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Chlorofluorocarbon Ban Tied to Sharp Rise in Inhaler Cost

Price of albuterol medication nearly doubled

MONDAY, May 11, 2015 (HealthDay News) -- Federal action to protect the ozone layer has resulted in a dramatic increase in the cost of asthma inhalers in recent years, according to new research. The study, published online May 11 in JAMA Internal Medicine, is the first-ever attempt to assess the impact of the ban on out-of-pocket costs for albuterol inhalers.

In 2008, the U.S. Food and Drug Administration banned asthma inhalers containing chlorofluorocarbons (CFCs), substances that contribute to the depletion of ozone in the upper atmosphere. Immediately following the ban, the mean cost of albuterol inhalers rose from $13.60 per prescription in 2004 to $25 in 2009, study author Anupam Jena, M.D., Ph.D., an assistant professor of health care policy and medicine at Harvard Medical School in Boston, told HealthDay. The researchers drew their conclusions from pharmacy and medical claims filed between 2004 and 2010 with 77 private health plans in the United States.

The cost of albuterol inhalers decreased slightly in the following months, dropping to an average $21 by the end of 2010, Jena said. Their price has hovered around that level ever since. Prices for the inhalers exploded because manufacturers swapped out established and cheap generic CFC inhalers for more expensive brand-name inhalers containing hydrofluoroalkane, Jena said.

The price hike was tied to a slight decline in the use of asthma inhalers, the researchers found. The decline amounted to about 5 percent, related to an average $10 in patient out-of-pocket expenses. "This is a set of medications that patients with asthma really need to use," Jena said. "That's perhaps why we didn't see a large decline in utilization, even though the out-of-pocket cost went up considerably." The researchers also did not see an increase in hospitalizations due to asthma, likely because most people ate the extra cost and continued to buy and use inhalers, he said. However, the study authors added that it's not clear what effect the increased cost might have had for people without insurance.

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