A popular asthma medication is discontinued, leaving some patients scrambling : Shots

Jacqueline Baqir needed a refill of her 4-year-old son’s asthma medication, Flovent, but couldn’t get it: drug company GlaxoSmithKline stopped making the popular inhaler in January.

To make matters worse, Vakil’s insurance company wouldn’t cover the alternative medication his doctor recommended.

“I was on constant calls with the doctor trying to find an alternative,” Vakil said.

All the while, her son James was coughing in the middle of the night, and she tried Vicks VapoRub, a humidifier, and the steam of a hot shower to soothe his throbbing cough.

“My son couldn’t sleep at night because of his cough,” she said. “When he went to school, the school administration told us that he had been coughing at school all day.”

Vakil spent hours talking to his pediatrician, pharmacist and insurance company trying to find an alternative. At first, the insurance company refused. Dry powder inhalers, But it didn’t work for his son because the breathing exercises required were too difficult for a four-year-old.

“The whole process was frustrating as I felt helpless,” Vakil said.

Finally, after seven weeks, James’ pediatrician Dr. Joanie Yeh Doctors at Nemores Children’s Health Center in Media, Pennsylvania, helped James find a medication that worked and was covered by insurance.

Even when things go smoothly, finding a new medication can take days, leaving patients frustrated and scared, Yeh said.

“Of course, parents work too,” she said. “They can’t spend all day looking for medicine or making phone calls.”

Yeh said some patients have been sent to emergency rooms or rush hours because their asthma has worsened.

That’s exactly what happened to 9-year-old Trey Curry of Philadelphia.

Shante Curry and her 9-year-old son, Trey, spent two days at Children’s Hospital of Philadelphia after suffering an asthma attack.

Chanté Curry

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Chanté Curry

Trey had been taking Flovent to control his asthma, but his mother, Shante Curry, said the drug was discontinued and he was no longer able to get it.Then, in late April, Trey had an asthma attack at home that left him coughing and wheezing. Short-acting rescue medications It didn’t help.

“You could see his ribs because he was having so much trouble breathing,” Curry said.

Trey’s condition was so bad that she immediately took him to Children’s Hospital of Philadelphia, where he was admitted to the intensive care unit, according to the release.

“He had to be put on a ventilator and had to be on an IV,” Curry said.

Curry and Trey’s father were with Trey during the two days he was in intensive care. The doctors didn’t want to let him go home without his asthma medication, but they couldn’t get any more Flovent, so it took them two days to find a replacement that their insurance would cover.

Doctors at Children’s Hospital of Philadelphia Reported in May Admissions to intensive care units for children with asthma increased by 50% in March and April compared to last year, and at least seven children in the Philadelphia area have died from uncontrolled asthma this year, significantly more than in past years, the report said.

“Asthma deaths are entirely preventable, so one child’s death is one too many.” Dr. Tyra Bryant Stevensmedical director of the Community Asthma Prevention Program at Children’s Hospital of Philadelphia;

Pediatrician and Health Researcher Dr. Chen Kenyon Other factors are probably contributing to the rise in asthma-related hospitalizations and deaths, he said, but he said this shouldn’t happen because there are effective medications that can prevent asthma attacks.

“This is causing friction and frustration in that families are not being given the medications that we know will help reduce asthma attacks,” he says.

The reasons why GSK stopped making Flovent and why no replacement was covered are complex.

Pharmacy benefit managers, the middlemen who decide which medicines insurance plans will pay for, decided not to cover generic asthma medications that could have served as alternatives for patients like James and Trey.

trade association for pharmacy benefit managers; Pharmaceutical Care Management Association, We asked economist Alex Brill, founder of an economic policy consulting firm, to answer some questions. Matrix Global Advisorsserves as a consultant to the Pharmaceutical Management Association of Japan.

Brill says this all started A new law was enacted In January, legislation was passed that would have penalized drug companies for dramatically raising the prices of drugs for Medicaid patients, and the drug company GSK chose to stop making Flovent rather than risk being penalized. GSK worked with another company to make a generic version of Flovent, but Brill said the generic version was not covered by many insurance plans because it was more expensive and pharmacy benefit managers didn’t want to pay more. The result of the stalled negotiations was that patients lost out.

Brill says the goal of pharmacy benefit managers is to reduce health care costs. Most people want their drug costs to go down, but they also don’t want their health insurance costs to be too high, he explains.

“And we’re trying to work between those two goals,” Brill said.

Patients in other parts of the country have experienced similar problems finding alternatives to Flovent. Dr. Christopher AumanDr. GSK, a pediatric pulmonologist at Children’s Mercy Hospital in Kansas City, said doctors have been bracing for the impact since GSK announced it was discontinuing Flovent last year.

“It was a major disaster, just as we expected,” he said.

Drugmaker GSK said in a statement it had stopped production of the popular inhaler after seeing an approved generic version, and said it would continue to work with the company to make the generic version available to younger patients.

Orman said the situation has improved since the beginning of the year. Pennsylvania’s Medicaid program new york, Texas and Mississippi They have made changes to make alternative medications more easily available to patients, and private insurers are taking similar steps.

However, some of these alternatives are now Experiencing shortages.