Chronic respiratory disease – a growing socio-economic burden

Asthma and chronic obstructive pulmonary disease (COPD) affect over half a billion people worldwide1,2  with the prevalence of both conditions increasing due to environmental, social and behavioural factors.1,3 While effective medications exist, non-adherence to prescribed dose is a major issue, leading to costly exacerbations and hospitalizations. Such is the scale of the problem, global guidelines now recommend monitoring adherence prior to any change in prescription.4

1 WHO FactsheetCOPD 2017.
2 WHO Factsheet Asthma 2020.
3 Nunes C et al. Asthma Res Pract 2017; 3:1. DOI 10.1186/s40733-016- 0029-3.
4 Global Initiative for Asthma.

Economic impact of medication non-adherence in the US


US patient population with asthma1


Estimated US patient population with COPD2


children with asthma are uncontrolled3


adults with asthma are uncontrolled3


severe treated asthma & COPD patients4


asthmatics reported one or more exacerbations in 12 months5


ER visits asthma patients2 & COPD patients6


hospitalisations asthma patients2 & COPD patients6


CPT RPM code physician billable per patient annually7

$433 - $1,500

cost per ER visit for asthma8,9 & COPD10

$5,040 - $9,815

cost per hospitalisation for astma11,12 & COPD10


1 Centre for Disease Control; httpd://

2 American Lung Association estimate based on:


4 Patient Epidemiology sources; GINA/GOLD/Global Asthma Network data 2017 (source AZ Investor presentation)


6 ES Ford. Hospital discharges, readmissions, and ED visits for COPD or bronchiectasis among US adults: findings from the Nationwide Inpatient Sample 2001-2012 and Nationwide Emergency Department Sample 2006-2011 Chest, 147 (2015), pp. 989-998

7 CPT CODE 99453, 99454.99457

8 Pearson WS, Goates SA, Harrykissoon SD, Miller SA. State-based Medicaid costs for pediatric asthma emergency department visits. Prev Chronic Dis. 2014;11:E108

9 Wang T, Srebotnjak T, Brownwell J, Hsia RY. Emergency Department Charges for Asthma-related Outpatient Visits by Insurance Status. J Health Care Poor Underserved. 2014 February ; 25(1): 396–405

10 Dalal AA, Shah M, D’Souza AO, Rane P. Costs of COPD exacerbations in the emergency department and inpatient setting. Respir Med. 2011;105(3):454–460

11 Hasegawa K, Tsugawa Y, Brown DF, Camargo CA Jr. Childhood asthma hospitalizations in the United States, 2000–2009. J Pediatr. 2013;163(4):1127.e3–1133.e3

12 American Health & Drugs Benefits "Inpatient Treatment of Asthma Is Costly: $5000 per Hospitalization Calls for Proper Office Management", 14/02/2019

Hailie® Solution - clinically proven to reduce acute attacks and hospitalisations

Adherium’s Hailie® digital solution comprises patented sensors and proprietary algorithms that track medication delivery, capturing data for clinicians and generating auditable reimbursement reports for payers and providers.

  • Most clinical evidence of any digital respiratory monitor (>85 studies involving 13,000 patients)
  • Clinically proven to improve adherence and outcomes
  • >170,000 devices sold in 30 countries
  • Widest US inhaler market coverage
  • Funded technology upgrade will access US reimbursement

Proportion of asthmatics with difficult to treat / severe asthma

Use of the Hailie® solution improved adherence to preventative medication by 180% and reduced use of reliever medication by 45% in a study of 220 children who were monitored over a 6 month period. Chan concluded the use of an audio-visual reminder inhaler can lead to significant improvements in medication adherence and asthma control in school-aged children with asthma.

Chan et al. Lancet Respir Med. 2015;3:210-219.