Question to the Department of Health and Social Care:

To ask His Majesty's Government how many plastic spacers for asthma inhalers (1) have been prescribed, and (2) at what cost, in each of the last five years; what guidance there is on how often such spacers need to be replaced; when such guidance was given to providers in the NHS; and what assessment they have made of the cost to the NHS of the implementation of this guidance.

The following table shows the total number of prescription items, quantities and Net Ingredient Cost (NIC) of spacer/holding chamber devices that were dispensed in England regardless of where prescribed from January 2019 to November 2024:

Source: NHS Business Services Authority (NHS BSA)

Notes:

1. Data was based on the information within the Prescription Cost Analysis published statistics, using Part IXA of the Drug Tariff for Spacer/Holding Chamber device as the basis to provide a list of spacer products held in the NHSBSA drn+d database
2. Items have been dispensed, but not necessarily prescribed, in England.

Information on how to look after a spacer device is included in the patient information leaflet that is provided to patients with their device. This can be found in the section on how to look after the device and includes cleaning and storage instructions as well as advice on when the device should be replaced. The general advice for the spacers available in the United Kingdom is that they should be replaced after one year.

Guidance for patients on device replacement can also be found on patient support websites such as Asthma and Lung UK which includes similar advice: ‘You should replace your spacer at least every year, especially if you use it daily, but some may need to be replaced sooner – ask your GP, nurse or pharmacist if you’re unsure.’

Guidance for healthcare professionals can be found on the Right Breath website and on the NHS clinical guidance page which recommend that all spacers should be replaced annually while the British National Formulary which provides healthcare professionals with up-to-date information about the use of medicines recommends that spacer devices should be replaced every six to 12 months.

NHS England is not aware of any additional clinical guidance it has issued, other than that contained in the product information, about replacing spacers.