Functionality of the B.44 drug programme “Treatment of Patients with Severe Asthma” in 2025 from the perspective of medical centres

Introduction
For over 10 years, the B.44 drug programme, “Treatment of Patients with Severe Asthma,” has been implemented in our country. During this period, both the standards of asthma care and the range of medications available through the programme have evolved significantly. Aim: To gain insight into the experiences, opinions, and challenges associated with its implementation, the Polish Society of Allergology, in collaboration with the Coalition for Asthma Treatment, conducted a survey among representatives of centres participating in the B.44 programme.

Material and methods
An anonymous survey of nine questions was distributed, with a particular focus on potential problems, risks, and practical challenges encountered by each medical centre operating the B.44 programme.

Results
An overwhelming majority of centres reported ongoing patient enrolment using the full range of drugs available within the programme. However, some patients experienced waiting times longer than 6 months before being enrolled at a given centre. Additional difficulties were reported relating to staff shortages, administrative constraints, and financial issues. Representative comments from respondents included: “Insufficient medical staff to run drug programmes”, “Shortage of space and an inadequate number of suitably adapted hospital rooms”, “Shortfalls in Polish National Health Fund payments at the end of last year”, “Programme limit was reached, with only verbal guidance from the Hospital Director”, “Too few doctors qualified to run drug programmes”, “Delays in payments by the Polish National Health Fund”. Furthermore, 24% of centres expressed concern that their eligibility to participate in the programme might be suspended as early in 2025.

Conclusions
The B.44 drug programme remains a highly effective intervention for patients with uncontrolled asthma. Nevertheless, emerging systemic and organisational challenges threaten patient access. This article identifies and addresses these risks of the programme. It is also necessary to begin work on the possibility of expanding the B.44 drug programme to include a broader patient population.