'A huge shock to the system': Doctors warn about asthma inhaler switch coming in January

[BumRushDaShow]

Source: CNN Health

Updated 8:47 PM EST, Thu December 28, 2023


CNN — Starting January 1, a drug that thousands of patients depend on to help them breathe will disappear from pharmacy shelves, and doctors are concerned patients may have delays switching to alternatives and getting them covered by insurance. Manufacturer GSK has said it’s discontinuing the branded asthma inhaler Flovent, and instead is making an “authorized generic” version, which is identical but without the same branding.

Physicians who treat patients with asthma say the authorized generic will work just as well as the branded drug, but it doesn’t appear to be covered as widely by insurers. That may mean patients will have to obtain new prescriptions and sort out coverage hurdles at the height of respiratory virus season.

“This medication has been the most commonly used inhaled medication for the past 25 or 30 years,” said Dr. Robyn Cohen, a pediatric pulmonologist at Boston Medical Center. “It’s the one that, overwhelmingly, pediatricians reach for when they decide that their patient needs a daily preventive medication. … The fact that it’s being discontinued is going to be a huge shock to the system for patients, for families and for doctors.”

Doctors are urging patients to take action now to ensure they’ve got their medicine heading into the new year and advocacy groups have been trying to get the word out.

Read more: https://www.cnn.com/2023/12/28/health/asthma-inhaler-generic-switch/index.html

[mopinko]

1. pretty overblown.

this makes it sounds like docs and pharmacists r stupid. a generic substitution, if available, is often preferred by patients, not to mention insurers.
this was a way overpriced drug. i’ve used it. fluticasone is flonase, available in a nasal spray for about 10% of the price of an inhaler.

[vsrazdem]

2. Flovent is not Flonase. I take Advair and my insurance will not cover the generic.

I just had an incident yesterday, where I got my Advair refilled and it was changed by the pharmacy computer to the generic Wixihub ihaler (generic). The difference in price for me with my insurance - Generic copay $165.00. The brand Advair copay $45.00. Needless to say, I called right away and found out their computer automatically switched it to generic. Also even with the insurance I do not get my albuterol inhaler through them as with insurance it is 45.00 and with Good RX it's 25.00. Its crazy how I can get meds cheaper through Good RX, than through my Cigna Medicare drug plan.

[mopinko]

5. it's the same ingredient. but

i agree that there is some price fixing/market manipulation going on.

[Give Peace A Chance]

13. My husband & I have used Good RX for about 10 years

It means you have to shop around on line for the lowest price (even there, it varies wildly) so you can't be married to any one pharmacy, but you will get your meds for a fraction of what big Pharma sets its price at. You get the exact same meds & you only need to take the coupon with you to get a very generous discount. Good RX is the best!

[TexasBushwhacker]

15. Have you tried Cost Plus Rx?

It's Mark Cuban's company. They don't have everything, but they add new drugs all the time.


https://costplusdrugs.com/

[pnwmom]

19. Why does the generic cost more than the brand name? It's supposed to be the opposite. nt

[vsrazdem]

20. I think the insurance companies negotiate prices with the drug companies and

they will only use certain medictions on their formulary. They will only pay for Advair not the generic. They also won't cover the generic albuterl HFA only the Ventolin (brand). They informed me via mail that in January, they wll no longer cover Advair and I have to switcht to a Breo Ellipta. Either they negotiate with big pharma, or they get some kind of kick back, thats' the only thing that makes sense.

[pnwmom]

21. Ventolin is a better product than the generic, in my experience.

My insurer required a switch to the generic, and I didn't think anything of it -- till the second time I used it, I reacted the same way as I had the first time: with a bronchospasm in immediate reaction to the spray.

Then I read the patient info and found out that that generic contains an ingredient that causes that reaction in some people. So I have to pay more now to switch back to Ventolin or Proventil.

