The High Cost of Asthma Medications in the United States
In my personal opinion, the high cost of asthma therapy in the United States (over $100 per month for each controller inhaler) is due to the greed of the big drug companies, and the costs will only get higher during the next two years. Inhalers are a ten billion dollar a year market worldwide, and growing rapidly. The profit is very, very high, even considering the inflated R&D expenses. During the past 7 years, pharmaceutical companies have successfully lobbied the FDA and Congress to ban any generic asthma inhalers (controller or reliever).
The problem with health plans fully covering every asthma inhaler is that it would provide no incentive for the manufacturers and distributors to control (lower) prices. The inhaler manufacturers run almost all of the research on asthma inhalers, so the new ones are only compared to placebo inhalers, and no head-to-head comparisons are done (for efficacy or for side-effect rates). It's amazing that the FDA allows such placebo-controlled studies of me-too drugs (or reformulations with new inhaler devices).
It is highly likely that all of the ICS medications (generics included) - after controlling for the dose delivered to the lungs - have roughly the same efficacy and side-effects for more than 80% of those with asthma. However, it seems as though nobody cares enough about consumers and poor folks to conduct such a study to disprove such a hypothesis.
The only non-industry people in the United States who could run such a study are
However, the majority of the staff and investigators of these programs have been "feeding at the trough," so I don't think you will see such studies funded by them anytime soon - unless a new asthma/COPD patient advocacy group starts talking to the press.
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Technorati Tags: medication cost, health care, asthma, inhalers
The problem with health plans fully covering every asthma inhaler is that it would provide no incentive for the manufacturers and distributors to control (lower) prices. The inhaler manufacturers run almost all of the research on asthma inhalers, so the new ones are only compared to placebo inhalers, and no head-to-head comparisons are done (for efficacy or for side-effect rates). It's amazing that the FDA allows such placebo-controlled studies of me-too drugs (or reformulations with new inhaler devices).
It is highly likely that all of the ICS medications (generics included) - after controlling for the dose delivered to the lungs - have roughly the same efficacy and side-effects for more than 80% of those with asthma. However, it seems as though nobody cares enough about consumers and poor folks to conduct such a study to disprove such a hypothesis.
The only non-industry people in the United States who could run such a study are
- the Lung Division of the NIH-NHLBI and
- the American Lung Association's Asthma Clinical Research Network (ALA-ACRC).
However, the majority of the staff and investigators of these programs have been "feeding at the trough," so I don't think you will see such studies funded by them anytime soon - unless a new asthma/COPD patient advocacy group starts talking to the press.
Related Topics:
Technorati Tags: medication cost, health care, asthma, inhalers
24 Comments:
I've been without health insurance coverage for my asthma for nearly three years. Less than a year ago I got a job with insurance, but without prior medical coverage, my asthma was considered a pre-existing condition and not covered until after a year of employment.
After more than two years of paying nearly $250 for my inhaler, I decided to let my health suffer. Yes, I would occasionally get a break from the manufacturer with a coupon to save about 10%, but that was not enough and I made just barely too much money to qualify for other forms of assistance (though their definition of "too much" is not enough to consider it a decent living).
A few months ago I had to start getting caught up on some other bills so I also abandoned my Singulair (at over $100 a month). Yesterday I had my first asthma attack and realized that with the approaching fall and increase in mold allergies, I can't avoid paying this expense any more.
Yes, if you did the math I was paying more than $350 a month for two asthma medications.
It is pathetic to think I will die without my asthma medication and the insurance companies do not care. Drug companies charge whatever they want and no one does anything about it.
In Mexico a doctor prescribed Ketotifeno (propably spelled a little differently in the US) for my pollen allergies, adding that its primary use is for children with asthma. In Mexico, the generic I buy costs $5 for a month's supply (or two weeks during the worst season). Here the short acting inhalers are 25% of the price of the long acting ones. Thought the comparison of treatment in the two countries might be of interest.
Yes the whole pharm business is outrageous. Medicines that cost pennies cost consumers hundreds of dollars. I take Singulair, which runs me about 100 per month. My druggist tries to give me the best price they can. I avoid allergy meds because the price is too high. I fill 1 prescription and take as needed and I also have friend and family who are covered give me allegra.
It is a total outrage
I take Singulair for my allergies, and i bit of astma, I was paying over $100 a month, but now I order from Canada Drugs and I pay $66.00 a month, still expensive, but sometimes I try to take it every other day if I can get away with it,this country needs to do something about the prescription cost,we are the only developed and wealthy country that does not give a darn about the welfare of their citizens, time has come to get rid of the greed of the politicians that can be bought by the Drugs Lobby.
I just filled my prescription for Pulmicort. The new med had changed from 200mcg to 180mcg but the "metered doses' had gone from 200 to 120, effectively shortening it from 50 days to 30 days. The price had NOT gone down!!! I have Medicare D but this is still robbery w/out a gun. Who can I complain to?
