As medical head, specialty at GSK, my work keeps me close to both the lived reality of severe asthma and the system pressures it creates.
Sponsored and written by
I see how the condition can be unpredictable and debilitating for patients and families, and how it can drive avoidable exacerbations, urgent care use and time lost from work and education. I also see the variation in access to specialist assessment and advanced therapies across England – and the opportunity to narrow these gaps through earlier identification, clearer referral pathways and more consistent implementation of evidence-based care.
Severe asthma is a condition increasingly being regarded as a distinct disease in itself and may be driven by different inflammatory pathways from those driving asthma[1].
The condition can lead to persistent breathing difficulties that negatively impact quality of life[2]. Severe asthma symptoms are also hard to control, even when taking high doses of treatments such as inhalers.
Treatments known as biologics are available for severe asthma patients and often recommended when symptoms remain uncontrolled despite adherence to the medication[3]. However, uptake is limited[4] and initiation delayed[5], with the median proportion of eligible patients in England having access to biologics being 16 per cent[4].
I’ve written before about the impact on patients living with severe asthma, but this burden extends beyond the experience of the patient to society, the NHS and the economy – areas that are increasingly in focus for government[6]. To better understand the current picture, GSK commissioned the Office of Health Economics (OHE) to assess the scale of the burden of severe asthma in England and estimate the savings gained by a potential increase in the uptake of biologics. The hope is that this research can be used to inform future policy, aid resource allocation decisions and importantly help improve patient outcomes.
The severe asthma burden
People with severe asthma often experience frequent exacerbations and hospital admissions[7]. The OHE estimates that severe asthma costs the NHS more than £417m annually, with £258m of this due to direct healthcare costs[3].
The OHE also found more than 9.4 million days are lost as a result of severe asthma-related patient absenteeism and presenteeism at work, costing about £2.2bn yearly[3].
Current treatment landscape and challenges
The barriers to diagnosis and subsequent treatment of severe asthma with biologic medicines are multifaceted and exist at both system and patient level. These include a lack of awareness of severe asthma and biologic treatments, a lack of consistent referral criteria[3], a fragmented and complex diagnosis pathway[8], limited system capacity, and unequal regional distribution of specialist services[5].
Delayed uptake of biologics can lead to an increased reliance on high-dose oral corticosteroids (OCS)[3]. This can lead to patients developing comorbidities such as obesity, osteoporosis, cardiovascular disease, and pneumonia, among many others, which cost the NHS about £160m annually, according to the OHE report[3].
Regionally, the North East and South West regions show the highest prevalence rates (273 and 273.5 per 100,000 people) compared to London, which has the lowest (175 per 100,000). Uptake of biologics is inconsistent across England, ranging from 2 to 29 per cent for eligible patients being prescribed biologics[5], highlighting the need to ensure all those living with severe asthma are receiving appropriate care regardless of where they live.
OHE report recommendations
The OHE analysis modelled potential healthcare and socioeconomic benefits that could be achieved if earlier access to biologics reduced the burden of severe asthma by 50 per cent[3], and outlined policy recommendations to support achieving this, including:
- improving awareness of severe asthma and treatment options;
- reiterating the harms of high OCS exposure;
- recognition of the need for specialist care among primary and secondary care providers; and
- having standard referral guidelines.
The analysis found the potential positive impact of wider and earlier access to biologics is substantial and may help justify efforts to improve biologics uptake and speed up referral processes for specialised asthma care.
For me, the OHE report is valuable because it translates what clinicians and patients describe every day into a clear, England-level picture of impact – across direct NHS costs, wider productivity losses, and variation in access to specialist care and biologics.
Having this independent analysis helps move the conversation from recognising severe asthma as a priority to acting on it: identifying where unwarranted variation exists, supporting business cases for service capacity and earlier referral, and focusing improvement efforts on interventions most likely to reduce exacerbations, avoid high OCS exposure and deliver better outcomes.
Read the full OHE report here.
NP-GB-ASU-WCNT-260002 DOP April 2026
References
[1] Primary Care Respiratory Society. Triggers for referral for poorly controlled and severe asthma. Available at https://www.pcrs-uk.org/resource/current/triggers-referral-poorly-controlled-and-severe-asthma. Accessed January 2026.
[2] Asthma + Lung UK website. What is severe asthma? Available at https://www.asthmaandlung.org.uk/conditions/severe-asthma/what-severe-asthma. Accessed January 2026.
[3] OHE report. El Banhawi H, Hayes H., Hampson G, Steuten L. Estimating the Broader Socio-Economic Burden of Severe Asthma and the Value of Biologics. February 2026.
[4] Rupani, H., Subramanian, D., Walker, S. and Bostock, B., 2024. Severe asthma biologics: a need to increase use and reduce inequity in England. Thorax, 79(Suppl 2), pp.A271–A272. DOI: 10.1136/thorax- 2024-BTSabstracts.433. Accessed January 2026.
[5] Asthma + Lung UK, 2025. Biologic therapies for severe asthma. [online] Asthma and Lung UK. Available at: https://www.asthmaandlung.org.uk/symptoms-tests-treatments/treatments/biologic-therapies. Accessed January 2026.
[6] LinkedIn post. Dr Joanna Hunt. Available at https://www.linkedin.com/pulse/unmet-need-severe-asthma-care-getting-ahead-disease-together-hunt-ssvue. Accessed April 2026.
[7] Asthma + Lung UK website. Identifying and managing severe asthma. Available at https://www.asthmaandlung.org.uk/healthcare-professionals/severe-asthma/identify-manage-severe-asthma#. Accessed January 2026.
[8] Hew, M., et al. 2020. Systematic Assessment of Difficult-to-Treat Asthma: Principles and Perspectives. The Journal of Allergy and Clinical Immunology: In Practice, 8(7), pp.2222–2233. DOI: 10.1016/j.jaip.2020.02.036.