[vsrazdem]

22. Sorry to hear that.

[Backseat Driver]

8. Has the mfg of Flonase ramped up production to the supply chain out to pharmacies of their "the same" generic that

replaces the branded version? Will patients be looking at more than just getting a new script (like shortage of product) in just a few days when they might be short of their previous script and crush the pharmacies with filling the new scripts or should they decide to not take the med pending the switch-over until the next time they see a doctor in clinic or hospital? I forwarded the article to a respitory therapist I know for better understanding, i.e., your take that the situation is pretty overblown, before I spread it elsewhere. Sounds more like some "inside" price manipulation for profitable claim reimbursement rather than a bothersome problem for patients, but IDK and I wouldn't want to raise anxiety of reactive patients. Asthma is a serious medical condition and nothing which with to fool around.

[Roy Rolling]

3. Just so I understand

This news release encourages patients to switch inhaler formulas by January 1, 2024.

Just “call your doctor and switch.”

Right. The Friday morning before the New Year’s holiday weekend I’m supposed to make an appointment with my doctor as they say. “My doctor” as if he/she’s in my pantry waiting for immediate activation.

Thanks for the one day notice. Affected patients are commanded to now wake up and do the practically impossible.

[BumRushDaShow]

6. My scripts are input electronically by my doctor and go right to the pharmacy I normally use

So for something like this, if a doctor does electronic scripts, the change can be made by their office (okayed electronically by the doc and/or attending/covering physician) without needing to make an "in person" appointment.

I think the point of this OP article was to alert that a change will be needed for this product (and probably for people to check to see if they have enough doses of their inhaler to cover them if/when a refill is needed to the generic or an equivalent). It's also possible that a pharmacy will have some of the original formulation in stock before that is exhausted.

[lostnfound]

10. "My doctor" you hit the nail on the head. Some people have one, many don't have one.

And is anyone taking bets on whether the replacement generic is or is not available at local pharmacies in sufficient quantities?

[BumRushDaShow]

18. For this particular product

it's usually prescribed by a pulmonologist (I had been on Advair some time ago before ending that and only needing albuterol as needed). If someone already has a script for this type of product, particularly as a long-term maintenance drug, then some physician is renewing that script.

[TxGuitar]

12. Surely you have more than a 1 day window

I have had asthma as long as can remember. I have 3 prescribed inhalers and would never let mine get to where I had only 1or 2 doses remaining

[lonely bird]

4. Hmmm

Perhaps they had a patent which expired? Or maybe they will not actually make the generic and, instead, will sub-contract the manufacturing while working on a new drug that they can patent?

[Aristus]

7. Yeah. Gotta keep milking that cash cow.

Years ago, the acid reflux medication omeprazole (Prilosec) went generic, and the developers had to watch other manufacturers make money on it.

So they went back into the lab, tweaked the molecule a tiny bit, dubbed it esomeprazole, re-branded it Nexium, and rolled out a huge advertising campaign for what was essentially the same medication. Profits re-gained.

It’s all a game of $$$ to those assholes…

[BumRushDaShow]

9. Most big pharma companies also own generic companies that will make their products

GSK may be reworking their pipelines to put this unit's resources into something else.

[lonely bird]

11. Oh, I don't doubt that

That being said I would also be unsurprised if GSK had the generic company walled off from GSK corporate so any legal issues with a generic fell on that company and not directly on GSK.

[cstanleytech]

14. I hope my insurance will cover it's as it's been the only thing I have been able to tolerate for decades as i have

problems using things like the damn powder ones that they tried to push me into using.

[FemDemERA]

16. The generic has been available for awhile

My pharmacy switched to generic for me earlier this year without me even asking for it and of course I asked what was up, with different package and low price. They said the generic was finally available. Yeah! Way cheaper co-pay. Good-RX shows the generic package.

https://www.goodrx.com/flovent/what-is

[FemDemERA]

17. I recommend checking with your pharmacist to

Ask if they can switch over and confirm coverage with your insurance. Might be faster/easier than contacting your doctor. My pharmacist did all of that back in March without me even knowing to ask. I give them points for being on the ball and making that switch.