Appeal Your Insurance Coverage
If your insurance refuses to pay for a medicine, you have the right to appeal, Carver says. Essentially, that means you are asking the insurance company to investigate and reconsider the decision to deny coverage of a certain medication or procedure. Healthcare.gov walks you through the steps of the appeal process.
Learn more about how Optum Perks works and how it can help you save on your familys prescriptions at over 64,000 pharmacies nationwide.
First New Asthma Inhalers Were Required
CFC inhalers worked well for most of us and we liked that we could feel the medicine being projected into our lungs. Unfortunately, CFCs were found to be harmful to the environment, specifically to our ozone layer. The U.S. signed an international agreement called the Montreal Protocol on Substances that Deplete the Ozone Layer in 1988. They continued to be leaders within the Protocol throughout its existence and took strong domestic actions to stop making substances that used CFCs . 2,3
Over time, CFC-powered inhalers were phased out in favor of more environmentally-safe versions called HFA inhalers. HFA stands for hydrofluoroalkane, which is simply a different, safer type of propellant. Unfortunately, we users have always maintained that HFA inhalers have a very different taste and feel from our CFC inhalers. The spray has a softer feel that’s harder to detect.
In addition, the care and cleaning of HFA inhalers is much more important in order to ensure you are getting the correct dose. But HFA inhalers deliver the same medicines and are every bit as effective as their predecessor CFC inhalers.
Heres Why Asthma Inhalers Are So Expensive
In 2013, the New York Times published an expose on the high price of asthma inhalers, in an article headlined The Soaring Cost of a Simple Breath.
So whats happened in the 7 years since? Prices have only gotten worse.
A GoodRx analysis of cash prices for asthma inhalers shows that prices climbed about 35% from 2013 to 2018, from an average price of around $280 in 2013 to more than $380.
The average cash price for one inhaler of , a leading medication for asthma, increased from $316 in 2013 to $496 in 2018 a 56% increase. The average cash price for , another widely prescribed brand, increased 41% between 2013 and 2018, from $207 to $292.
The average inhaler price combines prices for 16 leading inhaler products. These numbers are based on a representative sample of prescription fills at U.S. pharmacies. They reflect overall U.S. prescriptions, not fills using GoodRx. The data comes from several sources including pharmacies and insurers and provides a representative sample of nationwide U.S. prescription drug volume.
Even worse, high costs for asthma disproportionately hit underinsured and uninsured individuals. A report from the Centers for Disease Control and Prevention found that in some states as many as 20% of people with asthma do not have insurance and are forced to pay out of pocket for their inhalers. Even more, individuals lacking insurance tend to live in lower-income areas, which tend to have higher rates of asthma.
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When You Dont Want Credits
You may have your own reasons for wanting to use a branded version of your inhaler, and thats fine.
Be aware, however, that your health insurer may require you to try a generic drug for a set period of time before agreeing to approve a branded version.
You may also have to pay a higher copayment for a brand name drug than for a generic.
If you dont want the generic version of your inhaler, make sure your healthcare provider writes a prescription specifically for the non-generic formula. Some insurers require pharmacists to default to generic unless otherwise specified.
Risks Of Otc Asthma Medication
OTC asthma inhalers are quick-relief medications that a person should use as soon as asthma symptoms develop. A doctor may also prescribe them for people with exercise-induced asthma who will need to take the medication before working out.
Inhalers send medication directly to the inflamed airways, but it is important to make sure that it reaches the lower lungs.
As with other quick-relief medications, people should only use OTC asthma inhalers occasionally. According to the American College of Allergy, Asthma & Immunology, if people feel the need to use an inhaler more than twice within a week or on 2 or more nights a month, they should contact their doctor because their asthma treatment plan is not working as it should.
As asthma is different in every individual, some experts recommend against any kind of OTC treatment, emphasizing the importance of individualized treatment plans.
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What Does Ventolin Hfa Do
Ventolin HFA is a short-acting beta2-agonist . Its known as a bronchodilator, which means that it helps open up your airways. It does this by attaching to beta2-receptors that are on certain muscles in your airways.
When Ventolin HFA attaches to these receptors, it causes the muscles to relax. As the muscles relax, your airways open and become wider. This allows air to flow through them more freely as you breathe.
Because Ventolin HFA works so quickly to relax airways, its also called a rescue inhaler. This medication is meant to be used to quickly relieve bronchospasm symptoms.
How Environmental Concerns Have Made Inhalers More Expensive
Up until 2005, available inhalers contained chlorofluorocarbons , a greenhouse gas that is known to destroy the ozone layer. They were affordable and effective. At the time most products that contained chlorofluorocarbons, like packing materials and refrigerants, were banned per an agreement intended to protect the ozone layer called the Montreal Protocol. Unter this agreement, inhalers were considered essential medications and were exempt.
But this exemption was overturned in 2005 with some help from pharmaceutical lobbyists. From 2005 to 2010, Pharmaceutical manufacturers paid lobbyists over $500,000 to work to ban old CFC inhalers, with the argument of environmental protection. But, why would manufacturers spend money to ban CFC inhalers, ultimately deeming their products illegal and unsellable?
