Concerns over access to breakthrough asthma medicines

Experts said that around 37,000 eligible patients with severe asthma in England are not yet receiving a type of treatment called biologics.

It comes after the UK medicines watchdog approved depemokimab, a new biologic injection for patients with asthma, which only needs to be given twice a year.

The treatment, known as an “ultra-long acting biologic”, is an “add-on” treatment for people over the age of 12 with a certain type of asthma whose symptoms are not controlled by standard care.

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Made by GSK and also known as Exdensur, the drug has been shown to have a 54% reduction in asthma attacks over a year.

The treatment is one of a number of biologics created for severe asthma.

Biologics work using antibodies made from cells in a laboratory, these antibodies target specific cells in the immune system that cause inflammation in the lung.

Researchers said these medicines have “revolutionised the management of severe asthma” by reducing asthma attacks, hospital admissions and steroid use while improving quality of life for patients.

But concerns have been raised about access to these treatments in a study published in the journal Thorax in November.

Researchers, led by experts from University Hospital Southampton, examined data on initiation rates of the drugs.

They found that biologic uptake increased from 738 patients in 2016 to over 21,000 by early 2025.

But they found that an estimated 37,000 eligible patients “remain untreated”.

They also found that initiation rates for the drugs varied “markedly” across different health areas in England, ranging from 20% to 60% of eligible patients in different regions.

They pointed out that higher uptake was seen in areas which have specialist centres, with those who lived closer more likely to have access.

“While biologic use has steadily increased, a large unmet need persists,” the authors wrote.

“Based on our conservative estimate that 1.5% of adult asthma patients require biologic treatment, approximately 66% of eligible individuals are not yet receiving therapy.”

Charity Asthma and Lung UK have called for dedicated respiratory plan to improve access to care.

Professor Nick Hopkinson, medical director at Asthma and Lung UK, said: “A new biologic therapy, which only needs to be taken twice a year rather than every few weeks, has the potential to improve the lives of people with severe forms of asthma.

“These types of ‘biologic’ medications modify the immune response that cause asthma in some people, improving both their day-to-day symptoms and reducing the risk of life-threatening asthma attacks.

“The next step will be for Nice (the National Institute of Health and Care Excellence) to review the evidence around cost and benefit of this drug, to see if it should be offered on the NHS.

“However, at the moment, two-thirds of people with asthma who might be suitable for existing biologic treatment are not yet receiving therapies, with huge variations seen around referrals depending on where someone lives.

“This is why Asthma + Lung UK is calling for a dedicated respiratory plan to improve access to care and reduce the variation of care that people with lung conditions are currently getting.”

Earlier this month the MHRA approved depemokimab for use among asthma patients with “type 2 inflammation characterised by an eosinophilic phenotype” whose asthma is poorly controlled by traditional treatments.

It has also been approved for use among certain patients with severe chronic rhinosinusitis with nasal polyps.

Nice, the NHS’ spending body, is yet to make a decision on whether or not the jab will be made available on the health service in England.

It is understood that the jab will be made available for UK patients to buy privately from early 2026.

In a statement, a spokesperson for NHS England said: “Improving outcomes for patients with respiratory disease is a key priority for the NHS, with the aim of ensuring rapid access to the latest treatments for those with severe asthma.

“That is why there are now four asthma biologics approved by the National Institute for Health and Care Excellence and available on the NHS – patients should reach out to their clinical teams to discuss treatment options available to them.”