A woman uses an inhaler.
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Good day! Inhalers will soon become much cheaper for some Americans.
Three of the world’s largest inhaler makers have agreed to cap the price of their inhaler products and similar inhaler drugs at $35 a month for certain US patients.
British drugmaker GlaxoSmithKline announced the spending cap last week, following similar moves by AstraZeneca and private Boehringer Ingelheim.
But there is one caveat: Teva Pharmaceuticals, another major inhaler maker, has made no such commitment.
The spending caps from the other three companies will not take effect immediately. They didn’t come out of nowhere either.
In January, Sen. Bernie Sanders (I-Vt.) and other members of the Senate Health, Education, Labor and Pensions Committee launched an investigation into why all four companies charge more for inhalers in the U.S. than in other countries.
It adds to years of political scrutiny and public anger the broader pharmaceutical industry has faced over high US health care costs. Last year, Eli Lilly, Novo Nordisk and Sanofi moved to lower the cost of some insulin products for some US patients after pressure from the same Senate panel.
So who usually uses inhalers and how much do they cost in the first place?
People with chronic lung diseases that affect their breathing, such as asthma or chronic obstructive pulmonary disease or COPD, most often use inhalers. They can use daily inhalers to prevent or manage their symptoms and quick-acting inhalers at times when their breathing becomes worse, such as during an asthma attack.
An estimated 25 million Americans have asthma, while about 16 million suffer from COPD. Many of these patients rely on inhalers to help them breathe, and some end up having to ration these products because of the cost, the Senate HELP committee said in a January release.
Here’s what the panel says drugmakers charged for some of their inhaler products:
In addition to the price differences, the panel argued that the companies had inappropriately extended monopolies on their products.
The committee alleged that drugmakers used tactics such as obtaining additional patents near the end of their market exclusivity period, switching patients to newer versions of inhalers with longer patent protection, and entering into agreements with generic drugmakers , to prevent cheaper competition. Generic inhalers can cost as little as $30.
School nurse Carrie Personette holds a child’s inhaler in the nurse’s office at the Barrington Early Learning Center in Barrington, Illinois on February 15, 2017.
Stacey Wescott | Chicago Tribune | Tribune News Service | Getty Images
In particular, GSK said it recently reduced the list price of Advair HFA by an average of 20%, and a similar product, Advair Diskus, by an average of 50%.
GSK’s new price cap applies to both these products and the rest of its asthma and COPD inhaler portfolio. This includes the company’s popular Trelegy Ellipta and other Ellipta inhaler products, among others.
The restrictions come after GSK stopped production of branded asthma inhalers Flovent HFA and Flovent Diskus in early January. The company changed them with “authorised generic” versions of the inhaler that are identical except for the brand.
The company’s price cap will specifically benefit patients taking these drugs, whose monthly costs currently exceed $35. It will take effect on January 1, 2025, GSK added in a statement.
Meanwhile, AstraZeneca’s price cap will apply to the company’s entire range of inhaled products used to treat asthma and COPD. This includes Symbicort, Breztri Aerosphere, Bevespi Aerosphere and Airsupra.
The cap will apply to uninsured or underinsured patients and will take effect June 1.
This is the same day that Boehringer Ingeleim’s out-of-pocket cost cap will take effect for all of its inhaler products.
Boehringer Ingelheim’s cap will apply to the “most vulnerable patients,” including the uninsured or underinsured. The restriction applies to its products Atrovent HFA, Combivent Respimat and Spiriva, among others.
Sanders applauded the three companies for announcing their spending caps.
“This will significantly lower costs for millions of Americans with asthma and COPD so they can afford the inhalers they need,” he said in a statement last week.
We’ll be watching to see if Teva announces its limit.
Feel free to send any tips, suggestions, story ideas and data to [email protected].
Digital diabetes management tools drive up healthcare costs, fail to improve patient outcomes, report finds
Very digital diabetes management tools aren’t all they’re cracked up to be, finds a new report published by the Peterson Health Technology Institute (PHTI).
PHTI is a non-profit organization that conducts independent evaluations of digital health solutions. For its first report since its founding last year, the institute examined whether tools from DarioHealth, Glooko, Omada, Perry Health, Teladoc’s Livongo, Verily’s Onduo, Vida and Virta made a meaningful difference for patients with type 2 diabetes.
All of these companies claim that their digital diabetes tools help people monitor their blood sugar, and many offer additional information related to medications, diet and exercise.
The solutions PHTI included in its report were typically created between five and 15 years ago and use an app or website to connect to a non-permanent glucose monitor that patients use to measure their blood sugar by pricking their fingers.
PHTI found that these digital tools for diabetes management “did not provide meaningful clinical benefits,” the report said. For example, the solutions typically help patients only register “small decreases” in HbAIc, which is a blood test that measures their average glucose level over a three-month period. In addition, the small benefits of the tools “will diminish over time,” according to the report.
As a result, PHTI said these digital methods of diabetes management increase net health care costs for health plans, providers and self-insured employers.
“These tools do not replace other care that people with diabetes receive,” said Caroline Pearson, executive director of PHTI, in an interview with CNBC. “Once you factor in the cost of the technology, you don’t see enough savings in clinical benefits to offset that additional cost.”
The institute conducted its analysis of these diabetes management tools by reviewing existing published literature such as scientific articles as well as data provided by the companies themselves, the report said.
The PHTI report drew mixed responses from doctors and digital health experts. The Digital Therapeutics Alliance, whose members include DarioHealth, criticized the framework of the institute’s analysis.
The group said the limited choice of solutions and stakeholders, as well as PHTI’s reliance on predictive models, could be improved. He called for more “transparency and inclusiveness” in future reports.
“DTA respectfully disagrees with the conclusions reached, particularly in the case of DarioHealth, as we can only speak to the evidence and performance of DTA member companies,” the organization said in a statement.
Although PHTI evaluated solutions that connect to continuous glucose monitors, it said it did not evaluate how continuous glucose monitors affect patient outcomes. Continuous glucose monitors provide patients with real-time blood sugar readings and are becoming an increasingly popular offering for type 2 patients, although not all insurers cover them.
Traditional meters are now “far more common” in the US, according to the report.
Pearson said there were a few bright spots in the report, such as Virta’s tool for nutritional ketosis, which is a diet that often requires a major lifestyle change. Technology is also evolving, Pearson added, so she thinks the arrival of continuous glucose monitors and GLP-1s could “dramatically” change the way diabetes is managed.
But for now, she said the initial response to the PHTI report is one of appreciation as providers, health plans and self-insured employers work to determine which solutions are worthwhile.
“We believe that if the health care system is going to pay for digital tools, they should make people better,” Pearson said.
You can read the full report here.
Feel free to send any tips, suggestions, story ideas and data to Ashley at [email protected].