Think of it this way, in order to remove the CFC from an inhaler, manufacturers only have to substitute the propellant used, without touching the active ingredients. This means that manufacturers could rebrand their product, with little to no drug research and development costs, and add a completely new patent protection to their product that could grant them market exclusivity. And this is just what they did.
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Managing An Asthma Attack
If youre having an asthma attack, its important to remain calm. You should use your rescue inhaler as soon as you begin to feel the symptoms of an asthma attack occurring.
Continue to monitor your symptoms. You should feel relief within 20 minutes after using the rescue inhaler. Even if your rescue inhaler works to relieve the symptoms of your asthma attack, its a good idea to call your doctor to follow up.
Asthma attacks can sometimes be serious, requiring treatment in the emergency room. If your rescue inhaler doesnt relieve the symptoms of your asthma attack, seek immediate emergency medical care.
- rapid breathing during which your skin sucks in around your ribs while inhaling
- rapid movement of the nostrils
- ribs, stomach, or both moving in and out deeply and rapidly
- blue coloring of the face, fingernails, or lips
- chest that doesnt deflate when you are exhaling
What Are Warnings And Precautions For Albuterol
Warnings
- This medication contains albuterol. Do not take Proventil HFA, Ventolin HFA, Proair HFA, ProAir RespiClick, Proventil, AccuNeb, Ventolin Injection, Ventolin Nebules PF, Ventolin Oral Liquid, Ventolin Respirator Solution, or Vospire ER if you are allergic to albuterol or any ingredients contained in this drug
- Keep out of reach of children In case of overdose, get medical help or contact a Poison Control Center immediately
Contraindications
- Severe hypersensitivity to milk proteins
Effects of Drug Abuse
- Excessive use may be fatal do not exceed recommended dose serious adverse effects occur when administered dose exceeds recommended dose
Short-Term Effects
- See “What Are Side Effects Associated with Using Albuterol?”
Long-Term Effects
- See “What Are Side Effects Associated with Using Albuterol?”
Cautions
- Use with caution in patients with cardiovascular disease, asthma, glaucoma, diabetes, hypokalemia, hyperthyroidism, or seizures
- Use facemask in children under 4 years
- Excessive use may be fatal do not exceed recommended dose serious adverse effects occur when administered dose exceeds recommended dose
- May exacerbate heart failure in patients with reduced ejection fraction
Pregnancy and Lactation
- Use albuterol with caution during pregnancy if benefits outweigh risks
- Animal studies show risk and human studies are not available or neither animal nor human studies done
- It is unknown whether albuterol is excreted in the milk use while breastfeeding is not recommended
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Side Effects And Risks
Ventolin HFA and Symbicort contain different drugs. Therefore, both medications can cause some similar side effects. Below are examples of these side effects.
More common side effects
These lists contain examples of more common side effects that can occur with Ventolin HFA, with Symbicort, or with both drugs .
- Can occur with Ventolin HFA:
Drug Forms And Strengths
Ventolin HFA comes as an inhaler device. Its available in two inhaler sizes:
- an 8-g device that holds 60 inhalations
- an 18-g device that holds 200 inhalations
Each puff of Ventolin HFA delivers 90 mcg of albuterol.
A dose counter is built into each inhaler device. The dose counter tells you how many inhalations are left in your inhaler.
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Fda Approves Generic Of Commonly Used Albuterol Inhaler:
The first generic albuterol sulfate metered-dose inhaler, 90 mcg/inhalation has been approved by the Food and Drug Administration for patients ages 4 years and older.
The product is indicated for the treatment or prevention of bronchospasm in patients with reversible obstructive airway disease, as well as the prevention of exercise-induced bronchospasm.
There is an increased demand for albuterol products, particularly during the coronavirus disease 2019 pandemic, the FDA noted. In March, the FDA issued a revised draft of product-specific guidance for proposed generic albuterol sulfate metered-dose inhalers.
Manufactured by Cipla Limited, the generic inhaler was granted FDA approval based on data and information demonstrating that it met bioequivalence recommendations and standards ensuring quality to be as safe and effective as the brand-name counterpart.
According to a company statement, product shipments are being planned in a staggered manner, and inhalers also are being donated during the pandemic.
How Much Do Inhalers Cost Without Insurance
According to Dr. Gupta, asthma inhalers can be separated into two different categoriesquick-relief medications and control medications .
Short-acting inhalers, or rescue inhalers, help when youre experiencing asthma symptoms, or your asthma is not under control. This medication should only be used as neededideally, youd never have to use it. Everyone with asthma, whether mild or severe, should be prescribed a rescue inhaler. Inhalers of this category include short-acting beta-agonists, such as albuterol inhalers.
Long-acting inhalers, or maintenance inhalers, help with the inflammation in your airways in cases of moderate to severe asthma. These inhalers are not designed to provide quick relief in the event of an asthma attack. Instead, they should be used to help manage and control long-term asthma symptoms.
These medications need to be taken daily to be effective. Depending on the prescribed medication, this may mean once daily or multiple times per day. Inhalers of this category include long-acting beta-agonists, inhaled corticosteroids , and combination inhalers that contain both a long-acting beta-agonist and corticosteroid.
