As a person with asthma who was diagnosed in childhood, I have realised over the past few years that the management of my asthma hasn’t changed in decades. My condition is controlled through medication, and the only part of my treatment that has changed over the years is the trade name of my ‘blue reliever inhaler’ from Ventolin to Salbutamol. With 5.4 million people in the UK living with asthma and the NHS spending an estimated £1.1 billion on treatment annually, it seems hard to believe that patients do not have more access to innovative technology and products that could help their treatment and improve their quality of life.
Through the NHS Accelerated Access Collaborative’s Rapid Uptake Products (RUP) programme, the NHS has endorsed products that improve the diagnosis of asthma and the treatment of severe asthma. The 2021/22 RUP programme has included two innovative asthma products and fast tracks patient access to these products. They are approved by the National Institute for Health and Care Excellence (NICE) and support the NHS Long Term Plan’s key clinical priorities but have had lower uptake within England than expected.
As an Academic Health Science Network, the Health Innovation Network (HIN) supports the local adoption of these products in south London by raising awareness of their efficacy, facilitating clinical pathway changes and providing education and training for how to embed and use them.
2021/22 RUP innovations that improve the diagnosis and treatment of asthma
FeNO testing is a method of diagnosing asthma by measuring fractional exhaled nitric oxide (FeNO) in the breath of patients with suspected asthma, alongside other respiratory tests. It measures the levels of inflammation in a patient’s lungs through the nitric oxide in their breath. There is evidence that asthma is widely misdiagnosed. Overdiagnosis leads to unnecessary treatment and a delay in making an alternative diagnosis. Underdiagnosis risks daily symptoms, and potentially serious exacerbations1. The FeNO test can provide a more accurate diagnosis of patients suspected of having asthma when a diagnosis is unclear and can be used with other diagnosis tests such as spirometry and peak flow test. Additionally, FeNO can also be used to improve the management of patients with asthma by using FeNO monitoring to adjust the dosage of steroids or guide biological agent treatment.
Asthma Biologics, the second RUP asthma product, are four biologic therapy drugs taken to improve and reduce asthma attacks in people with eosinophilic asthma or severe persistent allergic asthma. Biologic therapies work in a different way to traditional asthma treatments. Xolair (Omalizumab) is for people with severe allergic asthma. It targets a chemical in your blood stream called IgE which is involved in the allergic response to an asthma trigger. Nucala (Mepolizumab), Cinqaero (Reslizumab) and Fasenra (Benralizumab) are for people who have severe eosinophilic asthma. This is asthma driven by high levels of a type of white blood cell called eosinophils causing the lungs to become inflamed, leading to asthma symptoms and asthma attacks.
Only 10.8 per cent of eligible severe asthma patients have access to biologic medicines today in the UK. The low referral rate could be due to many healthcare professionals being unaware that their patients could benefit from biologics. Increasing the use of biologics appropriately would reduce use of oral corticosteroids (OCS) associated with long term side effects, as well as exacerbations and hospital admissions2.
These asthma products could significantly improve care for patients receive, with the potential to transform the lives of people with difficult/severe asthma, prevent asthma attacks, and save lives.
NHS organisations in south London can access financial help to roll out these products, as both innovations are eligible for the Pathway Transformation Fund. The deadline to apply for this fund is midday 30 April 2021, and we would welcome health professionals, including pharmacists interested in supporting patient identification and accurate prescribing, to apply. Within the Health Innovation Team our RUP lead is really keen to help you to devise your project and help to complete your funding application.
Applications should be developed and submitted with the support of your local AHSN RUP lead, and we can help you get started.
We're here to help
Contact the HIN’s RUP team if you are from an organisation based in south London requiring more information or interested in beginning an application process.Email now