Drug therapy is the mainstay of asthma management.
Broadly speaking, medicines are used in three ways to treat asthma:
- to relieve symptoms when they occur
- to control the disease and attempt to prevent symptoms and exacerbations (or "flare ups")
- to treat exacerbations.
The most commonly used class of medicines for relief of symptoms are short-acting beta-agonists (salbutamol and terbutaline). However, rapid-onset, long-acting beta-agonists (formoterol) and short-acting anticholinergic drugs (ipratropium) can also be used for this purpose. Inhaled corticosteroids (beclomethasone, budesonide, fluticasone and ciclesonide) are highly effective at controlling symptoms and preventing exacerbations. Inhaled corticosteroids have long been the mainstay of treatment for exacerbations of asthma.
It is important to note that the medicines used for asthma are also used for patients with other chronic lung diseases, in particular chronic obstructive pulmonary disease (COPD). The data shown here relates to overall supply of these medicines (not specifically for asthma).
The supply of short-acting beta-agonists decreased between 2000 and 2004 and has since stabilised. There has been a progressive decline in the supply of short-acting anticholinergic ipratropium bromide. The latter trend has probably been accelerated by the introduction of tiotropium bromide, a long-acting anti-cholinergic medication that is mainly recommended for use by patients with COPD.
The annual total supply of inhaled corticosteroids has been relatively stable over a long period of time.
Long-acting beta-agonists first became eligible for reimbursement under the Pharmaceutical Benefits Scheme (PBS) in 2000. There was a rapid increase in the use of this class of medicines until 2005.
Reimbursement for prescriptions for leukotriene receptor antagonists has only recently been introduced and only children are eligible. The overall supply of this medicine has been increasing but remains relatively low.
According to PBS data, in 2009, 5.9% of people in Australia had at least one prescription for inhaled corticosteroids. This included 2.2% of those aged 0–4, 4.4% of those aged 5–14, 3.8% of those aged 15–34 and 6.1% of those aged 35–64.
Among persons aged 0–34, more than half of those dispensed inhaled corticosteroids only had one prescription dispensed for this medication during 2009.
People aged 65 and over were most likely to be dispensed inhaled corticosteroids and were most likely to have multiple prescriptions for this medication over the course of the year. Among people in this age group who had at least one prescription dispensed, approximately 30% had seven or more prescriptions for inhaled corticosteroids dispensed during 2009.
Source tables
Respiratory medications (a) supplied by wholesalers and manufacturers, by defined daily dose (DDD) (b) per 1,000 persons per day, 2000–2009
| Year |
Short-acting beta agonists |
Short-acting anticholinergics |
Long-acting beta agonists |
Long-acting anticholinergics |
Inhaled corticosteroids |
Leukotriene receptor antagonists |
| 2000 |
40.5 |
14.3 |
6.1 |
0 |
26.8 |
0.2 |
| 2001 |
38.4 |
13.4 |
9.7 |
0 |
27.7 |
0.2 |
| 2002 |
36.5 |
12.8 |
12.3 |
0 |
27.6 |
0.2 |
| 2003 |
34.5 |
9.0 |
13.2 |
2.0 |
25.6 |
0.3 |
| 2004 |
32.3 |
5.8 |
14.2 |
3.7 |
24.9 |
0.4 |
| 2005 |
32.7 |
4.7 |
15.2 |
4.5 |
24.4 |
0.4 |
| 2006 |
31.1 |
4.4 |
14.8 |
4.9 |
23.0 |
0.4 |
| 2007 |
30.5 |
4.0 |
15.6 |
5.4 |
23.6 |
0.5 |
| 2008 |
31.6 |
3.4 |
16.1 |
5.8 |
23.9 |
0.5 |
| 2009 |
32.1 |
3.1 |
16.2 |
6.0 |
24.0 |
0.5 |
(a) Respiratory medications classified according to the Anatomical Therapeutic Chemical Classification System (ATC).
(b) The defined daily dose is the assumed average maintenance dose per day for a drug used for its main indication in adults.
Source: IMS Health pharmaceutical data.
Proportion of the population using inhaled corticosteroids (alone or in combination with long-acting beta-agonists) by age group and number of prescriptions, 2009
| Number of prescriptions |
0–4 years |
5–14 years |
15–34 years |
35–64 years |
65+ years |
| 1 |
1.2 |
2.4 |
2.1 |
2.4 |
2.9 |
| 2–3 |
0.6 |
1.3 |
0.9 |
1.5 |
3.0 |
| 4–6 |
0.2 |
0.6 |
0.5 |
1.2 |
3.1 |
| 7–12 |
0.1 |
0.2 |
0.3 |
0.8 |
3.2 |
| 13+ |
0.0 |
0.0 |
0.0 |
0.2 |
0.7 |
Note: Data restricted to patients with a government health concession card.
Sources: Pharmaceutical Benefits Scheme 2009 and ABS.