IS ASTHMA-TREATMENT AFFORDABLE IN DEVELOPING-COUNTRIES

Background - A study was undertaken to assess whether the therapeutic aspects of published international asthma management guidelines are pr actically applicable in developing countries. Methods - Questionnaires were sent to expatriate doctors working in developing countries. Resu lts - Forty one replies were received from 24 countries in Africa and Asia. Oral salbutamol was prescribed ''usually'' or ''often'' by 35 of the 41 respondents, theophyllines by 30, inhaled bronchodilators by 1 2, inhaled steroids by two, and cromoglycate by two. Theophyllines wer e locally available in all 41 cases, oral salbutamol in 40, inhaled br onchodilators in 34, and inhaled steroids (usually beclomethasone 50 m u g) in only 15. Where they were available, the median (range) cost of a beclomethasone 50 pg inhaler was 20% (6.8-100%) of average local mo nthly income, salbutamol inhaler 13% (3.3-250%), 90 salbutamol 4 mg ta blets 3.8% (0.8-75%), and 90 aminophylline 100 mg tablets 4.5% (0.5-70 %). If they were available locally at a cheaper price, 34 (83%) respon dents would prescribe more inhaled steroids and 37 (90%) would prescri be more inhaled bronchodilators. Conclusions - Many asthma patients in developing countries are not receiving adequate treatment because the required drugs are not available in their area or are prohibitively e xpensive.