Other prerequisites include at least two exacerbations of asthma leading to hospital admission in the past year, a full trial and compliance with treatments outlined in the British Thoracic Society/ Scottish Intercollegiate Guideline Net-work guidelines, and that the patient does not smoke.

If a patient complies with this, they could be referred to a specialist for omalizumab treatment, which is injected subcutaneously every two to four weeks.

This could lead to annual costs as high as £15,400 per patient. But NICE says patients should be taken off the drug at 16 weeks if they show an inadequate response.

Response would be assessed by looking at improvements in daily symptoms and peak expiratory flow rate, reduced need for systemic corticosteroids and fewer unplanned consultations for asthma.

The document is open for consultation until 3 July.

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