How Is the Ban on CFC Inhalers Affecting Asthma Patients?

Discussion in 'Health and Lifestyle' started by Shogun, Dec 20, 2007.

  1. Shogun
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    Date updated: June 21, 2007
    Lisette Hilton
    Content provided by Revolution Health Group

    Beginning Dec. 31, 2008, one of the mainstays of asthma treatment — albuterol metered-dose inhalers — will no longer be available. The U.S. Food and Drug Administration (FDA) banned their production and sale in the U.S. because they contain chlorofluorocarbons (CFCs), an ozone-depleting substance.

    Scientists associate CFCs with depletion of the Earth's protective ozone layer. Most aerosols dropped use of CFC propellants more than 25 years ago. Under the terms of the Montreal Protocol on Substances That Deplete the Ozone Layer, the U.S. ended production and importation of CFCs for all commercial applications in 1996.

    To prepare for the new reality, many with asthma who use inhalers have begun switching from CFC inhalers to hydrofluoroalkane (HFA) inhalers — which deliver albuterol minus the CFCs.

    But the transition has not been seamless. The main reason: HFA inhalers aren't available in generic form and are thus more expensive than CFC inhalers. Even those with prescription coverage are paying higher out-of-pocket costs for HFA inhalers than for CHC inhalers.

    A second reason may have to do more with perception than cost. Some people believe that CFC inhalers are more powerful than HFA inhalers. But many doctors disagree, saying that HFAs are just as good — if not better — than their CFC cousins.

    Both offer same 'bang for the buck'

    There is little difference in terms of the "bang for the buck" between the two types of inhalants, says Sheldon Spector, M.D., clinical professor of medicine in the Department of Medicine at the University of California, Los Angeles (UCLA). "You're still using a metered-dose inhaler," he says. (A metered-dose inhaler is a propellant-driven delivery mechanism for inhalation of asthma medications, according to the American Academy of Allergy, Asthma & Immunology.)

    To prove to patients that they are getting the same effect with the HFA inhalers, Spector gives his patients a pulmonary function test that shows how both deliver the same results.

    HFA and CFC inhalers are also similar in shape and size. The main difference? They have a slightly different smell and taste, and the HFA mist is a little less forceful and warmer coming out of the inhaler, according to the FDA.

    HFAs also have some little-known advantages over CFCs, says Richard W. Honsinger Jr., M.D., an internist, allergy and immunology specialist and clinical professor at The University of New Mexico in Albuquerque. HFAs, for example, work better than CFCs at high altitudes and also tend to hold their pressurization better in cold weather.

    And if you don't like either type of inhaler — what then? Nebulizers deliver fine liquid mists of medication through a "mask" that fits over the nose and mouth. These are often used by infants and patients who can’t use inhalers. Other options include rotary inhalers and dry-powder inhalers that deliver asthma medication without CFCs.

    Cost differences

    "The only reason I like the old [CFC] inhalers is that they’re cheaper," Honsinger admits. Case in point: HFA inhalers generally cost between $30 to $60 vs. $5 to $25 for generic CFC inhalers.

    To ease the cost, manufacturers of HFAs such as Schering-Plough Corporation, GlaxoSmithKline PLC, Teva Specialty Pharmaceuticals LLC and Sepracor Inc. are offering financial assistance programs, giveaways and cost-cutting coupons for people who are financially pressed or lacking prescription drug coverage. For more details, call the Partnership for Prescription Assistance (PPA) at 1-888-477-2669, or visit www.pparx.org.

    The PPA links more than 475 private and public programs that offer specific medications with patients who don't have prescription drug coverage as well as individuals who earn $19,000 or less a year and families of three or more who earn $32,000 a year or less annually.

    Jessica Endress of Springfield, N.J., whose 12-year-old son Bobby has asthma, has already switched him to an HFA inhaler and says that it's been working well. Endress reports that she hasn't noticed much of a price difference with her prescription plan and says the benefit of saving the environment — whatever the price difference — is "worth it."

    Not everyone feels like Endress, however. Karen Kennedy of Claymont, Del., whose 14-year-old son Jimmy uses inhalers for his asthma, says her co-pay has risen exponentially — from $5 for the CFC inhalers to $55 for HFA brands — a spike that has prompted Kennedy to stock up on the CFC inhalers before the ban takes effect next year. (However, doctors advise checking expiration dates on inhalants before using them.)

    Those who bristle at the cost of the new inhalers might consider purchasing them at large pharmacies like Wal-Mart that often offer drugs, including nebulizers, at significantly discounted costs. Wal-Mart offers more than 300 generic medications for $4 for each prescription fill or refill (up to a 30-day supply). For more information, go to Wal-Mart's generic drug program site (www.walmart.com/catalog/catalog.gsp?cat=546834).

    When will prices drop?

    At the moment, Medicare and Medicaid are picking up the costs (coverage varies depending on individual plans and states) of the inhalers, and more private insurers are starting to get on the HFA bandwagon.

    "I have not had any [insurers] turn me down in about the last two months," Honsinger says.

    And more good news is on the horizon: The patent on HFA inhalers expires in 2010, at which point the lower-priced generic version should hit the market. That should help make everyone breathe a little easier.


    http://www.revolutionhealth.com/conditions/asthma/treatments/inhalers-nebulizers/cfc-ban-effects
     
  2. Shogun
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    As an asthmatic I can tell you that Proventil sucks compared to my Albuterol inhaler. Dr. Spector above must not have asthma. I'm going to be stocking up. If you, or a loved one, knows the panic of an asthma attack I suggest you pay attention. I''m not altogether convinced that this isn't a power play to force our market to increase the profitability of Proventil type substitutions since there is no generic alternative AND there is no evidence that CFCs from inhalers have any kind of significant impact on the ozone.

    This is a prime example of capitalism failing the consumer by manipulating the availability of one drug to force users to pay for the new non-generic.



    CFC ban will double albuterol inhaler market in US

    The US Food and Drug Administration's decision to ban the use of chlorofluorocarbon propellants in albuterol metered-dose inhalers (MDIs) from the end of 2008 will effectively mean the market will revert to one of branded rather than generic drugs and more than double in size, according to Datamonitor.

    While competition between Sepracor, Key, GSK and IVAX will create some downward pricing of MDIs, from the beginning of 2009, the generic albuterol market will revert back to a branded one. As a consequence, the value of the US inhaled albuterol market is expected to increase from $190 million in 2004 to $400 million by 2009, predicts Datamonitor.
    http://www.in-pharmatechnologist.com/news/ng.asp?id=59304-cfc-ban-will
     
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    Is time in the sun a new weapon against asthma?...
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    Granny says, "Dat's right - an' it'll keep ya 'regular' too...
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    Is a really yummy fruit smoothy with tremendous amounts of soluble and dietary fiber at wal-mart in the orange juice section. Bolthouse Farms brands. The blueberry one has the big fiber content. Discovered it a few years back while on an ultra-strict vegan diet (long since abandoned but discovered some new stuff I enjoy.) All natural ingrediants of just the fruits, nothing added no extra sweeteners etc.
     
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