With Flovent inhaler off the market, some parents face challenges in getting generics for kids with asthma

After Flovent, one of the most popular inhalers for treating childhood asthma, was discontinued this past January, some parents are reporting challenges in obtaining the generic versions of the medication.

Both versions are identical medications and manufactured by the same pharmaceutical company, GSK, which is based in London.

“Effective Jan. 1, 2024, and subsequent to the availability of these authorized generics, GSK will discontinue manufacturing branded Flovent HFA (all strengths) and branded Flovent Diskus (all strengths) for the U.S. market,” GSK said in a statement in the fall of 2023.

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“It’s important to understand that the transition from branded to authorized generics will not have an impact on our ability to supply the market, and we expect minimal disruption for patients,” the company added.

Most insurance plans likely will replace Flovent with a generic version, but some customers may experience delays if their insurance doesn’t cover the generic, the Asthma and Allergy Foundation of America (AAFA) says on its website.

“The U.S. has a complicated drug pricing ecosystem,” said Kenneth Mendez, president and CEO of AAFA, in a statement the foundation shared with FOX Business. 

“The U.S. has a complicated drug pricing ecosystem.”

“Drug manufacturers, pharmacy benefit managers, insurance companies, employers and federal policies can create situations that reduce access to critical medications for patients,” he added.

Here’s what to know about the transition from the brand name to the generic version of Flovent.

Generic versions vs. Flovent

Asthma is a chronic lung condition characterized by narrowing and inflammation of the airways, according to the National Institutes of Health (NIH).

Bronchodilators, such as albuterol, help dilate the airways, while inhaled steroids like Flovent help control lung inflammation.

Some patients with asthma need to take inhaled steroids daily to prevent worsening of respiratory symptoms.

GSK noted that the authorized generic versions of Flovent contain the same medicine – in the same device and with the same instructions – as the name-brand version.

“We have seen the price of Flovent increase. The price of Flovent HFA, fluticasone propionate HFA and Flovent Diskus has risen 47% since 2014,” Tori Marsh, director of research at GoodRx, who is based in Colorado, told Fox News Digital.

“Usually when we see brand drugs discontinued in favor of generics, it’s to create lower prices for consumers.”

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When medications become generics, multiple manufacturers can produce them, which creates more competition, she said.

Yet consumers don’t always see these savings because insurance coverage plays a big role in determining what they will actually pay at the pharmacy, Marsh added.

If the insurance plan doesn’t cover the generic fluticasone, AAFA recommends requesting a “formulary exception” to determine whether the provider will opt to cover the inhaler. 

If the insurance plan still will not cover the generic, providers will look for alternative brands of inhalers, like ArmonAir Digihaler and Arnuity Ellipta, according to AAFA.

When insurance only covers a different generic inhaler, but not generic Flovent, this is when customers typically see large price discrepancies, Marsh said.

Reactions to the switch

Some users are discussing on social media how the switch is affecting their children.

One reported that a pharmacy had difficulty maintaining a consistent supply of the drug.

“And as a bonus, my insurance still charges me the same copay as a brand-name medication,” a frustrated user wrote on Reddit.

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Other parents have not noticed any difficulties with the switch.

One user said they’re using the generic version, while another “just noticed that my son has actually been on the generic [version] for a while … He has not noticed a difference.”

Another parent expects her child’s doctor to switch the child to Arnuity, “which is basically the same thing.”

“I expect this to have minimal effect on her.”

Differences between inhaler types

“The type of device and type of medicine can impact effectiveness on individual patients,” Mendez told Fox News Digital.

Two common types of inhalers are meter dose inhalers (MDIs) or dry powder inhalers (DPIs) — but they are not used the same way, AAFA cautioned.

An MDI sprays a pre-set amount of medicine through the mouth into the airway, according to Cleveland Clinic’s website.

When the canister is pressed down, a propellant helps the medicine get into the lungs.

Some children have difficulty with this step because they must take a deep breath right as they press down on the canister, so the medicine may stay at the back of the throat instead of entering the lungs, Cleveland Clinic stated.

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Children often have an easier time using an MDI attached to a small cylinder-shaped tube known as spacer, according to the American Lung Association.

After the inhaler is attached to the end of the spacer, the child seals the lips tightly around the rubber ring on the other end.

Instead of having to synchronize a deep breath while pressing down on the inhaler, the child can take more normal breaths after the inhaler is pressed.

The spacer whistles to warn the child when they are breathing too fast to get the medicine to their lungs.

If a child is switched to a different brand of inhaler, he or she may be forced to use a DPI inhaler instead of an MDI, Mendez noted.

“A DPI is breath-actuated, meaning that a patient needs to be able to adequately breathe in the medicine and properly use the diskus device,” he said.

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Pulmicort, an inhaler in the same class of inhaled corticosteroids but with a different active ingredient than Flovent, only comes as a DPI.

The medicine is stored as a powder, but the inhaler does not contain a propellant to push the medicine into the lungs, so the patient must take a deep breath to use the inhaler properly, according to Cleveland Clinic.

“DPIs can be challenging to use for children, seniors who may lack dexterity, or those with severe asthma who cannot breathe deeply enough to get the medicine into their lungs,” Mendez said. 

Fox News Digital reached out to GSK, maker of Flovent, requesting comment.

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