Problems are expected after an asthma inhaler is replaced with generic version

A popular asthma inhaler is being discontinued. Although there is a generic version, the switch could lead to disruptions in care because not all insurance companies are covering it.

A MARTÍNEZ, HOST:

A popular asthma inhaler is being discontinue. The drug called Flovent will no longer be available starting in January. And some patients might not be able to switch drugs right away, leaving a gap in their medical care and putting them at risk for complications. NPR pharmaceuticals correspondent Sydney Lupkin is here to tell us more about this. Sydney, how long has Flovent been around?

SYDNEY LUPKIN, BYLINE: So Flovent is a pretty common asthma inhaler and it’s been around since the 1990s. It’s made by GSK, and it contains a corticosteroid used by patients 4 and older to prevent asthma attacks. It does that by reducing the inflammation in their airways to keep it under control. So it’s not an inhaler for emergency asthma attacks, it’s something patients need to take twice a day. Here’s Kenny Mendez, the president and CEO of the Asthma and Allergy Foundation of America.

KENNETH MENDEZ: Over 10 people die a day from asthma every year, so it’s really important to have your asthma well-controlled. And a lot of people don’t realize that asthma can be fatal, so it’s really important to make sure that you’re working with your doctor, getting the right medication.

MARTÍNEZ: Yeah, it’s really important for some people. Why is it being discontinued?

LUPKIN: So the company, GSK, says it’s discontinuing Flovent because it’s making its own generic version instead, and potentially saving patients money by doing so. This generic does have a lower cash price than the original Flovent according to the website GoodRx. But whether this is actually going to lower patients’ costs at the pharmacy counter is more complicated. This isn’t a typical generic made by an outside company to compete against the original product and ultimately lower prices, this is what’s called an authorized generic. It’s made by the same company. Here’s Mendez again.

MENDEZ: In general, people think generics should be cheaper, right? I mean, that’s kind of the common knowledge, but it really depends on the formulary and your insurance plan and what’s covered and what’s not.

LUPKIN: So here’s the issue with Flovent. In some cases, doctors are saying the authorized generic isn’t covered. Or if it is, patients have to pay more at the pharmacy counter. So some patients will need to switch or get new prescriptions, and that’s just hoops to jump through that potentially disrupt care.

MARTÍNEZ: So just to be clear, it’s the same product, right?

LUPKIN: Right. It’s the same medication, same device…

MARTÍNEZ: OK.

LUPKIN: …Made by the same company. The main difference is that it has a clean slate in terms of price hikes. I got some cash price data from GoodRx to get a better look. One Flovent product was around $230 a decade ago, now it’s around $340, so almost a 50% increase. And with price hikes like that, it’s possible the drug company would’ve faced new penalties aimed at excessive price hikes. Meanwhile, the authorized generic version has only been around a year, so it’s around $310. So by only offering this new generic, GSK can sell the drug but without a history of price hikes.

MARTÍNEZ: All right. So what can people do to make sure they still get their medication?

LUPKIN: Great question. What doctors and medical societies are suggesting is to be aware and take action now. Fill your prescription for Flovent while you still can. Start talking to your doctor and insurance company about options. There are other asthma drugs if that seems like the best choice for you. Every patient and every health plan is different. But you may need to get the ball rolling with your insurance on things like prior authorization, which can take time, so it’s best not to wait.

MARTÍNEZ: That’s NPR pharmaceuticals correspondent Sydney Lupkin. Thanks a lot.

LUPKIN: You bet.

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