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

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Future of Asthma Care in 2030

Often hidden by many, asthma is a set of chronic conditions that will, some believe, impact around 1bn of us by the end of the decade. It will see new diagnostics, new treatments as well as gain new social and economic perspectives in many nations. As part of a global Open Foresight programme to bring together an informed outlook for all to use, this is a draft synthesis based on dialogue with 100 experts worldwide. At a time when lung health is front of mind for many, this is an important topic for our future health.

We are keen to understand your view on this. What do you agree with, what is missing and what may need an alternative perspective? Please do share any comments and feedback to douglas.jones@futureagenda.org and we will include everything in the final report that will made available later this year.

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

  1. 1. The Future of Asthma Care in 2030 A Global Expert Perspective for Challenge and Debate - SUMMARY August 2021
  2. 2. The Future of Asthma Care CONTEXT – PROJECT SCOPE
  3. 3. The Future of Asthma Care 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.
  4. 4. The Future of Asthma Care 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?
  5. 5. The Future of Asthma Care 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.
  6. 6. The Future of Asthma Care 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.
  7. 7. The Future of Asthma Care THE 2030 VIEW OF ASTHMA CARE
  8. 8. The Future 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
  9. 9. The Future of Asthma Care 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.
  10. 10. The Future of Asthma Care 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.
  11. 11. The Future of Asthma Care 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.
  12. 12. The Future of Asthma Care 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.
  13. 13. The Future of Asthma Care 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.
  14. 14. The Future of Asthma Care 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.
  15. 15. The Future of Asthma Care 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.
  16. 16. The Future of Asthma Care 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.
  17. 17. The Future of Asthma Care 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.
  18. 18. The Future of Asthma Care 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.
  19. 19. The Future of Asthma Care 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.
  20. 20. The Future of Asthma Care 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.
  21. 21. The Future of Asthma Care 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.
  22. 22. The Future of Asthma Care 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.
  23. 23. The Future of Asthma Care 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.
  24. 24. The Future of Asthma Care 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.
  25. 25. The Future of Asthma Care 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.
  26. 26. The Future of Asthma Care 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.
  27. 27. The Future of Asthma Care 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.
  28. 28. The Future of Asthma Care 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.
  29. 29. The Future of Asthma Care 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.
  30. 30. The Future of Asthma Care 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.
  31. 31. The Future of Asthma Care QUESTIONS AND COMMENTS
  32. 32. The Future of Asthma Care 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?
  33. 33. Future Agenda 84 Brook Street London W1K 5EH +44 203 0088 141 www.futureagenda.org | @futureagenda

Future of Asthma Care in 2030 Often hidden by many, asthma is a set of chronic conditions that will, some believe, impact around 1bn of us by the end of the decade. It will see new diagnostics, new treatments as well as gain new social and economic perspectives in many nations. As part of a global Open Foresight programme to bring together an informed outlook for all to use, this is a draft synthesis based on dialogue with 100 experts worldwide. At a time when lung health is front of mind for many, this is an important topic for our future health. We are keen to understand your view on this. What do you agree with, what is missing and what may need an alternative perspective? Please do share any comments and feedback to douglas.jones@futureagenda.org and we will include everything in the final report that will made available later this year.

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