Starting on January 1, 2024, GSK will discontinue making its asthma inhaler, Flovent HFA, and their inhalation powder, Flovent Diskus. Flovent has been the most commonly used inhaler medication over the past twenty-five years. Flovent is also the most commonly prescribed treatment for children who suffer from a chronic allergic inflammatory condition of the esophagus called EoE. Doctors are worried that dwindling supplies of Flovent will have serious consequences for asthmatic patients, especially as respiratory infections reach their peak this time of year.
Starting in 2024, GSK will begin to mass produce generic versions of their inhaler medications. This allows the company to circumvent new Medicaid rules that charge the drug manufacturers uncapped rebate fees for higher-priced brand name drugs. Drug companies that raise the price of their drugs at a rate higher than inflation may have to pay a rebate that is higher than the drug price. GSK can get around this rule by creating generic labels.
However, consumers are concerned that the generic alternatives will not be covered by their insurance, thus limiting patient access to life-saving medications.
“This medication has been the most commonly used inhaled medication for the past 25 or 30 years,” says Dr. Robyn Cohen, a pediatric pulmonologist at Boston Medical Center. Dr. Cohen told CNN that Flovent HFA and Diskus have been the go-to medications for asthmatic pediatric patients.
“[Flovent] is the one that, overwhelmingly, pediatricians reach for when they decide that their patient needs a daily preventive medication,” she said. “The fact that it’s being discontinued is going to be a huge shock to the system for patients, for families, and for doctors.”
The American Academy of Pediatrics warns that some insurance companies won’t even cover the generic version of the medication and won’t even consider coverage for a preferred alternatives to the brand name. Some insurance companies, namely Blue Cross Blue Shield of Illinois, are only allowing three alternatives to Flovent – Arnuity, Qvar, and Asmanex. Two of these brands, Arnuity and Qvar, are not even recommended for children. With thousands of children switching to these medications, there will likely be complications.
“There are lots of children that are hospitalized every day in the United States with asthma exacerbations, and there are kids that die every year in the United States as a result of severe asthma exacerbations,” said Dr. Christopher M. Oermann, a member of the AAP Section on Pediatric Pulmonology and Sleep Medicine Executive Committee. “If those kids that are poorly controlled don’t have access to preventive inhalers, some of those kids could die.”
GSK has made large price increases to Flovent HFA inhalers and the Flovent Diskus medication. From 2014 to 2023, the inhalers went from $226.88 to $337.77 - a 49 percent increase. The price of the medication was hiked by 51% - from $173.91 in 2014 to $264.26 in 2023.
A new Medicaid rule for January 2024 was intended to curb these price increases for essential medications. The rule would force drug manufacturers to pay rebates for medications that are higher than their retail prices -- forcing the companies to incur losses on those items. To skirt this rule, drug manufacturers are reselling their drugs under new generic labels and lowering the price. However, these price drops are expected to be short term, and most insurance companies won’t even cover the cost.
The Asthma and Allergy Foundation of America is advising asthmatic patients to refill their prescriptions as soon as possible. Supplies of Flovent are expected to dwindle early in 2024. As drug companies and insurance companies compete for every last dollar and seek to dictate American healthcare, people's lives and livelihoods hang in the balance.
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