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CFC-Free Inhalers Are Available; Financial Assistance May Be Available

by Anne Marie Hummel, AARC Director of Regulatory Affairs

inhaler

As reported previously on Your Lung Health, at the end of 2008 the Federal Government began removing from the marketplace drugs that are harmful to the environment; that is, inhalers that use the propellant known as chlorofluorocarbons (CFCs). This action was mandated by certain provisions in the Clean Air Act.

While there are a number of products on the market that do not contain CFCs, for asthma sufferers and those with Chronic Obstructive Pulmonary Disease who were using the CFC inhalers, this meant having to switch to other medications that are friendly to the environment, such as those containing hydrofluoroalkanes, or HFAs.

In conjunction with this phase-out, if you have been using Primatene® Mist for the temporary relief of occasional symptoms of mild asthma, you will no longer be able to purchase the drug beginning next year. It is the only over-the-counter asthma inhaler medication sold in the United States.

Even though the removal of the drug won’t take place for a number of months, it is important for you to talk to your doctor or other health care professional as soon as possible so you can switch to another asthma medicine. It is best to plan ahead because current supplies may be limited.

A brochure from the Food and Drug Administration (FDA) about the removal of Primatene® Mist [http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm247196.htm] provides you with helpful information about switching to a new product and how to pay for drugs that may be more expensive. We encourage you to read it carefully. It also has links about the phase out of other CFC inhalers, such as Aerobid, Combivent and Maxair, which will take place between June 30, 2011 and December 31, 2013.

The brochure also has a link that provides information on the non-CFC drugs that are available to asthma and COPD patients. For your convenience, we have listed the products reported by FDA as of March 2011. As new non-CFC drugs are approved, the FDA will update the list and we will keep you posted accordingly. Remember, check with your doctor as to which may be the best choice of drug for your individual situation.

  • Proventil HFA (albuterol sulfate inhalation aerosol)
  • Ventolin HFA (albuterol sulfate inhalation aerosol)
  • ProAir HFA (albuterol sulfate inhalation aerosol)
  • QVAR (beclomethasone dipropionate inhalation aerosol)
  • Pulmicort Turbohaler (budesonide inhalation powder)
  • Pulmicort Flexhaler (budesonide inhalation powder)
  • Symbicort (budesonide and formoterol fumarate) Inhalation Aerosol
  • Alvesco (ciclesonide) Inhalation Aerosol
  • Flovent HFA (fluticasone propionate HFA inhalation aerosol)
  • Flovent Diskus (fluticasone propionate inhalation powder)
  • Foradil Aerolizer (formoterol fumarate inhalation powder)
  • Atrovent HFA (ipratropium bromide HFA inhalation aerosol)
  • Xopenex (levalbuterol sulfate HFA inhalation aerosol)
  • Asmanex Twistihaler (mometasone furoate inhalation powder)
  • Serevent Diskus (salmeterol xinafoate powder for inhalation)
  • ADVAIR Diskus (salmeterol xinafoate / fluticasone propionate powder for inhalation)
  • ADVAIR HFA (salmeterol xinafoate / fluticasone propionate)
  • Spiriva Handihaler (tiotropium bromide inhalation powder)

Financial Assistance Available for Many Drug Products
When the transition to non-CFC inhalers was first proposed, the AARC along with other groups strongly opposed any move that would create a cost barrier to patients’ access to the new alternatives. Nevertheless, the government moved forward with its plans. Unfortunately with the change to non-CFC inhalers, the cost of some of the new drug products is considerably higher than the previously available generic CFCs because they are Brand names and no generic substitutions are available at this time.

However, there are many resources available if you need help paying for your drug product or cannot pay at all. A number of drug manufacturers help low-income patients by easing the restrictions to receive free and discounted medicines. Coupons for free and discounted products are also available through physicians, at pharmacies and for download from individual manufacturer websites. There is also a low-cost alternative HFA inhaler (Ventolin HFA) that may be available at certain Target pharmacies for $9.00. You will need to check in your area to see if you can get it but know that it only contains 60 doses instead of the 200 doses that are generally prescribed. And, we are not certain how long it may remain available.

We are providing you with some of the key financial assistance programs available. You may find that some of these overlap with respect to the information available but we think these sites are most helpful. It is, however, by no means an all-inclusive list of programs. You will see as you click on these sites that they may also provide you with additional resources.

Prescription Assistance Program
This is a national program that provides many resources for financial help. It helps qualifying patients without prescription drug coverage get the medicines they need for free or nearly free.& According to the web site, they offer “a single point of access to more than 475 public and private programs, including more than 180 programs offered by pharmaceutical companies.”

It can also 1) direct you to programs that help with co-payments; 2) provide a link to savings cards, and 3) help you locate a free or low-cost clinic in your area. Click on the “Patient” link in the center of the page or the “Prescription Assistance Programs” link near the top to access the information. Assistance programs available in your state are also listed where applicable.

If you have trouble obtaining the information you need or are unsure how to use the website, there is a link for your doctor or pharmacist, a caregiver or community group member to help obtain assistance for you. They can help you by clicking on the “Patient Advocates” link.

www.pparx.org Call Toll free: 1-888-477-2669

RX Assist
This is an additional resource sponsored by AstraZeneca. It is a comprehensive database of programs run by drug companies to help you get free or low-cost medications if you cannot afford them. You can search by either the drug medication name or the drug company who makes the drug. Your doctor can also access the site and help you if necessary.
www.rxassist.org

Needy Meds
You can search this data base for financial assistance on brand name drugs as well as generics. It also has a link for drug coupons and how to find a free clinic near you.
www.needymeds.org

Asthma Patient Assistance Programs
This website lists 42 asthma drugs for which financial assistance is available as well the names of the drug manufacturers and how to contact them directly. It lists information on what is required from either your doctor or pharmacist and what you as a patient need to do to get help. Toll free phone numbers for the drug manufacturers participating in the program are also available.

The list was developed and updated by university pharmacy students several years ago so the information may not be completely accurate, but it cannot hurt to try it out inthe event in may be helpful.
www.ashp.org/Import/PRACTICEANDPOLICY/PracticeResourceCenters/
PatientAssistancePrograms/ SpecialtyResourcesGroup/
AsthmaPatientAssistancePrograms.aspx#GSK

Xopenex
This site is provided by the drug manufacturer, Sunovion and offers a “Breathe for Less” savings program. Xopenex comes in two formulations–Xopenex HFA Inhalation Aerosol (inhaler/puffer) and Xopenex Inhalation Soultion (nebulized solution). Talk to your doctor about which one is right for you. 
www.xopenex.com Call Toll free: 1-888-394-7377

Ventolin
This site is provided by Glaxosmithkine, the company that makes Ventolin. If you don’t have prescription drug coverage, the company may be able to help you regardless of whether you are age 65 or over, disabled or under age 65. Patient assistance programs from other sources are also available on this site.
www.gskforyou.com Call Toll free: 1-888-825-5249

© 2014 American Association for Respiratory Care