Over 28 million people in the United States (US) have asthma1,2, with the condition named as the leading chronic disease in children, affecting approximately 4.9 million under the age of 182,3. In the US, asthma is one of the most common and costly diseases, and these stark figures highlight why asthma still matters, even in 2026. This Asthma and Allergy Awareness Month, we are exploring the prevalence of asthma and how advancing technology can make a difference.
Asthma places a significant burden on healthcare and the economy, with annual economic costs between 2008 and 2013 contributing to:
- $3 billion in losses due to missed work and school days,
- $29 billion due to asthma-related mortality,
- $50.3 billion in medical costs.
The numbers prove that asthma is common, but it is important to remember that this chronic condition is also manageable; however, outcomes are not equal, and certain populations are disproportionately affected. These disparities are shaped by a combination of structural, social, biological, and behavioural factors. Structural inequities, such as5:
- Systemic racism,
- Residential segregation,
- Discriminatory policies,
Often influence the conditions in which people live, work, and access care. These, in turn, affect social determinants like income, education, housing quality, environmental exposures, and access to healthcare. While biological factors such as genetics and individual behaviours like smoking or medication adherence play a role, it is these broader social and structural inequities that largely drive unequal asthma outcomes across populations.
The hidden problem: Poor asthma control
Millions of people are diagnosed with asthma, with many of them not having the condition well managed. It is estimated that 44% of children with asthma have uncontrolled asthma6, which can lead to exacerbations and severe asthma attacks.
Many asthma patients rely heavily on rescue inhalers, which relieve the immediate symptoms but do not address the underlying airway inflammation. This quick relief can make patients feel in control of their asthma, but without addressing the root cause, asthma remains uncontrolled beneath the surface.
Another contributor to poorly controlled asthma is misdiagnosis. Asthma is not a single condition; it can be allergic/eosinophilic or non-eosinophilic. If the asthma is not diagnosed correctly, this can lead to ineffective or over/under treatment. If the underlying asthma type isn’t properly diagnosed, the treatment cannot be matched to the disease type.
Additionally, a lack of objective measurement in routine care can affect asthma control. Traditionally, asthma management has relied on:
- Symptoms,
- Patient recall,
- Peak flow.
The problem with just focusing on these points is that clinicians may over- or underestimate control, which leads to escalating or reducing treatment inappropriately. Symptoms do not always reflect underlying inflammation and may lead to missed opportunities for early intervention.
This is where better access to objective, point-of-care tools, such as Fractional exhaled Nitric Oxide (FeNO) testing, is needed. Without objective measurement, asthma care often relies on what can be seen and heard, not on what’s happening at the inflammatory level inside.
What is FeNO testing7?
A FeNO test is a quick, easy, non-invasive way to measure airway inflammation, specifically eosinophilic inflammation. When airways are inflamed, higher levels of nitric oxide (NO) are produced. This gas can be detected in exhaled breath, with higher levels indicating inflammation, making FeNO testing a vital tool for asthma care and management.
With FeNO providing a non-invasive, quick point-of-care test, it can help identify type 2 inflammation and predict steroid responsiveness, helping clinicians see inflammation that symptoms alone cannot reveal.
How FeNO improves decision-making
FeNO fits into the whole asthma pathway; it’s not just a diagnostic tool; it can also help treat and manage asthma. Diagnosing and managing this chronic condition isn’t always straightforward, and in the past, healthcare professionals have relied on guesswork. FeNO testing changes that, it can:
- Support a diagnosis of asthma,
- Guide inhaled corticosteroid (ICS) use,
- Monitor medication adherence,
- Predict exacerbation risk,
- Reduce unnecessary medication escalation.
FeNO is recognised in global guidelines for asthma care and management, with the ATS/ERS guidance positioning FeNO as a practical tool to support diagnosis, guide anti-inflammatory treatment, and monitor airway inflammation, helping clinicians move from symptom-based to more objective asthma care8.
Expanding access to FeNO testing
Objective testing has the potential to transform asthma care, but access remains a challenge. Limited availability outside specialist centres, time constraints in primary care, and geographic inequalities have all contributed to the underuse of tools such as FeNO. The result is a gap between what is possible and what is delivered in everyday care. Advances in technology only matter if people can access them.
Bedfont® Scientific Limited, an innovative MedTech company based in the UK with nearly 50 years of experience in medical breath analysis, has been improving asthma care and management worldwide for over 15 years with its NObreath® FeNO device. Working closely with its US distributor, coVita™, it has been working hard to improve access to FeNO testing by providing a fairly priced, low-maintenance FeNO device.
In 2025, the NObreath® became the allergists’ FeNO device of choice in the US, with Allergy Partners offering FeNO testing with the NObreath® through more than 125 locations in over 20 states. This partnership ensures that FeNO testing is being integrated into routine care, not just specialist settings, allowing more patients to get tested closer to home.
The future of asthma care
This Asthma and Allergy Awareness Month, we want to focus on how early intervention can lead to better long-term outcomes for asthma patients. Advances in technology mean that objective testing, such as FeNO, is more widely accessible, which is vital as biomarker-driven care becomes the standard. FeNO devices like the NObreath® provide clinicians with more insight into underlying inflammation that cannot be seen, enabling improved patient care.
To learn more about the NObreath® FeNO device and how it is improving precision in asthma care, visit the website here.
References
- NCHS/DHIS. NHIS Adult Summary Health Statistics [Internet]. Cdc.gov. 2021. Available from: https://data.cdc.gov/National-Center-for-Health-Statistics/NHIS-Adult-Summary-Health-Statistics/25m4-6qqq/about_data
- NCHS/DHIS. NHIS Child Summary Health Statistics [Internet]. Cdc.gov. 2021. Available from: https://data.cdc.gov/National-Center-for-Health-Statistics/NHIS-Child-Summary-Health-Statistics/wxz7-ekz9/about_data
- Ferrante G, La Grutta S. The Burden of Pediatric Asthma. Frontiers in Pediatrics [Internet]. 2018 Jun 22;6(186):1–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023992/
- Nurmagambetov T, Kuwahara R, Garbe P. The Economic Burden of Asthma in the United States, 2008–2013. Annals of the American Thoracic Society [Internet]. 2018 Mar;15(3):348–56. Available from: https://pubmed.ncbi.nlm.nih.gov/29323930/
- Asthma and Allergy Foundation of America. Asthma Disparities in America [Internet]. Asthma & Allergy Foundation of America. 2020. Available from: https://aafa.org/asthma-allergy-research/our-research/asthma-disparities-burden-on-minorities/
- CDC Archives [Internet]. archive.cdc.gov. Available from: https://archive.cdc.gov/#/details?url=https://www.cdc.gov/asthma/asthma_stats/uncontrolled-asthma-children-2018-2020.htm
- What is a FeNO Test? [Internet]. Aaaai.org. 2021. Available from: https://www.aaaai.org/Tools-for-the-Public/Conditions-Library/Asthma/What-Is-A-FeNO-Test
- Murphy RC, Zhang P, Tejwani V, Khatri SB, Hallstrand TS, Ruminjo JK, et al. Summary for Clinicians: Clinical Practice Guideline for the Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma. Annals of the American Thoracic Society. 2022 Oct;19(10):1627–30.
