Decrease in Asthma Inhaler Use Among Children Following Market Withdrawal of Popular Product

A recent study highlights a significant shift in how children with asthma are managing their condition after a well-known inhaler was withdrawn from the market. In 2024, pharmaceutical giant GlaxoSmithKline discontinued the popular steroid inhaler Flovent, which was commonly prescribed for preventing asthma attacks in children. Although the company continued to sell an authorized generic version of Flovent, many families faced difficulties in obtaining it due to insurance coverage issues and higher out-of-pocket costs.

The study, published in the Journal of the American Medical Association, found that the removal of Flovent from the market led to a decrease in access to inhaled steroid therapy among children. Specifically, between 2021 and 2023, the rate of children prescribed Flovent who had access to and used the inhaler dropped from nearly 41% to around 35%. In contrast, children using other inhaled steroids maintained consistent access levels of approximately 38%. This reduction in inhaler availability correlated with a heightened risk of asthma attacks, as children lacked the necessary medication to prevent attacks effectively.

Researchers suggest that the withdrawal of Flovent was driven by changes in Medicaid rebates following the American Rescue Plan Act of 2021, which eliminated the rebate cap in January 2024. The removal of this cap meant that rebates for certain drugs, including Flovent, could surpass the drug’s sales price, particularly after GSK raised the drug’s price rapidly. These financial factors likely influenced the decision to withdraw Flovent, inadvertently disrupting treatment for many pediatric asthma patients.

Dr. Kao-Ping Chua, lead researcher and pediatrician at the University of Michigan, noted that the disruption in therapy might increase the risk of severe asthma attacks among children. He emphasized the importance of proactive policy measures to prevent similar therapy interruptions for other drugs affected by rebate policy changes, including ensuring coverage of alternative medications.

The study underscores the unintended consequences of policy and market decisions on medication accessibility, especially among vulnerable populations such as children with chronic conditions. Policymakers are encouraged to consider the broader impact of rebate reforms and to implement safeguards to maintain access to essential medicines for all patients.