Scottish Longitudinal Study
Development & Support Unit

Cancelled Projects

Project Title:

Identifying the true cost of asthma in the UK: secondary analyses of national stand-alone and linked databases in England, Northern Ireland, Scotland and Wales

Project Number:



Mome Mukherjee (Health Services Research Unit, University of Edinburgh)
Chantelle Anandan (University of Edinburgh)
Andrew Stoddart (Health Services Research Unit, University of Edinburgh)
Brian McKinstry (Health Services Research Unit, University of Edinburgh)
Aziz Sheikh (University of Edinburgh)
Chris Dibben (University of St Andrews)

Start Date:

19 July 2013


Asthma is a common long-term condition that is associated with considerable morbidity, costs to the NHS and society and, in some cases, mortality. The UK ranks as having amongst the highest prevalence of asthma in the world (ISAAC, 2011). Through analysing high quality data from each of the four nations in the UK and by undertaking novel data linkages, we plan to better understand the epidemiology of asthma (and where possible, different asthma phenotypes), health and social outcomes and NHS and social care expenditure on asthma and estimate the wider costs to society. This mapping will allow us to identify data gaps, undertake economic modelling to, where possible, fill these gaps, and support research into how service changes or improvements could lead to better and more cost-effective care for patients with asthma.

Our previous review of the burden of asthma and allergy estimated a spend of >£1 billion/year by the NHS in England and Wales, these costs accruing in the main from prescribing, hospital admissions and primary care consultations (Gupta et al., 2004). Our analysis for Scotland revealed direct healthcare costs to be in excess of £130 million (Anandan et al., 2009). We however noted that these were substantial under-estimates because we were at the time unable to obtain data on out-of-hours, accident and emergency and out-patient prescribing and in-patient procedure costs. A recent systematic review looking at the economic burden of asthma (Bahadori et al., 2009), found that the costs associated with asthma are increasing globally, hence the need to update our earlier NHS cost estimates. These figures also need to be complemented with data from Northern Ireland in order to generate UK-wide estimates. There is in addition the need to calculate costs associated with social care provision and estimate the wider societal costs of asthma.

The overall aims of our study are in the context of asthma:

  1. produce a detailed, state-of the-art overview for the UK and its member countries (i.e. England, Northern Ireland, Scotland and Wales) estimates of prevalence, healthcare utilisation and outcomes;
  2. estimate health, social and societal costs;
  3. identify remaining information gaps and explore the feasibility of filling these evidence gaps; and
  4. provide insights into future research that has the potential to inform changes in policy and care provision leading to the provision of more cost-effective care.


  1. ISAAC 2011. The Global Asthma Report 2011; International Study of Asthma and Allergies in Childhood and the International Union Against Tuberculosis and Lung Disease (The Union).

  2. GUPTA, R., SHEIKH, A., STRACHAN, D. P. & ANDERSON, H. R. 2004. Burden of allergic disease in the UK: secondary analyses of national databases. Clin Exp Allergy, 34, 520-6.

  3. ANANDAN, C., GUPTA, R., SIMPSON, C., FISCHBACHER, C. & SHEIKH, A. 2009. Epidemiology and disease burden from allergic disease in Scotland: analyses of national databases. JRSM, 102, 431-442.

  4. BAHADORI, K., DOYLE-WATERS, M., MARRA, C., LYND, L., ALASALY, K., SWISTON, J. & FITZGERALD, J. M. 2009. Economic burden of asthma: a systematic review. BMC Pulmonary Medicine, 9, 24.

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