The National Implementation Committee of the Quality and Sustainable Asthma-care Roadmap – ‘NICQSAR’ – is a world first, multi-stakeholder, national collaboration, that will drive systems change to deliver better asthma outcomes and reduce the contribution of asthma care to climate change.
This World Asthma Day, NICQSAR is calling for fresh investment in systems solutions that are uniquely available now, to better support people with asthma to access best treatment based on latest evidence, with inhalers that are better for our environment.
Among the 2.8 million people in Australia with asthma, more than half are likely enduring excessive symptoms and burden from their condition. This has been the status quo in asthma for decades, predominantly due to the underuse of preventer inhaler use, and in addition to the profound cost to individuals, imposes a significant financial cost on the health system.
Additionally, recent global research has revealed the substantial planetary impact of this public health challenge, where poorly controlled asthma and high global-warming-potential hydrofluorocarbon (HFC) propellants in pMDIs contribute to rising greenhouse gas load, and global warming.
The implementation plan, if funded, will deliver on the 8 goals from the recently published National Sustainable Asthma Care Roadmap – Roundtable Report which include:
- Develop policies to improve access to evidence-based, clinically effective medicines, for high quality, and low emissions care.
(NICQSAR congratulates the Australian government for the improvements that have come from 60 day prescribing and the reduced OOP cost for prescribed medicines to $25 from Jan ’26). - Establish a national data dashboard to monitor progress towards high-quality, low-emissions asthma care.
- Supporting improved asthma medicine prescribing via:
– Processes to ensure clinical guidelines are updated and consistent resources developed for prescribers and consumers nationally
– Using digital tools to enable easier prescribing and personalised asthma plan development
– Education and raising consumer awareness to make the best self-management choices and improve asthma control - Research to implement and evaluate high-quality and sustainable asthma care
- Safe device disposal and recycling to reduce propellent leakage from discarded inhalers
- Advocacy for ‘health in all policies’, e.g. reducing air pollution, to decrease asthma risks
The committee particularly highlights the global shift in best practice asthma care, which will be reflected in the forthcoming National Asthma Council guidelines, recommending combination inhaler medicines including an anti-inflammatory from day one. This management approach is preferred by most people with asthma, is easier (as only one inhaler is needed), and results in improved outcomes with less oral steroid courses and hospital admissions. Further, at a societal level, improved asthma outcomes are associated with a reduced environmental impact from use of rescue inhaler therapy. The environmental benefits of this new approach to asthma are further increased by the use of dry powder inhalers.
Committee member Dr Mike Forrester, from Deakin University’s Institute for Health Transformation, and paediatrician at Barwon Health, Victoria, reflects on how important this movement is for patients in his care, and for clinicians in the system who want to see their patients stay healthy.
“It’s really exciting to have the asthma care sector working together at a system level to make better treatment easier for prescribers and consumers. The evidence for using combination inhalers as your reliever has been building for several years, the moment is now, with treatment guidelines lining up with this evidence to drive a new standard of care to improve outcomes for people and planet”.
Anthony Flynn, Director of Knowledge Management and Translation at Asthma Australia, also acknowledges the confluence of opportunities in today’s context that should inspire us to imagine better outcomes for people with asthma.
“Asthma Australia has for decades applied itself to support consumers access better care and make better self-management decisions,” he says. “We have been applying behaviour change methods and using innovative communications strategies to try to achieve this but inevitably the systems obstacles have been too great and people have been relegated to an old-fashioned standard of care and the unsatisfactory outcomes it produces.”
Acknowledging the strong connections to the GINA theme of making inhalers accessible to all, and that of Asthma Australia urging stewardship of oral steroids (through better asthma care), NICQSAR invites all stakeholders to consider how they might engage with this effort, to support the work of the national committee and drive towards better outcomes that people with asthma deserve.
Read more about Dr Mike Forrester’s research.
