Future of asthma care a global expert view - summary - august 2021

The Future of Asthma Care in 2030
A Global Expert Perspective for Challenge and Debate - SUMMARY
August 2021

The Future of Asthma Care
CONTEXT – PROJECT SCOPE

Asthma – A Global Challenge
Asthma is a set of complex chronic conditions that will soon impact around 1bn globally.
Often sidelined, its significance is growing as new diagnostics and treatments are
potentially aligned with digital innovations and deeper understanding across society.

Project Ambition
This collaborative project is looking out to 2030 to explore and define how the
future of asthma care may evolve, and what will be the associated unmet needs.
Building an expert-informed global view is providing rich context and insight.
As we look out to the future of asthma care in
10 years time, what change is predictable, what
is probable, possible and what is uncertain?
How will shifts in the the external world impact the
future of asthma care and unmet needs and how will
these align with internal and sector-driven change?

The Multinational Global Perspective
Over the past few months, dialogue with a wide range of experts has been undertaken to
build a ‘world’ view. As well as clinicians and researchers, interviews have included patients,
policymakers, behavioral and cultural research, extreme sports, the military and economists.

This Document
Ahead of integration of new patient research insights and the publication of a full report,
this document aims to share and connect 22 core foresights gained from over 100
discussions so that others can comment, challenge and so enhance the 2030 outlook.

THE 2030 VIEW OF ASTHMA CARE

Areas of Potential Change for Asthma Care
This is an overview of some of the primary areas that may impact the future of asthma care
by 2030. Based on the extensive dialogue to date, it highlights potential directions for
change across a broad range of issues identified from the global discourse.
A Changing
Landscape
Growing
Prevalence
The Language
of Asthma
The Full
Economic
Burden
Asthma in
Society (and
Politics)
Detailed
Understanding
Integrated
Diagnosis
Lasting Impact
of Covid
The
Anthropology
of Asthma
Accurate
Segmentation
Focused
Treatment
Personalised
Therapy
Adding Omics
Biomarkers
Upgraded
Inhaled
Delivery
Accessible
Biologics
The Patient
Experience
Taking
Holistic
Control
Behavioural
Rethink
The
Community
Pharmacy
Data and
Digitisation
AI-Enabled
Visualisation
Individual Risk
Profiling
Optimising
Existing
Solutions
Industry
Dynamics
Funding
Priorities
Changing
Business
Models
COPD and
Asthma
Cross-Sector
Collaboration

Growing Prevalence
With 1bn asthmatics by 2030, asthma’s prevalence doubles in a decade.
Driven by the effects of global warming, increasing air pollution and rising urban
obesity, demands for more effective health strategies and treatments escalate.

The Language of Asthma
A shared understanding of the spectrum of respiratory health conditions is amplified
by clearer terminology. A repositioning of the ‘asthmas’ may be driven by more
appropriate language that is more aligned to patient realities and cultural norms.

The Full Economic Burden of Asthma
A clearer, fuller and shared view of the socio and economic burden of asthma
in most nations includes all direct and indirect costs. This highlights the
specific areas of potential savings to be gained from key policy changes.

Asthma in Society (and Politics)
The public perception of asthma undergoes a significant shift in many regions.
It is better recognised as it becomes a proxy for wider health and wellness.
Increasing political focus on social and health inequalities put it centre stage.

Integrated Diagnosis
In the absence of a single ‘gold standard’ diagnostic, a combination of established
and new approaches are integrated with supporting data analysis to provide
more accurate and timely assessments of true, not assumed, condition.

Lasting Impact of Covid
While the pandemic itself raised public awareness of respiratory conditions and changed
some attitudes, the most durable lasting effect on asthma may come from long-Covid.
Research is focused on understanding how long-term lung health is most impacted.

The Anthropology of Asthma
The prioritisation of the patent-centric view in healthcare drives a re-evaluation of the lived
experience of the different asthmas. Deeper, richer understanding of how those labelled as
asthmatics manage a complex condition comes to the fore in clinical decision-making.

Accurate Segmentation
Given its complexity and multiple conditions, a cross-sector view of the ‘category’ of asthma
and associated treatments emerges. A more specific segmentation of asthma provides an
anchor for more meaningful communication on triggers and alignment of treatments.

Personalised Therapy
Deeper understanding of the phenotypes, endotypes, biomarkers and alternative endpoints
for asthma helps to better focus precision medicine. A more holistic view of each patients’
challenges and aspirations moves centre stage for individualised medicine and support.

Adding Omics Biomarkers
The integration of multiple omics biomarkers adds a new range of
indicators and delivers a step-change in speed and accuracy of assessment.
As part of a growing suite of diagnostic tools they deepen understanding of the individual.

Upgraded Inhaled Delivery
The much-cited problem of inhaler design and technique is addressed through
planned, shared adoption of proven technologies, but questions on who
funds this and how it impacts reimbursement models slow implementation.

Accessible Biologics
Biologic treatments expand beyond T2 severe asthma to address non-T2 as well as
mild / moderate asthma. Significant access is driven by a reduction in average costs of
treatment so that affordability and return on investment are no longer barriers.

Taking Holistic Control
More people with asthma seek to own their lives and not be defined by labels.
Empowerment, self-management and more accessible credible support all enable a
greater level of control where asthma is part of, not the determining factor of, life.

Behavioural Rethink
Patient / HCP interaction, non-pharmacological treatments and a more proactive view on
the day-to-day is enabled for many within the asthma community. Lessons from other
sectors are leveraged to redefine some of the emblematic characteristics of life with asthma.

The Community Pharmacy
Greater community support for asthma is focused on a more empowered pharmacy.
Supported by better access to patient data, pharmacists take over and improve on some
of the traditional prescription and patient education tasks that sat with physicians.

AI Enabled Visualisation
The application of pattern recognition and deep learning AI significantly improves the
ability to understand asthma in patients and specify treatment. Apps accessing personal,
clinical and proxy data provide HCPs and patients with a clear picture of their condition.

Individual Risk Profiling
The integration of digital biomarkers, personal data and historical trends drives a step-
change in risk stratification for asthma. Consistent, individualised risk profiles are shared to
warn patients of likely flare ups and enable more focused and timely interventions.

Optimising Existing Solutions
Better understanding and application of current diagnostics, treatments and non-drug
support is enabled through sharing existing datasets. Reductions in misdiagnoses,
improvements in efficacy and increases in system efficiency deliver tangible benefits.

Funding Priorities
Asthma remains outside the top 10 conditions for the majority of payers –
other than in those few locations where a wider view of longer-term societal
impact is taken into consideration alongside the core cost to the healthcare system.

Changing Business Models
New treatments, VBHC trials and a more holistic view of asthma’s economic and
social impacts combine to drive the piloting of different approaches to asthma care.
In some regions / systems more integrated business models emerge.

COPD and Asthma
Although traditionally separate in many systems, momentum builds towards
bringing COPD, asthma and other conditions together under respiratory health.
This seeds greater and wider understanding of a range of connected needs.

Cross-Sector Collaboration
Agreement on repositioning asthma in society, developing better treatments and moving
towards a value-driven approach of reimbursement seeds wider cross-sector collaboration
involving all parties, including patients, in a, potentially, more equitable manner.

QUESTIONS AND COMMENTS

YOUR FEEDBACK
To build an informed, global perspective we would very much welcome you comments.
What do you agree with? What do you disagree with? What is missing from this view?
What will be the key emerging challenges to be addressed over the next decade?

Future Agenda 84 Brook Street London W1K 5EH +44 203 0088 141
www.futureagenda.org | @futureagenda

Future of asthma care a global expert view - summary - august 2021

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