Go to the mobile version of this Web site.

Login | Contact Us | Site Map | Paid archives | Electronic edition | Subscription Questions | Extras

The inhaler squeeze

Rocky Mountain News

Published November 22, 2008 at 12:05 a.m.

Text size  

More Editorials

More stories »

As the air gets chillier, asthmatics will be reaching for their inhalers with increased frequency. But that shortness of breath might be exacerbated by the sticker shock from being forced to purchase more environmentally friendly medicine.

Back in 2005, the Food and Drug Administration mandated that inhalers containing chlorofluorocarbon propellants would be phased out ending Dec. 31, 2008. After that, there will be no more marketing, sales or production of the traditional inhalers - and, as it happens, no more generics for asthmatics and sufferers of chronic obstructive pulmonary disease to rely upon.

The American Academy of Allergy, Asthma & Immunology, while pushing the switch as necessary to help the planet, noted that hydrofluoroalkane (HFA) albuterol would cost anywhere from $30 to $60, depending on insurance coverage, as opposed to $5 to $25 for generic albuterol. And according to the academy's statistics, that should add up to a pretty penny: About 20 million Americans have asthma.

Prescription drugs to treat asthma cost about $5 billion each year. According to The New England Journal of Medicine, that includes about 52 million albuterol prescriptions filled annually - which will mean $1.2 billion in extra annual health costs once the HFA transition is complete.

To make the pill go down easier, drug companies have been offering coupons for the new inhalers, or financial assistance if patients meet certain uninsured, low-income guidelines. But sooner or later everyone will get stuck with a bigger bill.

And it's not just cost. Complaints from HFA users have ranged from the inhaler clogging more often and just not delivering the same level of relief (users who report having to take more puffs have been told by the FDA that the finer particles in HFA inhalers are actually better absorbed), to allergic reactions to the corn ethanol used in several of the new propellants.

It's easy to suspect that the switch had to do with more than just the ozone layer: GlaxoSmithKline, which began producing the environmentally friendly Ventolin HFA in 2002, and Schering-Plough, which introduced its Proventil HFA in 1996, didn't compete very well against the standard generic CFC albuterol until the FDA mandate came into play and consumers were left with no choice.

Ironically, the amount of CFCs released by inhalers has been comparatively tiny: about 1,200 tons a year, out of the 1.8 million tons released into the atmosphere when the Montreal Protocol environmental treaty was drafted in 1987.

Regardless of the FDA's motive in eliminating generic inhalers, though, it was difficult to foresee our current economic straits. The responsible thing to do now would be to indefinitely postpone the phase-out deadline, giving doctors and consumers the option of choosing which life-saving remedy is best for their symptoms and their pocketbooks.

Offering such choice would be a bold move to let patients come first in health care - as opposed to bureaucrats' priorities. That would be enough to let us all breathe a bit easier.

Comments

  • November 22, 2008

    5:59 a.m.

    Suggest removal

    slocatch writes:

    What realy hurts is the noxious weeds that have taken over the lush lawns that Denver was once known for. It really effects citizens with breathing problems. A real shame that one must use a steriod to gain a breath, because her neighbors will not cut or water the lawn. The Codes were developed with health in mind, over the past 20 years compliance of those Codes have been extremely negated.

  • November 22, 2008

    6:24 a.m.

    Suggest removal

    Mike_In_Hartsel writes:

    The FDA needs to be modernized.

    The "necessary to help the planet" is a load of manure. They cannot point to one hard fact that what they are doing will actually have an effect. It's ALL conjecture, smoke and mirrors. It's a fraud until PROVEN otherwise.

  • November 22, 2008

    9:08 a.m.

    Suggest removal

    DougH writes:

    The formulation for Albuterol actually was changed a couple of years ago, and yes, the price I paid went from about $ 9.00 to $ 30.00. for the same medicine , only with a different delivery propellant.

    I am still getting the very same Albuterol medication and I am quite sure that it did not cost millions to make the change. The Pharmco industry just found a way to make more money and misuse their monopoly power..

    It is always fun to blame the government, but the likelihood is that this change was pushed by lobbyists for pharmacy companies who seemed to have full reign in the Bush administration.

    The Rocky is correct that the responsible thing to do would be to indefinitely postpone the phase-out deadline.

  • November 22, 2008

    11:56 a.m.

    Suggest removal

    sponsor writes:

    The HFA metered-dose inhalers (MDIs) are NOT more "environmentally-friendly" than CFC MDIs; the HFA-134a propellant is SO much worse than CFC-11,12 in terms of Global Warming Potential that it has already been targeted for reduction by the Kyoto Protocol. And CFC emissions from MDIs at their peak global usage never accounted for more than .08% of peak global CFC emissions from all sources. Even HFA proponents (the honest ones) admit that the CFC MDI ban is PURELY POLITICAL- it has NO basis in science or medicine.

    Thousands of US patients as well as patients from all over the world (including patients who are MDs, PhDs, RNs and RRTs) can NOT tolerate HFA MDIs, and we're not just talking about albuterol. Other once great CFC MDI drugs for asthma patients have been DESTROYED by the HFA reformulation. This is a FACT. We've gotten serious medical complaints about HFA MDIs from Russia, France, England, Australia, New Zealand. The CFC MDI ban is an extreme example of junk science gone wild.

    We encourage all interested individuals to join our campaign to save these HARMLESS, LIFESAVING CFC MDIs by signing our petition here:

    Arthur Abramson
    The National Campaign to Save CFC Asthma Inhalers
    sponsor@savecfcinhalers.org
    www.savecfcinhalers.org
    http://www.ipetitions.com/petition/sa...
    or google "save CFC".

  • November 22, 2008

    7:43 p.m.

    Suggest removal

    Sweetpickle writes:

    Isn't this just "free enterprize" at work ?

  • November 22, 2008

    11:09 p.m.

    Suggest removal

    hoopoe36 writes:

    Is there a foreign country where CFC MDIs are still available?

  • November 23, 2008

    4:07 a.m.

    Suggest removal

    sponsor writes:

    Yes, between now and the end of the year Warrick CFC is available at Gillespie's Rx in Ohio ($30, cc only, no insurance- December 2008 exp. date only, though) and Ventorlin CFC salbutamol (salbutamol is what the rest of the world calls albuterol) (note: NOT Ventolin, "Ventorlin") is available from alldaychemist dot com in India at $3 a pop- (April/May 2010 exp.dates) and in our opinion, it's excellent (it's made by GlaxoSmithKline).

  • November 23, 2008

    9:14 a.m.

    Suggest removal

    hondaelite4 writes:

    You can go to "proair HFA" and get 5 $20 coupons you take to your pharmacist. Might help some people out.