PCRS Warns Against the Dangers of Online Sales of Salbutamol Inhalers
United Kingdom, Thursday 10th April
The Primary Care Respiratory Society (PCRS) and Asthma + Lung UK call for urgent action to address the growing number of online pharmacies selling salbutamol inhalers without appropriate medical oversight. This practice not only undermines safe prescribing but also poses serious risks to public health.
Online sales of salbutamol inhalers allow anyone to obtain the medication without a confirmed asthma diagnosis or the necessary clinical assessment. Alarmingly, this includes people who may not require the medication at all, as well as those who should be on alternative, more effective treatments in line with the latest national asthma guidelines1. The result is a significant risk of overuse and misuse.
Salbutamol is a short-acting beta-agonist (SABA) intended for short-term symptom relief but should be required rarely. Salbutamol alone is not a treatment for asthma; the mainstay of asthma treatment and control should be regular preventer medication. Failing to address symptom control through appropriate evidence-based preventer treatment containing inhaled corticosteroids contributes to excessive reliance on SABA inhalers. This ultimately increases the risk of poor control, asthma attacks and preventable deaths. In 2014, the National Review of Asthma Deaths2 highlighted that excessive reliever (SABA) prescribing was widespread in the deaths investigated, with 56% having received more than six inhalers in the 12 months before their death.
A particular concern is the lack of safeguards in place when purchasing these inhalers online. Online pharmacies state that they rely on patient-provided information. This approach fails to account for individuals who are unaware of the correct asthma treatment pathways, may not have a diagnosis of asthma, may not have received appropriate training in how to use their inhalers, or who may be ordering excessive quantities without triggering any regulatory flags. This loophole exacerbates the issue of overuse and does little to prevent patients from slipping through the cracks of proper asthma care.
PCRS urges greater regulatory scrutiny and legislative change to close these dangerous gaps. While we recognise that addressing this issue will require policy reform, we cannot ignore the immediate risk posed by online sales of SABA inhalers without appropriate supervision and consultation with healthcare professionals. Public health messaging must reinforce that SABA inhalers are not a standalone asthma treatment and should only be used under the guidance of a healthcare professional.
Furthermore, recent media coverage3 has misrepresented changes in asthma treatment recommendations, incorrectly framing them as being environmentally driven rather than clinically necessary. While sustainability is important, the shift away from excessive SABA use is primarily based on improving patient outcomes and aligning with best clinical practices as recommended in the National Guideline for the Diagnosis and Management of Asthma published in November 20241.
PCRS is committed to working with regulators, policymakers, patient groups and the media to protect patients from the dangers of inappropriate asthma treatment. We call on all stakeholders to support tighter controls on online pharmacy sales and to help spread accurate information about asthma management to ensure patient safety remains the priority. PCRS has produced a simple short video to help healthcare professional and patients understand the importance of appropriate treatment – see www.pcrs-uk.org/resource/asthma-myths-i-only-really-need-my-blue-inhaler.
Best practice guidance on online SABA sales is now available at: https://digitalclinicalexcellence.com/best-practice-guidelines
About PCRS
The Primary Care Respiratory Society (PCRS) is a UK-based organisation dedicated to improving respiratory care through education, advocacy, and clinical excellence. They work to support healthcare professionals in delivering high-quality, evidence-based respiratory care to patients. For more information, visit www.pcrs-uk.org.
About Asthma + Lung UK
Asthma + Lung UK is the only charity in the UK fighting for everyone with a lung condition, aiming for a world where everyone can breathe with healthy lungs. We fund cutting-edge research, and provide advice and support for the 12 million people who will get a lung condition during their lifetime. We also campaign for clean air and for better NHS diagnosis and treatment. For further information visit www.asthmaandlung.org.uk.
References
1. www.nice.org.uk/guidance/ng245
2. www.rcp.ac.uk/media/i2jjkbmc/why-asthma-still-kills-full-report.pdf
3. www.thetimes.com/uk/healthcare/article/gps-told-to-stop-prescribing-blue-inhalers-that-harm-the-planet-j5mvrd3k3