Asthma's New Expense
Phaseout of inhaler leaves patients gasping with sticker shock
Lai, the Decision Resources analyst, predicts that the FDA will feel pressure to accelerate approval of a generic form of CFC-free albuterol, perhaps by 2012. Meanwhile, GlaxoSmithKline says it has committed to freezing the price of Ventolin HFA until December 2007. It also emphasizes that the drug should be used no more than twice a week and that patients should instead be using the longer-acting preventive medications. GSK makes some of the most popular of those drugs, including Flovent and the blockbuster Advair. These drugs generally require high copayments.
The move toward costlier drugs irks Marth, who has relied on albuterol as her sole inhaled medication since 1986. "I was able to have a completely asthma-free existence," she said. "It was like a miracle drug for me. But now they're saying, 'Don't use it preventively.' Well, I'm sorry, but it worked beautifully for me."
Munzer says treatment of asthma has evolved greatly in recent years. "It has taken a long time for people to realize asthma is not just an intermittent, acute condition but a chronic condition," he says. But since many asthma patients experience the condition in episodes or seasonally, they often don't stay on the pricey long-term medication. The Journal of Allergy and Clinical Immunology recently reported asthma was not controlled in 55 percent of Americans with moderate to severe forms of the disease.
"It is a major challenge," says Munzer. "We talk about patients not being compliant, and we look for all sorts of reasons. Very often, the underlying reason is cost."