Pharmacists’ Unique Role Guides Patients Through Cost-Effective Asthma Treatment

Amid persistent knowledge gaps among many patients with bronchial asthma, pharmacists possess the proper medication expertise to significantly improve patient outcomes through cost-effective treatment.

“Many patients do not understand the fundamental basis of the disease. Asthma is driven by lung inflammation,” David G. Hill, MD, chair of the American Lung Association Board of Directors, said in an interview. “This inflammation can be the result of a variety of triggers, [like] allergies, viral infections, gastroesophageal reflux, air pollution, [and] smoke. Disease treatment consists of therapies that control the inflammation and medications that treat the bronchoconstriction, which occurs as a result of the inflammation.”

Regarding the basic understanding of the disease, as Hill stated, the pathophysiology of asthma is simple. Long-term inflammation in a patient’s airways causes the disease, forcing them to be more susceptible to the aforementioned asthma triggers. When patients with asthma are exposed to the triggers, an asthma attack occurs—otherwise known as bronchospasm or a narrowing of the airways.¹

According to the Mayo Clinic, there are 4 different types of asthma medication categories, including long-term asthma control medications, rescue medications, medications for allergy-induced asthma, and biologics prescribed to further quell inflammation. However, the most commonly used and most effective medications for patients with asthma are anti-inflammatory drugs called inhaled corticosteroids, such as fluticasone (Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex Twisthaler), beclomethasone (Qvar RediHaler), and ciclesonide (Alvesco).²

Despite 1 class of medications significantly carrying the load for effective asthma treatment, adherence, access, cost, and knowledge continue to be an issue for patients and providers in this area.

“Patients often do not understand the difference between controller medications, which treat the inflammation, and bronchodilators, which treat the symptoms,” Hill continued. “They sometimes think that because controller medications do not immediately relieve their symptoms, the medications are not working, and then they discontinue using them.”

While many patients with asthma may understand the significant need for inhalers, their lack of expertise on the medications’ mechanisms can be detrimental to their health. Hill explained there are multiple inhaler techniques to properly utilize the device that patients often don’t fully understand.

Finally, addressing the gaps in patients’ knowledge for treating their asthma, they may also be notably unaware of the various asthma triggers. From limiting allergen exposure to avoiding smoking, vaping, poor air quality, and more, each patient should fully understand the ways to avoid and prevent exposure to these triggers. According to Hill, some of those actions include “handwashing, mask wearing, and vaccination to limit infectious illnesses.”

While Hill is an expert on all topics around lung and respiratory health, pharmacists too have the unique positioning to address the aforementioned patient knowledge gaps on a population-level scale.

“Pharmacists can help teach patients proper inhaler technique. They can monitor for therapeutic duplication, particularly after acute hospital stays, when patients may be started on different medications due to formulary decisions,” said Hill. “Pharmacists have the ability to identify poor adherence and overutilization of rescue medications early, inform other respiratory care providers of the patient’s status, [and] identify potential therapeutic duplication or drug interactions and inform providers.”

With all of these resources available to 90% of all US patients at community pharmacies,³ pharmacists can play a monumental role in improving asthma care across the nation. Along with pharmacists’ ability to collaborate across the health care sector and tap into other providers’ expertise to improve asthma care, community pharmacists also have the incomparable ability to properly manage the cost of asthma medications.

“The high cost of asthma medications is a burden and obstacle to care for a large number of patients,” Hill said. “Prescribing practitioners often are able to identify medications [that] are on a patient’s insurance plan but are usually not privy to the actual out-of-pocket costs a patient will pay. Pharmacists have better access to this information and have a unique ability to help guide cost-effective treatment to the patient.”

Pharmacists have authoritative knowledge, not only on the variety of asthma medications and devices themselves but also regarding their costs, availability, and general avenues for getting patients safe and effective treatment options that won’t burden their financial standing.

For a disease that impacts 6.5% of US children and 8.6% of adults,⁴ pharmacists should be a necessary resource for patients across all communities. With their positioning and knowledge, pharmacists can conveniently fill in gaps that are not sustainable for asthma care across US health care.

References

1. Asthma. Cleveland Clinic. Updated June 18, 2025. Accessed October 30, 2025. https://my.clevelandclinic.org/health/diseases/6424-asthma

2. Asthma medications: know your options. Mayo Clinic. July 2, 2024. Accessed October 30, 2025. https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma-medications/art-20045557

3. Berenbrok LA, Tang S, Gabriel N, et al. Access to community pharmacies: a nationwide geographic information systems cross-sectional analysis. J Am Pharm Assoc (2003). 2022;62(6):1816-1822.e2. doi:10.1016/j.japh.2022.07.003

4. Asthma. CDC National Center for Health Statistics. Updated July 22, 2025. Accessed October 30, 2025. https://www.cdc.gov/nchs/fastats/asthma.htm