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Asthma patients skipping preventative medication to cut costs, study finds

The cost of asthma medicine means many sufferers are not taking what they have been prescribed, according to new research.

Half of all adults and a third of children are skipping or decreasing doses of preventative asthma medication, due to out of pocket costs, the study, co-authored by Helen Reddel from the Woolcock Institute of Global Health, found.

“Although we have a Pharmaceutical Benefits Scheme, there’s still a patient contribution. And for around about 40 per cent of people with asthma, that can be up to $40 for a month of treatment,” Professor Reddel said.

“For people who have a concession card, it’s just over $6.”

Professor Reddel said the research suggested many people with asthma avoided essential preventer medication and relied on cheaper, over-the-counter reliever inhalers.

“The risks of just using a reliever inhaler on its own with no preventer are absolutely well established,” she said.

“By using a preventer, you can reduce that risk by a half to two thirds.”

This was tragically illustrated during Melbourne’s deadly 2016 asthma thunderstorm, when nine people died, nearly 600 were hospitalised and thousands went in to respiratory distress.

Nearly half those hospitalised had been prescribed preventative medication, but were not taking it.

‘Families can’t afford milk, so they can’t afford to breathe’

Sarah Richardson’s whole family suffers from asthma.

The maternity nurse and mother-of-two’s asthma has been serious enough for her to need emergency hospitalisation.

“I was at home alone with the kids and the kids ended up having to call an ambulance,” she told 7.30.

Members of her family share prescriptions and Ms Richardson often goes without to cut costs and stretch the medication out further for her children.

“We will often use the same puffers,” Ms Richardson said.

“So we will get one prescription filled and we’ll all sort of use it.

“I tend to not use it as much as the children because it’s expensive. I don’t want to spend $120 a month on asthma medication if I can, so I will go a day or two without it.

“We’ll let our asthma get a little bit more out of control than we probably should.”

But she said she was reluctant to raise the cost of their medication with the GP.

“It’s hard. There’s a lot of shame. I don’t want people to know,” she said.

“I know my doctors are probably cringing at the thought of the fact that I’m not taking care of my asthma as well as I should.

“And a lot of families out there, working families, have this problem of, you know, not being able to afford milk, so [they] can’t afford to breathe, either.”

Well patients often avoid preventatives, GP body says

Asthma Australia chief executive Michele Goldman said asthma was “underestimated by the community”, and GPs were compounding the problem by unnecessarily prescribing more expensive types of preventers.

“Eighty-nine per cent of patients are prescribed [more expensive] combination therapies, whilst 70 per cent should achieve good control on [less expensive] inhaled corticosteroids alone,” Ms Goldman said.

“The GP is the gatekeeper. They’re the one who controls what medication they’re going to prescribe to the patient in front of them.

“So, along with further subsidies for asthma medications, it needs to be accompanied with education for health professionals.

“If you are well, the last thing you want to do is take a tablet.”

President of the Royal Australasian College of General Practitioners, Harry Nespolon, denied GPs fundamentally misunderstood what asthma medications was available and their associated costs.

“I certainly don’t raise [cost] with patients every time. But if a patient wants to raise it with me, I’m more than happy to talk to them about it,” he said.

“It really is up to the patient. Embarrassment can work both ways.”

Dr Nespolon said it was a problem with all preventative medication.

“Not adherence [to taking prescribed medication] is a problem for all medications, whether it’s blood pressure tablets, whether it’s antidepressants, whether it’s anti-asthmatic medication, they all have problems,” he said.

“When patients feel well, they don’t tend to want to take their medications.”

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