• Posted February 21, 2024

Parents Scrambling After Asthma Inhaler Flovent Removed From Market

A popular asthma inhaler was discontinued on Jan. 1, and the business move has left families scrambling to find a replacement for their kids.

Flovent was one of the most commonly prescribed drugs for childhood asthma, but maker GSK took it off shelves to replace it with a generic version, fluticasone.

The problem is that many insurance companies haven't added fluticasone to their list of covered medications, CNN reported.

Parents and doctors are now being required to fill out paperwork to get fluticasone, even though it's the same drug kids have been using for years.

In some cases, insurers are requiring patients to show they've tried other asthma drugs already on their approved list -- and that those drugs haven't worked -- before approving fluticasone, CNN reported.

"The discontinuation of Flovent has been an unmitigated disaster,"Dr. Christopher Oermann, a pediatric pulmonologist and director of the Division of Allergy, Immunology and Pulmonary at Children's Mercy Kansas City, told CNN.

Flovent contains a corticosteroid that reduces airway inflammation. Patients use the inhaler twice a day.

The family of Bryce Cohen, a 4-year-old asthma patient in New York City, relied on Flovent to keep him out of the hospital during asthma flares.

But his family hasn't been able to get fluticasone over the past month.

"This is a really big issue, and it's scary to think that we are in the middle of cold season,"Rebecca Baye Cohen, Bryce's mom, told CNN. She's been forced to call friends and relatives in search of extra Flovent inhalers.

Meanwhile, experts argue that GSK made this move in search of continued profits for a popular product.

The switch happened just before a provision in the 2021 American Rescue Plan Act went into effect that would have required GSK to have paid large Medicaid penalties because it had increased the price of Flovent at a rate higher than inflation for years.

But by replacing Flovent with a generic, GSK dodged those penalties. As a new generic, fluticasone doesn't have the same history of price hikes.

"Obviously, Pharma doesn't want to be selling at a loss on anything in its portfolio,"Andrew Baum, an analyst who covers the stock of GSK for the financial firm Citi, told CNN. "So it seeks to evade impact by, one: discontinuation; two: authorized generic."

But GSK claims it dropped Flovent in favor of an authorized generic form to save patients money.

"These authorized generics will provide patients in the U.S. with potentially lower cost alternatives of these medically important products," a GSK spokesperson told NPR. "We recognize that patients have a number of options in the therapeutic area and therefore remain committed to ensuring the affordability of our medicines."

Still, it's not clear that fluticasone is that much cheaper than Flovent.

"In general, people think generics should be cheaper," Kenny Mendez, president and CEO of the Asthma and Allergy Foundation of America, told NPR. "That's kind of the common knowledge, but it really depends on... your insurance plan and what's covered and what's not."

GoodRx listed Flovent inhalers at around $340 in December, NPR reported. Meanwhile, fluticasone, which has been on the market for about a year, already costs around $310, GoodRX told NPR.

One insurer told CNN that GSK introduced fluticasone at a "much higher net price"than Flovent.

Optum Rx, the pharmacy care services business of UnitedHealth Group, said it instead chose to add two other types of asthma medicine to their list of covered drugs, with a net cost to plan sponsors of 70% to 80% less than fluticasone.

Optum Rx described GSK's decision as one that "puts profits before patients."

Dr. Christy Sadreameli, a pediatric pulmonologist and assistant professor of pediatrics at Johns Hopkins in Baltimore, told CNN that "many kids"are falling through the gaps.

"This is the worst I have ever seen in my career with respect to difficulty getting the right drug in the right type of inhaler to the right age patient,"Sadreameli said.

More information

The Asthma and Allergy Foundation of America has more on Flovent.

SOURCES: CNN, NPR