Science Daily reports that the new hydrofluoroalkane (HFA) asthma inhalers are effective and safe but will come at nearly triple the cost to consumers.
The use of chlorofluorocarbon (CFC) metered-dose inhalers will be prohibited after 2008 because of CFC's ozone-depleting effects.
Albuterol is the seventh most commonly prescribed drug in the United States. About 52 million prescriptions are filled each year, and most contain a generic version of CFC propellant.
A report published in the New England Journal of Medicine predicts that Americans will spend an additional $1.2 billion a year on three patented brands using the HFA propellant (Ventolin, ProAir, and Proventil) until generic versions become available around 2012. Patients will pay an average of $26 more per prescription. That adds about to about $312 more per year. People who have prescription benefit plans will likely face higher co-pays.
There are a few differences with the new HFA inhalers. One brand, for example, has a shelf life of just two months after its protective pouch has been opened, while most CFC inhalers can be stored for 15 to 24 months. Also, only one brand (Ventolin) will come with a counter to track the amount of medicine.
‘There isn't any reliable way of estimating when they're going to run out,’ says Leslie Hendeles, University of Florida professor of pharmacy and pediatrics and consultant to the FDA.
HFA inhalers also tend to clog more easily. To prevent clogging, patients should remove the metal canister and clean the plastic actuators once a week.
HFA inhalers are spew slower and warmer plumes of medicine that CFC inhalers, so some patients may feel that they're not strong enough.
‘There undoubtedly will be some people who are absolutely certain it doesn't work as well,’ Hendeles says, adding that patient education is the key to proper care. However, it's the same drug in both types of inhalers, and they both work fine.
Two brands of the new inhalers contain ethanol (alcohol), which may not be appropriate for some because of religious beliefs. They may also cause false positives on breath alcohol sobriety tests performed by law enforcement officials.
Hendeles notes that CFC inhalers release negligible amounts of the propellant and do not pose a threat to ozone depletion; however, in 1978 the United States and 185 other countries signed the Montreal Protocol, a treaty for the complete withdrawal of all CFC products. CFC inhalers were considered medically necessary until the development of HFA inhalers.