OBJECTIVES: To determine economic burden of short-acting β2-agonist (SABA) overuse in Türkiye from payer perspective with respect to updated GINA 2022 treatment recommendations.

METHODS: A total of 3,034,879 asthma patients including 525,034 (17.3%) mild asthma patients (0.3 exacerbations/year) and 2,509,845 (82.7%) moderate-severe asthma patients (1.3 exacerbations/year) comprised the study population, via estimations extrapolated from the Türkiye arm of the global SABINA III study. Patients were categorized by their SABA prescriptions with over-prescription defined as ≥ 3 SABA canister prescriptions/year. The economic burden (costs related to the drug and exacerbations) was compared in subgroups of overall (≥0 canisters/year) vs. GINA-recommended (0-2 canisters/year) SABA use, as well as in subgroups of appropriate use (0-2 canisters/year) vs. overuse (≥ 3 canisters/year) with extrapolation of SABINA Türkiye data to Türkiye asthma population. Monetary results were converted by using CBRT March 2023 effective buying rate (20.27 TL/€).

RESULTS: The cost burden of overall SABA use with respect to GINA-recommended SABA use in mild asthma and moderate-severe asthma patients was calculated to be €20.43 million and €427.65 million in terms of exacerbations, and to be €829,352 and €7.20 million in terms of drug costs, respectively. The total economic burden arising from not applying recommended SABA use was estimated to be €456.11 million. Considering appropriate use vs. SABA overuse subgroups, SABA overuse in mild and moderate-severe asthma patients was estimated to yield an additional cost of €16.38 million and €385.59 million, respectively in terms of exacerbations, and a total €11.30 million additional drug cost. The overall economic burden arising from SABA overuse was estimated to be €413.27 million.

CONCLUSIONS: The estimated total economic burden arising from not applying GINA recommended SABA use indicates that SABA overuse yields considerably high costs for the Turkish Healthcare System, corresponding up to 26% of the total direct cost of asthma reported in our country.