Asthma sufferers denied vital jab by GPs who are baffled about who’s eligible
PATIENTS with severe asthma are being left to battle debilitating and potentially fatal symptoms because doctors are failing to prescribe drugs that cut the risk of attacks by up to 70 per cent.
Research suggests less than a quarter of those eligible are benefiting from a new class of asthma medication called biologics.
These injections, needed once every two months, give sufferers an alternative to standard treatments, which can stop working – and also cause side effects that include weight gain, brittle bones and skin rashes.
But the charity Asthma And Lung UK claims that GPs often don’t refer patients to lung specialists who can prescribe biologics because there is confusion over who is eligible. The drugs cost £30,000 a year, meaning all patients must be referred and then assessed before receiving a prescription.
Studies also show that about 40 per cent of those referred were forced to wait more than three years to access the drugs due to a lack of respiratory specialists.
‘Currently people are left at risk of life-threatening asthma attacks, and waiting far too long for a diagnosis,’ says Sarah MacFadyen, head of policy and external affairs at Asthma And Lung UK.
‘This needs to change. It makes no sense to have biologics available if people with severe asthma can’t access them. We are urgently calling on NICE [the NHS spending watchdog] to provide doctors with guidelines on how to spot the signs of severe asthma and when to refer a patient to a specialist.’
About eight million Britons live with asthma, which develops when the breathing tubes that carry air in and out of the lungs become inflamed and narrow – sometimes triggered by allergies or exercise.
For most, symptoms are mild and easily controlled with inhalers, but about 200,000 asthmatics have a severe form of the disease. They are usually reliant on stronger medicines, including powerful steroids which can trigger uncomfortable side effects.
For roughly 60,000 patients, even the steroids are not enough to prevent regular attacks, which often require urgent treatment in hospital. Over the past decade, biologics have offered hope to this group.
Also known as monoclonal antibodies, they work by blocking proteins released by the immune system that actually worsen lung inflammation, as well as causing fewer side effects than steroids.
Joanne Beecroft, 42, was first diagnosed with asthma when she was 30, but when standard treatments failed to control her severe attacks, it still took four years to get biologics. She says: ‘I’d tried all the medications but nothing stopped the attacks. It feels like someone is standing on your chest and your lungs are getting smaller and smaller. It is terrifying.’
In 2019, Joanne was finally prescribed a biologic called benralizumab. ‘I’ve had one attack since and it wasn’t a severe one,’ she says. ‘I’m not wheezing as much as I used to or reaching for my inhaler. It’s unfair how many others are waiting for these drugs.’
Last month The Mail on Sunday revealed that a new biologic, tezepelumab, created to tackle some of the hardest-to-treat forms of asthma, is expected to be approved for NHS use later this year. But doctors say that, too often, Britons who could benefit from alreadyapproved biologics are not being given the option.
‘These are expensive drugs so every eligible patient has to be assessed at a specialist centre before getting a prescription,’ says Dr Andy Whittamore, clinical lead at Asthma And Lung UK and a GP in Portsmouth. ‘There is a shortage of respiratory specialists, so waiting times can be long.’
At present, only 13 hospitals in England and Wales can prescribe and administer the injections. This creates a postcode lottery, where some will wait far longer than others – and many patients will be forced to travel for their injection every two months. Dr Whittamore adds: ‘If you live near one of the centres, you’ll get seen by a consultant much sooner.’
Another problem is GPs often do not know which patients are eligible for the treatment. ‘Biologics are still relatively new and many GPs are unaware of what symptoms qualify someone to receive them,’ says Dr Whittamore.
ONE patient struggling to access biologics is Louise Harwood, 32, who was diagnosed with severe asthma ten years ago. Louise, from Lincolnshire, has such serious asthma that at one point she was having an attack every three weeks. She has twice had to undergo emergency surgery to save her life.
For the past four years she has been taking steroids, but she still suffers regular asthma attacks. The drugs have also left her with side effects including weight gain and skin rashes.
‘I feel like I’m stuck in limbo, taking medication that doesn’t work,’ says Louise. ‘I’ve lost two jobs because of my health and been admitted to hospital countless times. I’m desperate for help.’
In 2020, Louise was finally referred to a specialist centre in Nottingham, but the appointment was cancelled due to Covid. She is still waiting to be seen.
She adds: ‘It seems mad that I’m living with a serious condition that could at any point put me in hospital, but the NHS is in no rush to allow me to access drugs which could give me my life back.’