Major Change in Asthma Medication Sparks Concerns Among Patients and Physicians

Come January 1, thousands of patients relying on the asthma inhaler Flovent will face a significant change as the manufacturer, GSK, discontinues its production. 

According to CNN, the branded medication will be replaced by an identical "authorized generic," raising concerns about potential delays in patients switching to alternatives and navigating insurance coverage.

Physicians have voiced concerns over the Flovent transition, highlighting that the authorized generic, while equally effective, may not be as widely covered by insurance plans. This could lead to patients having to get new prescriptions and navigate insurance-related issues, especially during the height of respiratory virus season. The transition may cause disruptions for many patients in need of this medication.

Dr. Robyn Cohen, a pediatric pulmonologist at Boston Medical Center, notes the significance of Flovent in asthma treatment over the past three decades, calling the discontinuation a "huge shock to the system" for patients, families, and doctors. Advocacy groups urge patients to take proactive measures to ensure access to their medication in the new year.

The decision to discontinue Flovent is part of GSK's strategy to introduce authorized generics amid changes in Medicaid rebates. Starting January 1, 2024, the removal of a cap on Medicaid rebates could lead to substantial penalties for GSK due to previous price increases on Flovent. This legal change prompts pharmaceutical companies to explore alternatives such as authorized generics to maintain profitability.

The authorized generic is priced lower than branded Flovent, but concerns arise as major pharmacy benefit manager CVS Caremark favors another branded inhaler, Pulmicort, over the authorized generic in its coverage. The lack of broad insurance coverage for the authorized generic poses challenges for patients, who may face the need for new prescriptions during the critical winter respiratory virus season.

According to Dr. William Feldman, an asthma medication expert, Flovent's price has increased by 47% since 2014. The decision by GSK to cease production of the branded version is viewed as a response to the changing landscape of Medicaid rebates and drug pricing in the United States. 

Physicians have stressed the importance of patients, physicians, and pharmacists being aware of this imminent change and taking swift action to explore alternatives and confirm insurance coverage. The discontinuation of Flovent HFA poses an additional challenge for patients with conditions like eosinophilic esophagitis, who rely on this medication for treatment. This transition may limit the available treatment options for these patients.

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