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March 31, 2008

Eco-friendly inhalers will cost kids with asthma more green

U-M expert says even with insurance, co-pay for new HFA inhalers will likely rise 200% to 400% for families that have kids with asthma

Ann Arbor, Mich. – While having products “go green” helps to protect the environment, these changes often leave people with a little less green in their wallet.

And for the 6.5 million American children with asthma, newly mandated environmentally friendly inhalers will come at a greater cost to low- and middle-income families – most will see a significant increase in their prescription co-payments or out-of-pocket costs, especially since a generic version of the medication will not be available.

In a letter appearing in the current issue of the Journal of Allergy and Clinical Immunology, University of Michigan C.S. Mott Children’s Hospital pediatric allergist Harvey L. Leo, M.D., writes that the transition from chlorofluorocarbon (CFC) albuterol metered dose inhalers to hydroflouroalkane (HFA) inhalers is an important one, but it could amount to a 200 percent to 400 percent increase in out-of-pocket costs for insured patients.

Even federal programs that help low-income families obtain asthma medications are expected to see a two- to threefold increase in cost since no generic medication will be available, he says.

"Our review suggests that the upcoming changes in the cost and availability of a truly generic albuterol metered dose inhaler option will have significant financial impact on children and their families, especially in the current economic times,” says Leo, adjunct clinical professor in the Department of Pediatrics and Communicable Diseases at U-M C.S. Mott Children’s Hospital and assistant research scientist at the Center for Managing Chronic Disease, U-M School of Public Health. “This may impact the quality of care and general health of all children with asthma."

With increased costs and more than 650,000 children with asthma who are uninsured, Leo worries that patients may try to save money by purchasing less effective medications to control their asthma, or using their medications less frequently than prescribed. He says such changes in recommended treatment plans would ultimately lead to increased risk for children with asthma, and the need for more urgent and costly care.

Even families with health insurance will assume the burden of added costs as the result of this change. Families that once paid a $5 to $10 co-pay for generic prescriptions may soon find themselves paying $20 to $50 per prescription, since no generic of the HFA inhalers will be available.

“While the transition for CFC-based medication to HFA propellant technology is important for our environment, there are still gaps in the practices of the health care system and the pharmaceutical industry, which could leave children with asthma stranded in ways not anticipated,” says Leo.

To protect the health of children with asthma, Leo urges the federal and private insurance systems to take steps now to reduce the costs of HFA medications for the most vulnerable families.

In addition to Leo, U-M C.S. Mott Children’s Hospital Child Health Evaluation and Research (CHEAR) Unit co-authors are: Kevin J. Dombkowski, DrPH, MS; and Noreen Clark, Ph.D.

Reference: Journal of Allergy and Clinical Immunology, March 2008, Vol. 121, No. 3.

Written by: Krista Hopson

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