The cost per inhaler will typically vary based on the type of inhaler that it is and whether its a brand-name or generic drug.
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How Do Anticholinergic Bronchodilators Work
Anticholinergics are bronchodilators mainly used for treating COPD and asthma.
- Atrovent treats COPD and can be used off-label to treat asthma flares. You can get it as an inhaler and a nebulizer solution. Dry throat is the most common side effect. If the medication gets in your eyes, it can cause blurred vision for a short time.
- Revefenacin is a new medication used daily to help those with COPD breathe easier. Long-acting, it is taken once a day with a nebulizer.
- Tiotropium bromide is for people who have either asthma or COPD. It comes in an inhaler. Anyone over 6 can may use this medication once daily as a long-term asthma treatment. Itâs used for COPD flares and long-term treatment if inhaled bronchodilators donât help.
Why People Use Their Inhalers Too Much
According to Gerald, inhaler overuse is fairly common among patients with asthma, and there are many factors that contribute to overuse.
One reason people overuse their inhalers is that they arent able to access health care. A person who hasnt been able to get the right controller medication may lean more heavily on an inhaler because its often easier to get a prescription for it.
Over-users also tend to have lower knowledge about asthma as a disease, said Gerald. And they report being less able to manage asthma on their own.
As Geralds research found, inhaler overuse might also be tied to depression. While the link between albuterol overuse and mental health is not totally clear, depressive symptoms may change a person’s perception of their asthma symptoms and how well their disease is controlled.
There have also been some reports that depression has been linked to less responsiveness to the albuterol medication itself, said Gerald. The logic is that there are some common physiologic pathways between depression and asthma that might change a patients response.
There is a lot more research to be done, he added.
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Other Asthma Costs To Consider
If you have moderate or severe asthma, youll need to see your doctor more regularly to check on your treatment plan. However, you should only need a yearly check-in if you have mild asthma, shares Dr. Gupta. In addition to the costs of your routine office visits and prescription medications, testing will also be done at least annually to see how your lungs are doingthis adds an additional cost to your asthma treatment plan.
According to one 2018 study by the CDC, the average annual medical cost of asthma was $3,266 per person. This total annual cost per person was then broken down into the following:
- Prescription medications accounted for an average of $1,830 of the total annual cost per person.
- Office visits accounted for approximately $640 of the total annual cost per person.
- Hospitalization accounted for approximately $529 of the total annual cost per person.
- Hospital-based outpatient visits accounted for approximately $176 of the total annual cost per person.
- Emergency room visits accounted for approximately $105 of the total annual cost per person.
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Even with proper medication adherence and additional cost-saving methods, the total cost of asthma can be a financial burden for many. Talk to your healthcare provider about alternative inhaler options and possible side effects. They will help determine if a less expensive inhaler may work for the treatment of your asthma symptoms.
Agency Supports Development Of Complex Generic Drug
Today, the U.S. Food and Drug Administration approved the first generic of Symbicort Inhalation Aerosol for the treatment of two common pulmonary health conditions: asthma in patients six years of age and older and the maintenance treatment of airflow obstruction and reducing exacerbations for patients with chronic obstructive pulmonary disease , including chronic bronchitis and/or emphysema. This complex generic drug-device combination product, which is a metered-dose inhaler, should not be used to treat acute asthma attacks.
Todays approval of the first generic for one of the most commonly prescribed complex drug-device combination products to treat asthma and COPD is another step forward in our commitment to bring generic copies of complex drugs to the market, which can improve quality of life and help reduce the cost of treatment, said Sally Choe, Ph.D., director of the Office of Generic Drugs in the FDA Center for Drug Evaluation and Research. This reflects the FDAs continued efforts to increase competition and access to quality, safe, effective and affordable medicines for patients and consumers.
This drug-device combination product is a metered-dose inhaler , which contains both budesonide and formoterol . Two inhalations, two times a day , treat both diseases by preventing symptoms, such as wheezing for those with asthma, and by helping with better breathing, for those with COPD. The inhaler is approved for two strengths .
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Patient Assistance Programs Offered By Drug Companies
Many drug companies offer patient assistance programs , which offer free or lower-cost medicines to people. Drug companies offer these programs voluntarily, and discounts will vary.
The Allergy and Asthma Network provides a list of asthma and respiratory drugs and their manufacturers. The list includes more details about reduced cost savings programs, drug costs, and contact information for the drug companies.
Patient Assistance Programs For Drug Costs
There are a number of patient assistance programs that can help you pay for your asthma medicines and other drugs you need. These resources also allow you to print a discount card to use at your pharmacy.
- NeedyMeds can connect you to prescription assistance programs for specific asthma drugs. The site also provides information on a variety of nationwide and state-specific services for people with asthma, including testing/screening, medical supplies, and treatments.
- RXAssist has information about free and low-cost drug programs. You can also find details on other ways to lower your drug costs.
- RXOutreach is a nonprofit pharmacy that makes drugs more affordable for eligible people with asthma and other illnesses.
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