Severe asthma

Asthma is a common and generally mild condition, but 3–10% of people with asthma have severe asthma, a distinct condition in which they experience repeated, uncontrollable and life-threatening asthma attacks.

A breath of fresh air: addressing missed opportunities in severe asthma care


Most people are familiar with asthma as a relatively mild condition, but severe asthma is very different in terms of its symptoms, treatment and management.

Severe asthma can affect a person at any age. They may be unable to go to school or work, socialise and carry out daily activities. They are also at risk of premature disability, which can result in financial hardship. Despite severe asthma affecting only 3–10% of people with asthma, it accounts for at least 50% of the disease’s healthcare costs and utilisation.

Severe asthma needs to be recognised as a distinct condition that requires a comprehensive care pathway. People often wait years before being referred to an asthma specialist and offered effective treatment. Access to treatment is highly variable, and overreliance on long-term use of high-dose oral corticosteroids to treat asthma attacks remains common despite recent guideline recommendations.

Optimising the management of severe asthma has more than just clinical benefits. Fewer asthma attacks will mean fewer hospital admissions, alleviating pressures on already stretched health systems and reducing productivity losses. Better management of severe asthma can also help reduce the carbon footprint linked to overuse of inhalers and asthma-related hospitalisations.

There are significant disparities in access to and quality of care for severe asthma. Much of the burden of severe asthma could be avoided by adhering to existing guidelines and quality standards. Embedding globally recognised standards of care for severe asthma into national-level respiratory disease plans is vital to effectively support people living with severe asthma.

What we’ve achieved

HPP conducted desk research and worked with a group of respiratory and allergy specialists, including representatives from patient associations, to develop a policy report on severe asthma. The report makes recommendations to ensure that every person with severe asthma receives specialised care appropriate to their specific condition.

Key partners and stakeholders

This report was written by Angel Gonzalez de la Fuente and Suzanne Wait at The Health Policy Partnership.

We would like to thank the following experts who contributed their insights:

  • Professor Job van Boven, Associate Professor of Respiratory Health Economics and Drug Outcomes Research, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, the Netherlands
  • Professor Giorgio Walter Canonica, Professor of Respiratory Medicine and Director of the Personalised Medicine, Asthma and Allergy Centre, Humanitas Research Hospital IRCCS, Milan, Italy
  • Henry Gregg, Director of External Affairs, Asthma + Lung UK, and Chair of Taskforce for Lung Health
  • Dr Steve Holmes, family physician and Somerset and NHS England (South West) Clinical Respiratory Lead, UK
  • Laura Williamson, Policy and Public Affairs Officer, Asthma + Lung UK, Taskforce for Lung Health, UK
  • Tonya Winders, President and CEO, Global Allergy & Airways Patient Platform

Project funding

This report was fully initiated and funded by AstraZeneca in collaboration with The Health Policy Partnership (HPP) who consulted with a group of expert stakeholders in the delivery of this report. HPP led project management, research, stakeholder interviews and drafting of the report. AstraZeneca reviewed all content for factual accuracy. All interviewed stakeholders reviewed the full report.