £2912 (SD £2212) to £4217 (SD £2449). Significant predictors of costs were FEV1% predicted, location of care, maintenance oral corticosteroid treatment and body mass index. Treating individuals with severe refractory asthma presents a substantial cost to the health service.

  • Asthma
  • Health Economist

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