By Rippon Ubhi, General Manager Specialty Care, Sanofi UK and Ireland

Inequalities in COPD Care

It's World Chronic Obstructive Pulmonary Disease (COPD) Day, and as the NHS faces another challenging winter, the case for taking action to address disparities in respiratory care has never been more urgent.

COPD is a common condition and the third most common cause of death worldwide.1 Treatment for COPD is multi-faceted and issues such as inhaler technique, smoking cessation, and antibiotic overprescribing2,3,4 must be considered in conjunction with wider disparities in respiratory care to truly improve health outcomes for people living with COPD.

These disparities exist across socioeconomic background, gender, ethnicity and even environmental factors. Research from several studies has found significant disparities in asthma and COPD patients linked to gender: hospitalisations and even deaths from respiratory failure are more common in women with COPD than men.5 In both COPD and asthma, ethnicity plays a role in your experience and care. Both South Asian and Black British patients are less likely to receive pulmonary rehabilitation referral for COPD compared to white patients.6

Additionally, according to the National Institute for Health and Care Excellence (NICE), there are significant geographic variations in the prevalence of COPD, and it is closely associated with levels of deprivation.7


Oral steroid use in COPD

There are also disparities in how COPD is treatment. Oral corticosteroids (OCS) are commonly used for the management of asthma and COPD, either episodically for managing severe attacks, or chronically as maintenance therapy for people who do not respond well to inhaled therapies.8 It is widely recognised however, that maintenance OCS use should be minimised9, because continuous OCS use increases the likelihood of patients developing debilitating side effects such as hypertension, obesity, and type 2 diabetes.10

Sanofi are determined to close the inequality gap in respiratory care. We commissioned a study to explore whether a relationship existed between social deprivation and the treatment that asthma and COPD patients received. We worked with York Health Economics Consortium to investigate the link between deprivation and the prescribing of OCS.

Our study found there is a nearly 50% difference in prescribing of OCS for patients with asthma or COPD in GP surgeries located in the most deprived areas versus those located in the least deprived areas.11 Not only are patients affected by social, economic and environmental factors, but geography and deprivation can impact treatment too. This World COPD Day, we're calling for meaningful change that bridges the gaps in equitable access, diagnosis and treatment in respiratory conditions.

Breathe Equal

Sanofi UK and Ireland has created the #BreatheEqual campaign to shine a light on inequalities in respiratory care and demonstrate how we are working to prioritise these issues amongst patients, government, industry and the NHS. We want to bring together clinical and patient advocacy voices to raise awareness and explore what alternative models can be created to improve care across the UK. Through true collaboration, our ambition is to see improvements in the recognition, diagnosis and quality of care for those living with respiratory conditions, regardless of location and socioeconomic status, improving the lives of patients long term.


  1. World Health Organization (2020). The top 10 causes of death.
  2. ALUK. What are the treatments for COPD? Available at: chronic-obstructive-pulmonary-disease/what-are-treatments-copd
  3. Bonini M, et al. The importance of inhaler devices in the treatment of COPD. Available at:
  4. Gillespie, D. Associations with antibiotic prescribing for acute exacerbation of COPD in primary care: secondary analysis of a randomised controlled trial. Available at:
  5. Somayaji, R. Chalmers, JD. Just Breathe: a review of sex and gender in chronic lung disease. European Respiratory Review 2022 31: 210111. DOI: 10.1183/16000617.0111-2021
  6. Martin, A et al. Effect of ethnicity on the prevalence, severity, and management of COPD in general practice. Br J Gen Practice. 2012. 62(595): e76-e81. doi: 10.3399/bjgp12X625120
  7. NICE. Quality Standard 10 Chronic obstructive pulmonary disease in adults. 2016. Available at
  8. Sullivan PW, et al. Oral corticosteroid exposure and adverse effects in asthmatic patients. Journal of Allergy and Clinical Immunology. 2017;141(1):110-6
  9. Menzies-Gow A, Canonica G, Winders TA. et al. A Charter to Improve Patient Care in Severe Asthma. Adv Ther. 2018;35:1485-9.
  10. Sullivan PW, et al. Oral corticosteroid exposure and adverse effects in asthmatic patients. Journal of Allergy and Clinical Immunology. 2017;141(1):110-6 
  11. York Health Economics Consortium (2022) - Data held on file

MAT-XU-2305178 (v1.0)
Date of Preparation: November 2023