People with severe asthma continue to experience symptoms and disease burden, despite taking medications. Medication costs are ongoing and can be high. Significant side effects can also result, in particular from ongoing high-dose oral corticosteroids. These factors can contribute to doubts about treatment efficacy and reduce adherence and compliance to prescribed medications or promote overuse of reliever medications. Decreased medication use, without medical recommendation, puts people at increased risk of severe asthma attacks / exacerbations.
“I hate it, I never liked taking tablets or medicine and now I depend on them…a lot of times I miss taking my medication at night….at the start of the day I can’t be bothered, but I know if I don’t, I’m in trouble”
Video provided by Professor Lorraine Smith and Dr. Daniela Eassey, University of Sydney.
“I felt uncomfortable, I was despairing….I lost faith”
Video provided by Professor Lorraine Smith and Dr. Daniela Eassey, University of Sydney.
People with severe asthma will weigh the benefits of taking medications (e.g. oral corticosteroids), against the impact of side effects. It is important to recognise that what may appear as ‘non-compliance’ is often a conscious/strategic choice adopted by a patient. Exploring patients’ experiences in a non-judgemental and open way will help to uncover the true reasons for this apparent non-compliance, enabling the healthcare provider to work with their patient to find solutions that will work for the patient. For more information see Adherence
In addition to medication costs, people with severe asthma experience additional financial costs. These include:
- Long-term medication costs
- Cost to treat/manage medication side-effects
- Absence from work – due to disease burden or clinic appointments/travel
- Associated travel costs, to attend appointments
“I just got to keep working and do overtime….to pay for the medication….it ranges anywhere from $100-150 per week….it all starts adding up really quick”
Video provided by Professor Lorraine Smith and Dr. Daniela Eassey, University of Sydney.
Patient experiences with add-on therapies, such as biologics and macrolides, have shown substantial improvements in quality of life, symptom control, and reductions in exacerbations and healthcare utilisation (Clark et al., 2021; Bever et al., 2024). Biologic treatments also lessen the need for oral corticosteroids; however, the heterogeneous nature of asthma results in variable responses among patients (Lanario et al., 2022). The use of biologics and other add-on therapies has led to remission being recognised as a treatment goal for certain subgroups of patients with severe asthma. Many individuals with severe asthma have described the initiation of biologic therapy as “life changing,” noting that injectable administration was convenient, quick, and provided longer-lasting effects compared to inhaled medications (Lanario et al., 2022; Majellano et al., 2024).
For people living with severe asthma, there can be significant financial impacts on their daily lives. Many people report the inability to do their job, having to retire early or missed opportunities in the workplace due to their inability to carry out tasks or decreased productivity (Majellano et al. 2024). Such absenteeism and loss of productivity impacts workplaces financially. However, employers should have steps in place to help mitigate risk for employees with asthma such as reducing exposure to triggers, Asthma First Aid training, and being upfront about sick leave policies to better support people living with asthma (Asthma Australia, 2025).