As a third year medical student who has now had two externships in Family Medicine, I was surprised at how prevalent asthma is and at how expensive the medication is. When I first heard the canned speech about how the new Levobuterol (Xopenex) does a better job of rescue without all the side effects, I was sold, until I heard a patient say it was over $100 for the medication. I don't know how much the generics had cost, but it does seem like the choice should be up to the patient. I know that some older medications come with significant cardiac risks (such as theophylline which IS still available)but it seems that for the albuterol (which is still available in nebulizers for pretty cheap) ... the choice should be up to the patient if they are willing to put up with the jitteriness and other S/E ... unless they (the patients) do have proven cardiac risks themselves. I don't know. That's just me. I was also surprised to see that Primatine sold OTC contains Epinephrine... maybe that's an alternative for some, though I don't know how many puffs you get for the $15 inhaler. That's just my know-just-enough-to-get-into-trouble two cents about it. Good Luck!
Please let me correct a major misstatement in the original post. The pharmaceutical industry had NOTHING to do with "lobbying" to prevent generic inhalers. The only reason that regular albuterol (rescue) metered-dose inhaler (MDI) has gone up dramatically is because of the Montreal Protocol which defined the phase out of all CFCs worldwide.
Drug companies had to reformulate the inhalers using non-CFC propellants plus do multiple full clinical trials. This is all incredibly costly. Plus the reformulations had to go through FDA review for safety and efficacy which, for many of these products, was years.
In order to comply with the Montreal Protocol, all CFC-inhalers (ie the cheap ones we've been getting for years) must be ELIMINATED. So when two non-CFC products were on the market, all the CFC ones had to go off the market. Generics of these will eventually be available but right now, it was the pharmaceutical companies that made the investment and now they are earning profits from their endeavors.
We are paying a higher cost for our medicine because our medicine, our lovely CFC inhaler, was allegedly harming the environment.
allow me to play devils advocate.
researching new medicines is insanely expensive and partially funded by the prices that we pay for the meds we use now. it has been said that for every 100 drugs that make it to phase 3 in clinical trials one 1 gets approved. this isn't even counting the medicines that have been researched for years and fail to even make it to phase 3.
having said that yes, we the chronically ill need help with the prices we have to pay for our drugs. for those without insurance, God bless you because i don't know how you do it. being sick can literally bankrupt a family. it isn't fair, it isn't right and it needs to change. but - is there anyone in congress listening? no, because they've got awesome insurance and don't have to worry about it.
I have a question about allergies that I have with bee stings.
For years I have been deathly allergic to bee stings, I use an epi pen.
Last week I got stung 3 times and nothing happened.I did not have to use my epi pen.. I hadn't stung for 25 yrs.
Is it possible that I outgrew this allergie? I am really confused.
Thank you , Patty Johnston
I can understand the concern of the high cost of Asthma medications.
It is upsetting when the large drug companies are taking advantage of the general public.
Hopefully somehow we can get the drug companies to lower their prices.
Maybe we should start an online petition to the government.
Eva
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I have done some reading on your blog, Alleries and Asthma, and I would like to invite you to the Breathe Easier breakfast panel on October 2, 2007 at Home Studios in New York City.
This hour long panel will feature two medical professionals, an indoor air
quality industry expert/contractor, and a homeowner - providing a
can't miss, well-rounded, and insightful presentation on the importance of
respiratory wellness and residential air filtration. Our panelists will each
touch upon their perspective of the critical role that indoor air quality
plays in maintaining a healthy home.
Would this be something you would be interested in attending? Please contact
me directly for additional information, with any questions or to RSVP.
Regards,
Leslie McDermott
lmcdermott@fcfschmidtpr.com
http://www.ipetitions.com/petition/saveCFCinhalers/index.html
The FDA has approved the ban of the generic albuterol inhalers. They will no longer be available after 12/31/08. T
The new HFA inhalers are now on the market and they do not work nearly as well and cost 3-5 times as much. Please sign the above petition that will be sent to the FDA asking them to recall the ban on the generic inhalers. Thank you!
A more reliable link to the petition that I posted earlier is.
http://tinyurl.com/yphmp4
Please sign, so we all have a chance at breathing better.
I have mild asthma, and now have to take ProAir HFA over my "old" CFC based inhaler. What a joke. This stuff simply does not work. How on earth did the FDA approve this stuff.
I saw the negative results immediately. Now what happens to those with severe asthma?
My feeling is that the research is seariously flawed, and that many are on board with this change for reasons other than medical. We triple the cost and effectiveness goes down dramatically. What a great system we have here in the US.
