Asthma inhaler change: Switch to albuterol HFA increases price; government mandates the cause

by James Hubbard, M.D., M.P.H.

Unless you have asthma, you probably don’t know the cost of inhalers doubled starting the first of the year. This wasn’t due to market factors or greedy pharmaceuticals, nor did it improve quality of or access to health care.  It was due to a government regulation, just like the regulations on the mortgage, auto and airline industries that have contributed to their bankruptcy.

Millions use albuterol inhalers on an as-needed basis to relax and open up bronchial airways.  They’re essential to have on-hand and can be lifesavers.

Until December 31, 2008, one generic albuterol inhaler cost around $20 and I’m guessing it lasted an average of three to six months.  The problem is the propellant used to spray the medicine contained chlorofluorocarbons (CFC),which damages the earth’s ozone layer.  National and international agreements banned these about 20 years ago but gave medical inhalers a few years to phase it out.  December 31 was the deadline.

Hydrofluoroalkane (HFA) is the new environmentally friendly propellant.  The spray doesn’t come out as forcefully as the ones with CFC, but studies have proven they work as effectively.  Some patients aren’t as convinced.  One reason is they don’t feel the spray in their throat nearly as well.  Also, you have to keep the opening clean since it tends to get stopped up.  At best, they take some getting used to.

This mandate required finding a new propellant and inventing a new spray device. So the new inhalers are under brand name and cost around $35 to $45 each.  If you have insurance, you now have to pay the higher brand-name deductible, usually $20 to $30 more.  Patents will last five years at least and predictions are the extra cost will be around one billion dollars per year.

Now if it really saves our ozone layer, it’s worth it, but my point is the more government gets involved with health care, the higher the costs. Regulations and mandates just seem to be in the nature of the beast.  The albuterol example is minor compared to coming trade-offs and compromises if health-care reform ever becomes a priority.

The late Senator Everett Dirksen once said, “A billion here, a billion there, and pretty soon you’re talking about real money.” I just hope some of those in power take that to heart.

Doctors and business owners: Send customized issues of James Hubbard’s My Family Doctor to your customers or patients. E-mail publisher-at-familydoctormag.com for details.

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8 Responses to “Asthma inhaler change: Switch to albuterol HFA increases price; government mandates the cause”

  1. cathy Says:

    Interesting. I would have thought that some things – like certain medical devices and fire extinguishers (though not necessarily filled with CFC, they were once – and maybe still – filled with components that were definitely not ozone layer friendly) would be exempted from CFC phase-out. I imagine that the new price will really hurt a lot of people’s pocketbooks.

    cathys last blog post..So you’re ready to give up high fructose corn syrup…

  2. Blake Says:

    Yeah, I’m not a big fan of the HFA inhalers. I guess they are better for the environment and that is good, but when I am in the middle of an asthma attack, I don’t care about much else but getting my airway open in a timely manner! The old inhaler was better, and faster, in my opinion. The cost bugs me too, but oh well, I gotta have it. :)

    Blakes last blog post..Paint Your Plate

  3. James Hubbard, M.D., M.P.H. Says:

    Cathy, Not a great economic time to have to pay more for an essential medicine. I guess there really is never a great time for that.

    Thanks

  4. James Hubbard, M.D., M.P.H. Says:

    True Blake,

    Thanks for the insight from someone affected by the change.

  5. Steve Parker, M.D. Says:

    I wonder if there is time to stock up on the old inhalers that are still on the pharmarcy shelves.

    I had no idea the price would escalate so much!

    Steve Parker, M.D.s last blog post..Try Some Dark Chocolates

  6. jen Says:

    to learn the facts about the new hfa inhalers, please visit our website at:
    http://www.savecfcinhalers.org

    some people cannot tolerate the ethanol (i am one of them) and other ingredients in the new inhalers. please visit our website to sign our petition to bring back the old cfc inhalers for those who need them. thank you!

  7. James Hubbard, M.D., M.P.H. Says:

    Dr. Parker:

    Good luck, I think they were supposed to get rid of them by Jan. 1.

  8. Industrial Lasers Says:

    Definitely, when Government gets involved it drives the cost up. Asthma patients use this medication on a daily basis, so if the deductible goes up how could people afford the medication. I guess with so much deficit, money has to come somewhere..why not from people who need medication the most. This is ridiculous. We definitely live in a very interesting time. Thanks for the post.

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