Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to Sanofi's report on the analysis of the relationship between the use of prednisolone for asthma and COPD and social deprivation, published in November 2022, if his Department will take steps to investigate the potential higher prescribing of oral corticosteroids for people living with asthma and COPD in areas of higher social deprivation; whether his Department will make an assessment of the potential merits of (a) taking steps to reduce the higher prescribing of oral corticosteroids for asthma and COPD in the areas of highest social deprivation and (b) introducing a target or incentive for the reduction of maintenance oral corticosteroid use in patients with asthma.

There are no plans to undertake an assessment of the prescribing of oral corticosteroids for asthma and chronic obstructive pulmonary disease (COPD).

Reducing health inequalities amongst people with COPD and asthma is a key cross-cutting focus for NHS England. Respiratory clinical networks have been established to support delivery of the objectives set out in the Long-Term Plan, which includes a particular focus on reducing health inequalities.

The National Institute for Health and Care Excellence and the British Thoracic Society and the Scottish Intercollegiate Guidelines Network (SIGN) provide clear guidance on the prescribing of oral steroids for both COPD and asthma. For both conditions, short courses only are recommended in cases of acute exacerbations.

For people with COPD, NICE do not normally recommend maintenance use of oral corticosteroid therapy. However, some people with advanced COPD may require maintenance oral corticosteroids when these cannot be withdrawn after an exacerbation. In these cases, the dose of oral corticosteroids should be kept as low as possible