Patterns of asthma medication use and hospital discharges in new zealand

Background In New Zealand (NZ) a progressive increase in budesonide/formoterol dispensing, accompanied by a reduction in short-acting beta2-agonists (SABA), inhaled corticosteroids (ICS) and ‘other ICS/long-acting beta2-agonists’ (ICS/LABA) dispensing, occurred in the 18-month period following publication of the 2020 NZ asthma guidelines which recommended budesonide/formoterol anti-inflammatory reliever therapy. Objective To investigate more recent trends in asthma medication use and asthma hospital discharges in NZ. Methods NZ national dispensing data for inhalers from January 2010 to December 2022 were reviewed for patients aged 12 years and older. Monthly ‘dispensings’ of budesonide/formoterol, ICS, ‘other ICS/LABA’, and SABA, were displayed graphically by LOESS plots. The rates of dispensings and hospital discharges for asthma were compared between the last six months that dispensing data was available (July-December 2022) and the corresponding period July-December 2019. Results There has been a progressive increase in dispensing of budesonide/formoterol since 2019, with a 108% increase between July/December 2019 to July/December 2022 in adolescents and adults. In contrast, there was a reduction in dispensings of ‘other ICS/LABA’, ICS, and SABA by 3%, 18% and 5% respectively. During this period, there was a 17% reduction in hospital discharges for asthma. Conclusion There has been a further widespread uptake of ICS/formoterol reliever and/or maintenance therapy in adolescents and adults with asthma in NZ. The changes in prescribing practice have been temporally associated with a reduction in hospital admissions for asthma.