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Asthma Sufferers Beware!

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Asthma Sufferers Beware!
Price of Albuterol Skyrockets;
Replacement Inhalers Present
Problems & Danger to Public

"In a place where life had no meaning,
death sometimes had its price."
-- For a Few Dollars More

By J. F. Miglio

For the 20 million-plus individuals in the United States who suffer from asthma, the prescription drug albuterol is their lifeline, their primary support system to keep breathing when undergoing an asthma attack.

The drug itself has been available in the United States since 1980 and has been sold under a variety of brand names, including Proventil and Ventolin. Of all the current drug treatments designed to help breathing problems, such as sudden shortness of breath, wheezing, and asthma seizures, albuterol is the safest and most effective on the market. In addition, millions of people use the drug and depend on it -- sometimes for life itself.

When albuterol went generic years ago, the price of the drug dropped dramatically, and up until this year, asthma sufferers who didn't have health insurance could purchase albuterol inhalers for a little over $6 a piece at large discount pharmacies, like Sam's Club.

Unfortunately, those days are over. Since the beginning of 2007, the price of albuterol has skyrocketed to $31 per inhaler at large discounters. Smaller pharmacies charge a lot more, and even customers who have health insurance that include prescription drugs do not escape the high cost. Many of them are paying up to $20 in co-payments.

According to the pharmaceutical industry, the reason for the price spike is that albuterol inhalers use chlorofluorocarbons (CFCs) as propellants for their oral delivery system, and CFCs are one of the substances that are in violation of the Montreal Protocol, an international treaty designed to protect the ozone layer. As a consequence, albuterol inhalers that use CFCs need to be phased out by Dec. 31, 2008, and replaced with a more environmentally friendly propellant.

Shouldn't be a problem, right? Just put the same albuterol formula without CFC propellants into new inhalers, phase out the old inhalers, and phase in the new ones using a more environment-friendly propellant. Ostensibly, this is what the good folks at Schering Plough and GlaxoSmithKline, the two major producers of albuterol, have been doing since the beginning of the year.

But there are problems. The new albuterol inhaler, which uses hydrofluoroalkane (HFA) instead of CFC to propel its mist into a user's lungs, is no longer available as a generic drug. You see, according to drug company logic, the exact same drug that used to be a generic is no longer a generic because it comes in a different container! As a result, albuterol has gone back to being proprietary to the companies that produce it under different brand names.

In other words, what used to cost customers $6 for albuterol (CFC) now costs them $31 for albuterol (HFA). But what justification is there to charge over five times as much for the same drug with a different inhaler? Big Pharma does not have a good answer for this except to say, "Well, you know, we had to switch delivery systems, and it costs us money to do that."

Okay...but over five times as much? When I checked with the Food and Drug Administration (FDA) about this apparent price gouging, their representative told me they couldn't help me because "we don't regulate the cost of drugs." Ditto with the American Pharmacists Association (APA).

"But don't you think this is price gouging?" I asked a spokeman for the APA. "It's not up to me to decide," the spokesman replied. "We live in a free market economy and the drug companies can charge whatever they want."

Yeah, free market -- free for multinational drug companies to gouge American citizens, and free for these same companies to pay off politicans to make sure they can continue to keep gouging American citizens without government intervention. As Bernie Sanders, the feisty independent Senator from Vermont, has stated many times: The drug companies have one of the most powerful lobbies in the country and have the highest margin of profit of all major corporations.

Of course, the price gouging is only part of the story. The new HFA albuterol inhaler is a different formula than the older CFC version, and it includes drugs that were absent from the previous one, including sulfates and ethanol. As a result, thousands of asthma inhaler users from all across the country have reported problems with the new HFA inhaler, from not being as effective as the old CFC version to having side effects that are dangerous and life-threatening. In response to this widespread dissatisfaction, Websites and chat rooms are springing up online filled with horror stories about asthma sufferers using the new product.

For example, a mother from Gale Cross, Indiana, wrote on a NO HFA Web site: "My son is now at risk. I stood beside him when he used the HFA inhaler for the first time. His air passages started to tighten immediately, coughing, etc. He had to use his nebulizing machine with chromolyn-sodium and albuterol solution to counter the HFA inhaler. He was irritated the rest of the day and worried this is supposed to be the future emergency treatment for an attack...when it caused an attack! Release the ban on CFC inhalers immediately!!!!"

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John F. Miglio is a freelance writer and the author of Sunshine Assassins, a dystopian political thriller. His articles have been published in a variety of periodicals, including Los Angeles Magazine and LA Weekly. His most recent articles (more...)

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