Doctors, parents scrambling after asthma inhaler switch takes popular medication off the market

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For children with severe asthma, the medication is both necessary and lifesaving.

Flovent reduces inflammation in airways of people with asthma. Editor's note: Dr. Edith Bracho-Sanchez is a primary care pediatrician, director of pediatric telemedicine and assistant professor of pediatrics at Columbia University Irving Medical Center.

Bryce Cohen has asthma and wasn't able to make an easy switch to the new generic of the medicine Flovent, his mother said.Bryce lives in New York City and is a patient at Columbia University Irving Medical Center. His family hasn't been able to get the new generic version of Flovent in the past month.

Experts who follow the industry pointed out that the switch happened at precisely the time a provision in the 2021 American Rescue Plan Act went into effect. In it, a change in Medicaid rebates would have caused GSK to have to pay large penalties after increasing the price of Flovent at a rate higher than inflation for years. The penalties could have incurred rebates to Medicaid greater than the price of the drug, meaning GSK would have had to sell Flovent to Medicaid at a loss.

Lovinsky-Desir and I are colleagues from different departments at Columbia. For this story, I also spoke with other pediatricians across the country who reported similar struggles in getting patients the care they need. In addition to the volume of paperwork, when it comes to children with asthma, the process is flawed, Lovinsky-Desir said.

Four-year-old Ana, also a patient at Columbia University Irving Medical Center, has been to the intensive care unit twice, both times requiring continuous positive airway pressure, or CPAP, to breathe. On Flovent, she finally stabilized and stayed out of the hospital, said her mother, Mariluz. GSK said it partnered with Prasco LLC to manufacture and distribute the generic version of Flovent "and Prasco alone determines the market price for those authorized generics."

With Flovent gone, some payers have added the medication Asmanex to formularies. It's an inhaled corticosteroid also aimed at decreasing airway inflammation and is delivered via a metered-dose inhaler, in the same way Flovent is. Within a few days, it was hard to find, Oermann noted, and it's now in short supply around the country.

 

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