Believe it or not the American Lung Association is actually one of the main supporters behind the ban of the CFC's. More information can be found in an on-line article in the US News and World Report dated August 2007. (See second link below). They receive huge funding from the drug companies and the drug companies want the Generics (CFC's) to go away. Below is a link to the petition to bring back the CFC's.
http://tinyurl.com/yphmp4
http://health.usnews.com/usnews/health/articles/070819/27asthma.htm
My daughter who is 24 has tried singular and an inhaler for her asthma. Nothing seems to be working. What else can we do for her. I thought of a breathing machine. Her cough is deep and croupie sounding. It's been that way about 3 1/2 months. We've tried steriods, cough medicine,inhalers, singular, and I don't know what else to have her doctor give her. Any ideas or suggestions? Please help.
Sarah's Mom:
For answers to your questions about inhalers, please post your question on Dr. Enright's message board.
Thank you!
I am uninsured with asthma. I am thankful that singulair has controlled my symptoms well enough to drop my inhalers saving me appx $300 a month. However when I become ill and need office visit, antibiotics, and cough medicine in addition to the singulair I am now in debt to the tune of anywhere from $800-$1200 for one episode. This has to change. I am hoping for a not-for-profit health system to emerge. We need to shift the thought process: $$$ to prevent disease---find a cure and less to treat. I know we need medicines to treat but do we need 10 by 10 different drug companies all treating the same thing? Some with a pink label some with blue? Marketing ... putting more $$$ in drug companies pockets. I think not-for-profit health care would help in this respect. Thank you for all your opinions and insightful, personal stories.
For 9 years I took asthma medications, starting when I was about 40 years old. At the end I took 2 drugs every day (Serevent, Advair) and 3 other drugs (Albuterol, Theophyline, Prednisone) occasionally when I was doing worse. I also had other medical problems that came on in the last several years. I met someone who was trained in natural healing and began following his suggestions. I completely changed to a whole-food vegan diet (no milk!), started using a juicer, cleansed my colon, liver, and kidneys with herbs. Within 6 weeks I stopped taking any asthma drugs because I no longer needed them. That was over 6 years ago. Most of my other medical problems went away also. Needless to say, I’m not too fond of drugs any more - they only treat the symptoms and not the cause of disease.
I used to take Albuterol for my asthma, but recently had to change to singular and advair because Albuterol was not helping. I will say that I can breathe better, but I can also feel a difference in my wallet. Normally the Advair cost $218.00 and Singular cost about $116.00...what's funny is that when I take Prednisone it only cost $5.00. Thank God I have really good insurance and only paid $55 for the Advair, and $30 for the Singular. I still think to myself, "How can people with no insurance afford this?" Does the government not care about us? The sad thing is that I need these medications to stay alive. I'm starting to think that maybe a pharmacy in Canada or Mexico might be able to put some ease on my wallet, but I'm so afraid to get drugs outside of the US because of the scary stories you hear on the news. Does anyone else get their asthma medicine outside the country? And if so, can you order it on-line? I live in the Dallas, Texas, so Canada would not be a hop away and Mexico is at least 9 hours away.
I too have had trouble with my insurance covering many medications. However, I sought out a different solution. I order my prescriptions from Canada and save a bundle. I've had excellent service from DoctorSolve - on the web.
Anyway, I get a 3 month supply of medication from Canada for what it costs me for 1 month here in the US.
Another neat thing, say you order a 3 month supply on February 10th. On February 11th I can order the next 3 month supply of the same drug from my prescription (if refills are available on your script). I do this with my tax return, stock up - so I don't have to suffer.
Don't like supporting another economy in another country, but I have been left with no choice.
Please, do not expect a company to care about you and your health, they won't and don't.
You must take responsibility and take charge of Your overall well-being. No one else, so flush that expectation and get on with things, if you don't you're setting yourself up for let downs and frustration.
I am a 19-year-old girl in good health, with the exception of my allergies and asthma. I am allergic to pretty much everything you could name from pet dander, to dust, grass, feathers, and mold and I have severe, persistent asthma. Over the past two years alone I have been hospitalized more than 10 times(over-night stay, usually at least 3 days) and have had to go to the hosptial at least 50 times(30 by ambulance). Thankfully I have fairly good medical insurance, but as you can imagine this does not even begin to cover my medical bills.
I am on the strongest form of advair and singulair, and I am using duo nebs every 6 hours. For just my asthma medicene I pay close to $300/month. I am also on several medications for allergies. For all of my medications I pay close over $450/month and this hasn't even kept my asthma under control.
It is very frustrating to me how much money these companies are making off of people with asthma. If it was an illness that is not deadly and not as important to control I could understand, but the fact that asthma is a disease that could, and does kill. How can these companies knowingly jack up prices when people die from asthma everyday because they cannot afford their medications? If it weren't for my amazing parents who have paid so much for my health I would more than likely be dead right now.
Does anyone seriously think that Big Pharma did NOT lobby for this?
The old inhalers were AFFECTIVE and they were also GENERICS making them INEXPENSIVE.
All of the new inhalers I have seen so far are NON-GENERIC meaning the the pharma companies basically have a MONOPOLY on them making them EXPENSIVE.
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