Regional variation in intensity of inhaled asthma medication and oral corticosteroid use in Denmark, Finland, and Sweden

Figures & data

Figure 1. High-level algorithmic approach to identifying patients with asthma, by treatment intensity.

ATC, Anatomical Therapeutic Chemical Classification System; GINA, Global Initiative for Asthma; ICS, inhaled corticosteroids; LABA, long-acting beta 2-agonists; LAMA, long-acting muscarinic antagonists; OCS, oral corticosteroids. ^aUsers of tiotropium were not excluded. ^bAverage daily ICS dose calculated by cumulative ICS claims ÷ 365 days.

Table 1. Estimated asthma prevalence and treatment intensity by country

	Denmark (N = 5,050,251)	Finland (N = 4,817,818)	Sweden (N = 8,762,767)
All asthma, n (%)	374,167 (7.4)	560,534 (11.6)	711,012 (8.1)
Patients on GINA Step 4–5 treatments, n (% all asthma)	69,811 (18.7)	86,206 (15.4)	115,374 (16.2)
OCS use, n (% of patients on GINA Step 4–5 treatments)
≥1 course	15,747 (22.6)	25,903 (30.0)	53,296 (46.2)
≥2 courses ≥40 mg/day × 7 days	7063 (10.1)	19,819 (23.0)	5754 (5.0)
≥912.5 mg (2.5 mg/day × 1 year)	5525 (7.9)	11,110 (12.9)	11,042 (9.6)
≥1825 mg (5.0 mg/day × 1 year)	3460 (5.0)	4407 (5.1)	5428 (4.7)

OCS, oral corticosteroids

Figure 2. Estimated regional prevalence of patients on GINA Step 4–5 treatments, those on Step 4–5 treatments receiving ≥2 OCS courses, and OCS claims in Denmark. (a) Regional prevalence of patients on GINA Step 4–5 treatments among all patients with asthma; (b) frequency of patients receiving ≥2 OCS courses among patients on GINA Step 4–5 treatments, and frequencies of patients on GINA Step 4–5 treatments dispensed (c) ≥912.5 mg and (d) ≥1825 mg OCS during the 1-year observation period.

Figure 3. Estimated regional prevalence of patients on GINA Step 4–5 treatments, those on Step 4–5 treatments receiving ≥2 OCS courses, and OCS claims in Finland. (a) Regional prevalence of patients on GINA Step 4–5 treatments among all patients with asthma; (b) frequency of patients receiving ≥2 OCS courses among patients on GINA Step 4–5 treatments; and frequencies of patients on GINA Step 4–5 treatments dispensed (c) ≥912.5 mg and (d) ≥1825 mg OCS during the 1-year observation period.

Figure 4. Estimated regional prevalence of patients on GINA Step 4–5 treatment, those on Step 4–5 treatments receiving ≥2 OCS courses, and OCS claims in Sweden. (a) Regional prevalence of patients on GINA Step 4–5 treatments among all patients with asthma; (b) frequency of patients receiving ≥2 OCS courses among patients on GINA Step 4–5 treatments; and frequencies of patients on GINA Step 4–5 treatments dispensed (c) ≥912.5 mg and (d) ≥1825 mg OCS during the 1-year observation period.