WASHINGTON, D.C. — Starting January 1, a drug essential for the respiratory well-being of numerous patients is set to vanish from pharmacy shelves. Physicians express concerns about potential delays in patients transitioning to alternatives and navigating insurance coverage.
GSK, the manufacturer, has announced the discontinuation of Flovent, a branded asthma inhaler. Instead, they will introduce an authorized generic version identical in composition but lacking the familiar branding.
Physicians specializing in pediatric care assert that while the authorized generic is expected to perform comparably to the branded medication, it may not enjoy the same extensive insurance coverage. This could compel patients to navigate new prescriptions and address coverage challenges during the peak of the respiratory virus season.
Dr. Robyn Cohen, a pediatric pulmonologist at Boston Medical Center, expressed concern, stating, this medication has been the most commonly used inhaled medication for the past 25 or 30 years. The fact that it’s being discontinued is going to be a huge shock to the system for patients, for families, and for doctors.
Physicians are advising patients to take proactive measures to secure their medication supply for the upcoming year, while advocacy groups strive to disseminate information.
The reasons behind the discontinuation of Flovent and the potential lack of insurance coverage for its ostensibly identical replacement underscore the intricate dynamics of American healthcare and drug pricing.
GSK asserts that the transition is part of its commitment to patient well-being, emphasizing the introduction of authorized generics in May 2022 and October 2023. The company cites potentially lower costs for patients in the United States as a result of these changes.
However, industry experts, both in financial markets and academia, highlight GSK’s strategic timing. The shift coincides with alterations to Medicaid rebates, where a removal of the cap on rebates could subject companies to significant penalties for price increases on Flovent over several years.
Dr. William Feldman, an expert in asthma drugs, noted, these are precisely the sort of drugs that will be affected by the new policy eliminating the Medicaid rebate cap.
To circumvent potential financial repercussions, GSK opted for an authorized generic, which is perceived as a distinct product but enables the company to retain some economic benefits. This move shields the medication from the history of price increases that could trigger substantial rebates to Medicaid.
While GSK priced the authorized generic lower than branded Flovent, insurance coverage decisions present additional challenges. CVS Caremark, a major pharmacy benefit manager, favors another branded inhaler, Pulmicort, over the authorized generic versions of Flovent due to cost considerations.
For patients with persistent asthma, the transition away from widely covered Flovent could necessitate obtaining new prescriptions during the winter respiratory virus season, posing challenges for both patients and healthcare providers.
In light of these developments, physicians express concern about limited alternatives for specific patient groups, such as those with eosinophilic esophagitis. The discontinuation of Flovent, a commonly prescribed topical steroid, raises worries about potential hurdles for patients with this inflammatory condition, who already face limited medication options.
As the January 1 deadline approaches, the healthcare community grapples with the implications of these changes, emphasizing the need for awareness and proactive measures among patients and medical professionals alike.