CHANGE IN THE AIR

August 14, 2008

A federal ban on ozone-depleting chlorofluorocarbons (CFCs), to conform to the Clean Air Act, is, ironically, affecting 22.9 million people in the United States who suffer from asthma, says Scientific American.  Generic inhaled albuterol -- the most commonly prescribed short-acting asthma medication that requires CFCs to propel it into the lungs -- will no longer be legally sold after December 21, 2008.

As more patients see their prescriptions change and costs go up -- the reformulated brand-name alternatives can be three times as expensive, raising the cost to about $40 per inhaler -- many question why this ban must begin before generics become available.  Some skeptics point to the billions of dollars to be gained by the three companies, GlaxoSmithKline, Schering-Plough and Teva, holding the patents on the available HFA-albuterol inhalers. 

However, the main public health issue may not be the drug's chemistry, but rather the side effects of the economics:

  • Multiple studies have shown that raising costs leads to poorer adherence to treatment; one study discovered that patients took 30 percent less antiasthma medication when their co-pay doubled.
  • In the case of a chronic disease such as asthma, it is particularly difficult to get people to follow regular treatment plans.
  • The choice to forgo medication could affect more than just the patient; for example, in a pregnant mother with untreated asthma, less oxygen is delivered to the fetus, which could lead to congenital problems and premature birth.

Considering that the disease disproportionately strikes the poor, what seemed to be a good, responsible environmental decision might in the end exact an unexpected human toll, says Scientific American.

Source: Emily Harrison, "Change in the Air: Banning CFC-driven inhalers could levy a toll on asthma sufferers," Scientific American, August 2008.

For abstract:

http://www.sciamdigital.com/index.cfm?fa=Products.ViewIssuePreview&ARTICLEID_CHAR=08BE4E66-3048-8A5E-1056EEFC6FDC40AA

 

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