Why are asthma/ COPD inhalers so costly? What can you do?

The following was originally published at healthcentral.com on November 14, 2014. 

The Soaring Cost of COPD Inhalers and What You Can Do

If you have COPD or asthma you are probably well aware that inhalers used to treat these diseases can be very expensive. This topic has become such an issue in recent years it even inspired Elizabeth Rosenthal to write an article, “The Soaring Cost of a Simple Breath” for The New York Times.

An albuterol inhaler could be bought for as little as $5 or $10 ten years ago. This was a price that most of us were more than happy to pay for inhalers that can give us our breath back.

The price is now $50, and the reason is because of the Montreal Protocol, which resulted in new regulations that forced pharmaceuticals to make the switch to environmentally friendly propellants. This forced pharmaceuticals to change their formulas.

Because of the new formula, they were able to re-patent these inhalers, thus eliminating other companies from making cheaper generic versions of albuterol, thus driving up the cost for us.

So, while these inhalers may now be environmentally friendly, they are not wallet friendly. To make matters worse, inhalers used to control and prevent COPD and asthma cost even more than albuterol -- way more.

Advair and Breo are expensive because they use complicated formulas that require complicated delivery devices that are very expensive to produce.

The patent on the Advair Discuss expired in 2010, but, as I explained in my post “When can we expect a generic Advair?,” no cheaper generic alternatives appeared because of the high cost of testing to gain FDA approval, and the difficulty of producing a cost effective delivery device that doesn't infringe on existing patents (the patent on the discuss doesn't expire until 2016).

To get an idea of how much these inhalers cost without insurance, I called our local Walgreen’s pharmacist and he gave me the following prices:

1. Advair 50/250: $300
2. Advair 50/500: $400
3. Breo Elipta: $300
4. Albuterol inhaler: $50

This is what you'd have to pay without insurance.

Here is what these inhalers might cost if you have insurance, although it depends on the plan you have. I will use my own co-pays that will be effective as of January 1, 2015: 

1. Advair 50/250: $50
2. Advair 50/500: $100
3. Breo Elipta: $100
4. Albuterol inhaler: $40 for one

So, you see, these inhalers are expensive even if you have insurance. With or without insurance, the cost of “a simple breath” is “breathe taking.” Sorry to use a cliche there, but it was only fitting.

In order to gain and maintain good asthma and COPD control, it's essential that you take the medicines recommended by your physician.

If you need help affording the steep prices, please check out my post “10 tips to help you afford asthma medicine.” The post was written for the asthma site, but, since many of the same medicines apply to both diseases, these tips will work for COPD patients too.

I have personally used tip No. 1 (talk to your doctor about free samples) quite often. Also, to reduce the cost of Breo (a medicine I need to control my asthma), my wife is planning on using tip No. 5 (contact the producers of your medications). All she has to do is fill out some papers and GlaxoSmithKline will reimburse us $50 for each inhaler, making the cost $50, a price we can live with.

There is a lot of risk taken by pharmaceuticals to produce new medicine, and it costs millions of dollars. So I'm fine with paying something. But $300 a month is a bit steep. The good news is that once the patent for these medicines and their delivery devices expire, we should expect for these prices to come down quite a bit. Until then we'll just have to do with the above prices.

Albuterol, Advair, and Breo are great medicines for controlling and treating COPD and asthma. If your physician recommends them for you, it’s important to take them exactly as prescribed. If you need help affording them, check out the link above.