This is an archive article published on May 3, 2022

Over 90% of asthma patients in India do not receive the right medication

The country has an estimated 34.3 million asthmatics, that is 12.9% of the global 262 million cases.

4 min readPuneMay 3, 2022 03:33 AM IST

Every year, 4.61 lakh people die due to asthma in the world, and India contributes to 1.98 lakh deaths. (Getty Images/Representational)

INDIA CONTRIBUTES to 42 percent of global asthma deaths, according to a report published online in Lung India journal related to respiratory medicines on Tuesday. While inhaled corticosteroids (ICS) is a standard treatment, authors of the study have said that the main reason for the rise in deaths is that 90 percent of asthmatics do not get the right medication.

The country has an estimated 34.3 million asthmatics, that is 12.9% of the global 262 million cases. Every year, 4.61 lakh people die due to asthma in the world, and India contributes to 1.98 lakh deaths. This is indeed very worrying, and it was important to identify the cause for this, Dr Sundeep Salvi, Director of Pulmocare Research and Education (PURE) Foundation and the lead author of the study, told The Indian Express.

“We conducted an in-depth analysis earlier this year after obtaining the sales of inhaled corticosteroids (ICS) in India from the IQVIA (Intercontinental Marketing Services and Quintiles), an authentic source of drug sales in the country. This was compared with the expected sales of inhaled corticosteroids. For the 34.3 million asthmatics in India, the total sales of inhaled corticosteroids should be 384 million units, but the actual sales in 2020-21 were only 26.4 million units. This means that more than 90% of asthmatics in India do not receive the right asthma medication, Dr Salvi pointed out.

According to the latest data from the Global Burden of Diseases (GBD) study in 2019, states of Uttar Pradesh, Bihar, Odisha are among the top three with the highest number of asthmatics. However, the number of ICS units sold here were clearly inadequate for the number of patients with the disease. For instance, the number of asthmatics in Uttar Pradesh is 40.83 lakh. While the expected sales of ICS should have been 49 million units according to the study, only four million units were sold. Similarly, Bihar has 31.42 asthmatics and the expected sale of ICS is around 37.7 million units. According to the study, the sale was only 1.9 million units.

Inhaled corticosteroids (ICS) are the mainstay of asthma treatment in the world. They reduce the underlying inflammation in the airways, which is the characteristic feature of asthma, and reduce the airway swelling, spasm and mucus hypersecretion. ICS use has been shown to reduce asthma deaths and suffering in the western world. The number of asthma deaths in the world are actually declining, but in India asthma deaths have increased significantly over the past three decades, most likely due to underuse of ICS, and overuse of the inhaled bronchodilator drugs, Dr Salvi said.

In most cases, doctors treating asthma patients do not prescribe ICS. When prescribed, many patients do not take it because of myths, misbeliefs and fears associated with ICS. Among those who take ICS, they do so on an irregular basis. Also, most public hospitals do not have ICS in their formulary. Therefore, doctors cannot or do not prescribe ICS for asthmatics. Most medical college hospitals do not have ICS in their pharmacy and according to Dr Salvi, undergraduate and postgraduate students do not learn to prescribe the right medications for the asthma patients.

It is inhaled bronchodilators which give immediate relief that are the most widely used inhaled medications for asthma. However, they do not reduce the underlying inflammation and therefore make the disease more chronic. May 3 is recognized as the world asthma day to create awareness about this important disease that causes immense suffering and death. All asthmatics must receive inhaled corticosteroids as a standard treatment. This not only reduces the risk of dying, but also improves quality of life and reduces suffering, Dr Salvi added.

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. ... Read More

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