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Tags: asthma | inhaler | drug costs | flovent | children | pharmacy | profit

Dispute Over Asthma Drug Puts Parents in Middle

By    |   Monday, 19 February 2024 09:50 AM EST

Controversy surrounding Flovent, the most common asthma inhaler for children, reportedly has put parents in the middle of a fight between a drug company and pharmacy benefit managers.

GlaxoSmithKline stopped making Flovent on Jan. 1 and began offering "authorized generic" version Flovent HFA, distributed through a different company.

But pharmacy benefit managers like CVS Caremark, Express Scripts, and OptumRx have largely refused to pay for the generic version — and if they do, patients have to kick in higher co-payments, according to The Hill.

OptumRx, in blasting GSK, said it has two "clinically appropriate options" on its preferred list that after rebates, cost health plans 70-80% less than the generic fluticasone.

"The manufacturer and its third-party partner introduced an authorized generic of only the HFA form of Flovent at a much higher net price. This puts profits before patients," OptumRx told The Hill.

Robyn Cohen, a pediatric pulmonologist and director of pediatric asthma program at Boston Medical Center, told The Hill that he saw the chaos coming.

"The amount of work to get patients to switch was going to be an exorbitant lift … it's actually been worse than I envisioned," he said.

In some cases, PBMs demand doctors first show that other medications have failed. The Hill noted, however, those other medications are mostly not appropriate for the youngest patients.

"In a best-case scenario, it takes a few days to get the appropriate inhaler to our patients. In a worst-case scenario, it could not only take weeks, but they'd have to pay for an inhaler that we know won't work," Ben Nelson, a pediatric pulmonologist at Massachusetts General Hospital for Children, told The Hill.

"The bottom line is, we're all really struggling. And we're all spending so much time trying to figure out what we can get covered for patients, and finding that in some cases, there might not be any suitable alternatives."

GSK's decision to discontinue Flovent was likely due to a new Biden administration policy change targeting drugs with a history of price hikes, according to The Hill. On Jan. 1, when drug companies had to pay extra rebates to Medicaid if they raise the price of medicines more than inflation, experts told The Hill that GSK stopped selling Flovent. 

"While I, too, believe the PBM is here to serve some blame, I just would encourage all of us to think about how we got into this mess in the first place and the role that GSK played in obtaining patents, doing what they could to block generic competition, raising those prices year over year over year … and then pulling the product from the market," William Feldman, a physician and faculty member at Brigham and Women's Hospital and Harvard Medical School, told The Hill.

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Controversy surrounding Flovent, the most common asthma inhaler for children, reportedly has put parents in the middle of a fight between a drug company and pharmacy benefit managers.
asthma, inhaler, drug costs, flovent, children, pharmacy, profit, patients, medications
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2024-50-19
Monday, 19 February 2024 09:50 AM
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