Asthma medication Flovent's end sparks concern among doctors as illnesses rise

After two popular asthma drugs were discontinued this month, some physicians are concerned that patients could be left scrambling for alternatives and face higher refill costs for its generic replacement.

Drugmaker GSK announced that with the availability of the generic, it would cease to make branded versions of Flovent HFA and Flovent Diskus on Jan. 1,

Instead, the company said it would work with pharmaceutical company Prasco to make generic versions.

Health experts say the rollout of the authorized generics during respiratory disease season could cause treatment gaps for people whose insurance does not cover generic medications.

"Some of our most vulnerable asthmatics — in the middle of the flu season — may be affected by the fact that they're not covered," said Dr. Mangala Narasimhan, a pulmonologist and senior vice president of Critical Care Services at Northwell Health.

On Long Island, more than 40,000 children have asthma while more than 230,000 adults have the disease, the American Lung Association said in 2023 reports.

GSK said it expected "minimal disruption for patients" and touted the move as a potential cost-saving measure. However, paying out-of-pocket for the medication could be pricey for some who could benefit from the medication. 

GoodRx Research, part of GoodRx, which tracks prescription drug prices, noted the price of a Flovent Diskus inhaler rose from roughly $170 in January 2014 to approximately $265 in December of last year.

Dr. Jeffrey Wolf, a pulmonologist and director of the surgical intensive care unit at St. Francis Hospital, said he hopes there is a smooth transition for patients.

"The real important thing is that their therapy isn't interrupted," he said.

Generic drugs, which work just like the branded ones and are estimated to account for more than 90% of prescriptions in the United States, are often lower priced, the United States Food and Drug Administration said.

That is because once a branded drug has been approved, one manufacturer typically has market exclusivity, which allows the company to price the medication without competition, said Tori Marsh, director of research at GoodRx. When a generic is approved, Marsh said, consumers can generally see savings because more manufacturers drive the cost down.

But sometimes, that does not trickle down to patients, particularly when insurers do not cover the medication.

"Some may find that their insurance suddenly doesn't cover their medication, which could require additional paperwork," doctor's visits and "effort to regain coverage," she said.

A spokesman for CVS Caremark, which handles prescription coverage for Aetna, said the company analyzed the price differences between the two drugs and found "the authorized generics were more expensive than the brand name medications."

CVS Caremark will prefer the brand Pulmicort, a different drug, said Mike DeAngelis, the spokesman.

Blue Cross Blue Shield Association said in a statement that Blue Cross and Blue Shield Plans will "continue to provide access to respiratory therapeutics, such as the authorized generic of Flovent, and/or other clinically appropriate medications."

At Nassau University Medical Center, Dr. Javed Iqbal said there had been at least one instance in which a patient came in with a notice from an insurer that the generic version of the drug would not be covered and that the person had the option to switch medications.

With the change, a patient might have to search different pharmacies to fill their prescriptions, said Iqbal, chief of the medical center's pulmonary division. Their copay may also fluctuate.

Still, he hopes the issue will stabilize and that more insurers add the generic to their medications.

"But for now, in this busy flu and RSV season, [from] what I see, it will be a problem," he said.

Marsh said those concerned about their asthma prescriptions should reach out to their medical provider.

A clinician can see if an alternative medication in the same class might be cheaper, she said.

Patients can also look out for discounts, she said, or they can get a larger supply of medication, which can be less expensive. 

"All of this can take time and energy, so it's best to start the process early," Marsh said.

By Tiffany Cusaac-Smith

tiffany.cusaac-smith@newsday.com@T_Cusaac

Education: Howard University 

Tiffany Cusaac-Smith came to Newsday in 2023 after being a race and history reporter at USA TODAY, where she wrote enterprise and spot articles examining how the past shapes the present. Previously, she worked as the race and justice reporter at the USA TODAY Network of New York, covering issues such as criminal justice reform, housing, environmental justice, health care and politics. At The Journal News/lohud.com in Westchester County, she covered Yonkers, the state's third-largest city. She also worked at The Associated Press in Atlanta.

Honors and Awards: Criminal justice reporting fellowship with the National Press Foundation;  New York News Publishers Association award for distinguished investigative reporting;  Contributed reporting for Best of Gannett honor; Member of Table Stakes, a program funded by the Knight-Lenfest Local News Transformation Fund and managed by the American Press Institute to transform local news.