“On January 1st, the prescription list will change again, but we don’t know what’s going to be on it,” said Dr. Robin Cohen, associate medical director for asthma control at Boston Medical Center. Ta. “I’m worried we’ll go back to where we were last year.”
The root of the families’ distress lies in a 2021 federal effort aimed at keeping drugs affordable by adding penalties when drug price increases exceed inflation. Penalties were enforced from the beginning this year. Most companies responded by lowering the list price of drugs. Instead, GSK excluded the generic drug Flovent, which is not subject to the same penalties. (GSK also said it had intended to discontinue Flovent for some time.)
Johns Hopkins University professors found in a November study that if GSK had simply lowered the price of Flovent to avoid new federal penalties, it would have been at least $30 cheaper than the generic version, compared to the average authorized selling price. I estimated it would have been about $150 cheaper by comparison. Generic price is approximately $184. One reason is that generic drugs don’t offer the same level of discounts and rebates that insurance companies got for Flovent.
The Massachusetts Department of Public Health issued an advisory in November explaining that GSK’s decision to discontinue Flovent would create additional barriers for people already struggling to access health care.
Sen. Elizabeth Warren accused GSK of “price gouging” and claimed the company switched to generic drugs as a way to circumvent federal drug price controls. Warren said the switch was a huge blow to Medicaid providers. Without the rebates and discounts associated with Flovent, Medicaid administrators, including MassHealth, would currently pay about four times as much for essentially the same drug, according to a letter Warren sent to GSK chief executive Emma Walmsley on Wednesday. He is said to have paid an amount of
of Johns Hopkins research It is estimated that switching from Flovent to an approved generic drug could increase net Medicaid spending by more than $500 million this year.
“GSK’s actions appear aimed at circumventing new provisions passed by Congress that hold drug companies accountable for years of historic price increases,” Warren wrote.
This was reported by a British company. Operating profit It will exceed $8 billion in 2023.
Flovent was manufactured by a second company, Prasco Laboratories, under license from GSK. A GSK spokesperson deferred comment to Prasco, which did not respond to requests for comment.
Warren’s letter also accused GSK of not responding to requests for more information about profit sharing between it and manufacturers.
“It is shameless for corporations to try to blame and shift responsibility when children across America are suffering at the hands of clear and undisputed corporate greed,” Warren said in a statement Friday. said.
Flovent is a corticosteroid treatment currently sold under the generic name fluticasone propionate. In particular, it is one of the most commonly prescribed childhood asthma treatments. That’s because the inhaler used to administer the drug was designed for infants’ small lungs. Alternative drugs, such as Asmanex and Symbicort, are in short supply or more difficult to get covered by insurance companies.
Jeromy Ballreich, associate research professor at the Johns Hopkins Bloomberg School of Public Health and author of the report on Flovent, said other drug companies are still following GSK’s example, perhaps because of the bad publicity the move has brought. He said that he was not following the example. But whether such tactics will become more common under the incoming Trump administration is an open question, he said. Some of President Trump’s nominees, including Robert F. Kennedy Jr., have been critical of Big Pharma. There may also be people who are more pro-business and oppose regulation.
“We don’t know how more regulation, more pressure on drug companies and less pressure on drug companies will play out,” Borreich said. “It’s a very cloudy crystal ball.”
Hamilton O’Rourke, from Acton, is one of many people struggling to provide care after the transfer. Until last year, the 10-year-old was regularly prescribed Flovent. Near the end of 2023, her mother, Sarah O’Rourke, had her insurance company pay for a prescription for Symbicort as an alternative to Flovent. However, in 2024, the drug will no longer be included in insurance company prescriptions.
She and her son’s doctor, Ben Nelson of Massachusetts General Hospital, spent several months on the phone with insurance companies, trying to get coverage for the boy’s prescriptions. Her son tried using powdered medication, but it didn’t work until the insurance company relented. We covered Symbicort in November. Still, she had to contract with a mail delivery company to avoid a $425 charge at a local pharmacy, and still ended up paying out of pocket to buy an air chamber to pump medicine into Hamilton’s lungs. Ta.
Battle for substitutes Nelson, a pediatric pulmonologist, said treating asthma puts a huge strain on staff.
“If you’re worried about delays in getting your medication, you have to prescribe a second-line medication, have prednisone on hand, and give them a script.” [for prednisone] “It’s so they can avoid the ER and the hospital,” he said.
Review of October hospitalization data by Healthcare industry researchers have noted that childhood asthma-related hospitalizations have increased since Floben’s withdrawal. In the second quarter of this year, children were hospitalized nationwide for asthma-related complications and prescribed certain types of fluticasone propionate, including Flovent. According to the previous years, there was a 24% increase compared to the same period in 2022 and 2023. epic researchthe public research department of Medical software company. Admissions to intensive care units increased by more than 21% over the same period.
“It’s very frustrating,” said Dr. Timothy Lux, director of Central Mass Allergy and Asthma Care in Worcester. “Especially during the winter months, environmental factors can affect your dog’s condition, so having an inhaler available is very important.”
Hamilton has experienced three asthma flare-ups this year, with dry coughs so severe that he vomits. When he was at Flovent, attacks this severe usually only happened once a year.
“They think they’re saving money, but what they’re making people do is send people to the emergency room because their kids can’t breathe,” Sarah O’Rourke said. spoke.
O’Rourke now has enough Symbicort to get her son through March or April, she said. She is hoping for better luck later on.
“I don’t know if I’ll have to go through the same thing next year,” she said. “I think so.”
Jason Laughlin can be reached at [email protected]. follow him @jasmLaughlin.
