SUS changes asthma protocol and opens the way for new treatments that can transform the care of severe patients in Brazil

Asthma still pressures the healthcare system

Currently, Brazil has one of the highest prevalences of asthma in the Americas, behind the United States and Canada. Despite a drop in hospitalizations, from 134,222 in 2013 to 87,707 in 2023, the disease still burdens the public system. Between 2014 and 2021, the average mortality was 1.16 cases per 100,000 inhabitants per year. This number represents about six deaths per day in the country. The highest proportion of deaths occurs among women and people aged 60 or older, while children and adolescents account for 2% of deaths.

Primary care takes on a strategic role

The protocol reinforces that primary care should be the entry point for care. Basic units need to identify symptoms, monitor patients, and refer complex cases to specialized services. Asthma control, however, still faces significant obstacles, such as inadequate diagnosis, incorrect use of inhalers, low adherence to treatment, and lack of reference centers for severe asthma. The excessive use of cortisone without medical prescription also concerns specialists. According to Pizzichini, this frequent use can cause obesity, diabetes, osteoporosis, cataracts, infections, and other problems.

New protocol aims to reduce crises and hospitalizations

The main goal of treatment is to control symptoms, preserve lung function, and prevent crises. The guideline also seeks to reduce hospitalizations and improve patients’ quality of life. To achieve this, managers must organize care flows, reference services, and access to prescribed medications. The lack of a deadline for the provision of new immunobiologicals, however, maintains uncertainties. Given this scenario, the update represents an important technical advance, but its effectiveness will depend on real access to treatment.
After all, how can adequate control of severe asthma be guaranteed without precise diagnosis, available medications, and specialized centers throughout the country?