Prevalence rates of asthma in the United Kingdom and Republic of Ireland are among the highest in the world, with over 4 million asthma consultations each year.1 Primary care diagnosis of asthma exacerbations is about five-times higher than 25 years ago and, currently, asthma accounts for more than 1500 deaths per year in this region.1
Estimates demonstrate that the symptoms of approximately one in four people with moderate-to severe asthma could be relieved if treatment were reviewed and made more appropriate.1 The total cost of asthma in this region has been estimated to be around £2.5 billion.1
Asthma prevalence in Western Europe (Austria, Belgium, France, Germany, Italy, Luxembourg, The Netherlands, Portugal, Spain and Switzerland) is generally high within urban areas, lower in suburban areas and lowest in rural areas.1
Although there are wide variations in the treatment of asthma within this region, it is generally under-treated and management does not comply with that recommended by international guidelines.1 The burden on healthcare systems is substantial, with 25% of children and adults with asthma requiring one urgent care visit per year. Increased hospital admissions are also drivers of rising medical expenditures for asthma.1
In general, most countries in this region have shown reductions in asthma mortality rates, which is thought to be due to improvements in asthma management and the increasing use of ICS.1 For example, Germany demonstrated a significant negative correlation between asthma mortality and ICS use in the 1990s. Some countries, including France, have shown a slower decline in asthma mortality rates within the past decade compared with other countries in this region.1
The prevalence and/or diagnosis of clinical asthma in the Middle East (Bahrain, Iran, Iraq, Israel, Jordan, Kingdom of Saudi Arabia, Kuwait, Lebanon, Occupied Territory of Palestine, Oman, Qatar, Syria, United Arab Emirates and Yemen) are low, but data indicate that prevalence has increased during recent decades.1
The burden of severe asthma is also quite considerable, with hospital admission rates in excess of 150 to 200 per 100,000 people per year in some countries. A striking example of this is in Israel, where 20% of children with asthma visit the emergency room each year and 10% of children with asthma are hospitalized due to a severe exacerbation per year.1
This region encompasses Japan and North and South Korea. Japan has one of the highest asthma prevalence rates within Asia at 6.7%, with symptoms and exacerbation rates rising during recent decades.1 While 30 years ago only three asthma patients per day per 100,000 people were treated in medical facilities, that number has risen to over 100 cases per day per 100,000 people.1 In addition, the estimated number of inpatients with asthma is approximately 15 cases per 100,000 in the general population in Japan, representing a dramatic burden on the healthcare system.1
In addition, around 10,000 people per year die from asthma in Japan and North and South Korea. The factors contributing to these deaths are similar for other regions: delays in seeking medical help, over-reliance on β2-agonist therapy, poor adherence to long-term therapy and under-use of ICS therapy.1
The prevalence of asthma in the US and Canada is among the highest in the world for both adults and children, with especially rapid increases occurring over recent decades. The prevalence of diagnosed asthma and asthma symptoms in the US for children and adolescents has been reported to have increased by 25–75% per decade since 1960.1 In addition, an increase in the percentage of patients hospitalized for asthma in North America who require intubation, even as the number of hospital admissions for respiratory diseases in general has gone down, indicates a rise in the prevalence of severe asthma.1
Morbidity is also high, with approximately 40% of all children and adults with asthma requiring hospitalization or emergency room treatment, or other urgent care, in the previous 12 months,1 despite over 95% of the population in the US and Canada having access to essential drugs according to the World Health Organization. Furthermore, in the US, there has been a progressive increase in mortality rates; in the mid-1990s the rate was approximately double that in the mid-1970s.1
References:
1. Masoli M, Fabian D, Holt S, Beasley R. Global Burden of Asthma. Developed for the Global Initiative for Asthma (GINA). 2005.