Flovent Inhaler Discontinuation Causing Concerns Over Generic Switch
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A widely used asthma medicine is disappearing from drugstore shelves starting this month, and doctors are worried that some patients may struggle with switching to an alternative generic version if their insurance doesn’t cover the new option.
At the end of 2023, drugmaker GSK halted U.S. sales of its brand-name drug Flovent, an inhaled corticosteroid that has been used for years to manage asthma symptoms in children and adults. As of this month, the only version of the drug sold in the United States is an authorized generic made by GSK that contains the same ingredients.
GSK has said that its authorized generic contains the same medicine as the discontinued brand-name Flovent inhalers — and that the new options “will provide patients in the U.S. with potentially lower cost alternatives.”
The trouble is that these Flovent generics may not be covered by insurance at all, requiring some patients to pay hundreds of dollars a month for their asthma medicine, doctors say.
“Today alone, my practice had over 20 phone calls with patients struggling with Flovent prescriptions,” says Angela Duff Hogan, MD, chair of the asthma committee of the American College Allergy, Asthma, and Immunology. “Multiple insurance plans still do not cover generic Flovent, and patients must replace their daily controller medications with a different inhaler. Sometimes there is a significant cost difference.”
Inhaler Costs
Fluticasone, the active ingredient in Flovent and in the newer authorized generics, works by controlling inflammation and swelling in the airways to prevent asthma attacks. Fluticasone HFA inhalers use aerosol as a propellant, and may be combined with a spacer attachment to help medicine enter airways more efficiently. Fluticasone Diskus inhalers work differently, requiring people to breathe in a powdered medicine.
Without insurance, the lowest price for one generic Flovent inhaler is more than $200, according to GoodRx. Many patients with more severe asthma can require multiple inhalers each month to manage their symptoms, especially during cold and flu season when they are more susceptible to respiratory illness.
“It is really important for people with asthma to continue their asthma control medicines, especially during respiratory illness season,” says Melanie Carver, chief mission officer for the Asthma and Allergy Foundation of America. “Pharmacy delays can put a person with asthma at risk of worsening inflammation.”
Are There Flovent Alternative Inhalers?
Anyone already using Flovent should contact their insurer to see if the new authorized generic version of their inhaler is covered under their policy, Carver advises. If it’s not, patients should get a list of which inhalers are covered, along with the out-of-pocket prices, then check with their doctor on what option might be best, Carver says.
“There are not direct substitutes for the fluticasone HFA and fluticasone diskus other than the authorized generics,” Carver notes. “Other inhalers may have a different medicine, a different dose, or be operated in a different way.”
Some individuals with asthma — particularly young children or people with developmental disabilities — may struggle to learn how to use a different type of inhaler if they need to switch from Flovent to another type of corticosteroid, says Dr. Hogan. It can be hard for some people to learn how to use a spacer with the inhaler, or tricky to master how to correctly seal their mouth around the device to make sure the medicine gets where it needs to go, Hogan says.
This makes it crucial to check with your doctor once you know what options will be covered by insurance, Hogan says. Not everyone will need to come into the office to get a new prescription, but this may be necessary if patients need training on how to use inhalers that work differently than their previous Flovent inhaler.
“In our practice, if a patient’s asthma is stable and they have been attending regular follow-up appointments, they can call us, and we will switch them to a medication that is suitable for their age and covered by their insurance plan, wherever possible,” Hogan says.
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