Solving the £260m inhaler problem

It’s hard to believe that only 10 years ago, there were only a handful of inhaler devices.

Since then, the inhaler landscape has become much more complex and expensive. We’re now approaching 150 unique device and steroid combinations.

The rise in devices coincides with a rise in demand. Each year, the National Health Service (NHS) spends over £260m on inhalers. And four of the five most expensive drugs are respiratory inhalers.

The complex world of inhalers

GPs and health professionals also need to keep up. Not just with inhalers and spacers but also with changes to national guidance - the pathways.

So choosing the right inhaler means …

Picking the right point on a pathway

Knowing which inhalers are available at that point

Knowing what their patient can use - if they have arthritis can they really work a pump inhaler

And keep cost in mind.

It’s a LOT.

The challenge for patients

For patients, it’s similarly complicated. Research showed that only 25% of patients received training in how to use their inhaler. Those that did receive training, often found it inadequate.

If an inhaler is used incorrectly, a large amount of the drug is wasted. Worse still it can lead to an acute attack and a trip to hospital.

That’s three large issues to solve

• GPs knowing what to prescribe
• Patients knowing how to use their inhaler
• The NHS keeping a handle on rising cost

But how?

Our clients at the London Procurement Partnership were aware of the problem and brought together a team from across London

• UK Medicines Information (UKMI)
• London Respiratory Network (LRN)
• The Association of the British Pharmaceutical Industry (ABPI)
• Imperial College Health Partners

to collaborate on funding and solution.

At the time we had been working closely with a London Healthcare Innovation lab on an app to improve clinical handover in Secondary Care and that mix of digital experience and healthcare experience made us an ideal fit

Responding to user needs

We adopted an Agile way of working across the team. For many it was their first experience of Agile, so we used Kanban and spent time educating the team on the various ceremonies. Pretty soon we had a good rhythm - delivering features, reviewing, and releasing.

The final platform contains all the current inhalers and spacers in the market.

It’s built around the primary user needs. GPs have a rich search interface. They can filter by the stage in the patient pathway, to get the correct therapy by national guidance. They can further filter by patient or device characteristics to get the right match for the patient.

With the right inhaler selected, they can follow the same process for spacers before sharing the target inhaler with the patient so as soon as they download the app, it has their inhaler with details in how to use it right there in the app.

The information for each inhaler is as rich as the collection of inhalers, showing

• clear images to help patients identify an existing inhaler
• prescribing and cost information
• device characteristics
• which pathway steps the inhaler is suitable before
• national taxonomy alignment with dm+d
• full prescribing risk data taken from First Data Bank

Success for patients and clinicians

The results speak for themselves. Right Breathe has high-adoption across the NHS and patient community and is regularly praised by patients and medical staff.

We were able to go from a simple idea to a rich application platform that really helps users. If we can help you in the same way. Get in touch.