In an attempt to avoid causing more damage to the ozone layer, asthma inhalers are now required to be made with a more environmentally safe propellant — which area pharmacists said is very expensive and may have a different feel to users.
Peter Kistler, a pharmacist at The Medical Center Pharmacy in Sunbury, said while the new ingredients in the inhalers are better for both the environment and people, the prices are much higher.
For example, Albuterol — one of the more common inhalers used by asthma patients — sold for about $10 an inhaler 10 years ago, Kistler said. Now, it is close to $18.
Albuterol containing the new ingredients is around $50.
The price increase varies between brands and will be covered by insurance if the old inhaler was.
“It’s a burden on everyone,” Kistler said. “But they are rescue inhalers, you have to have them.”
Dean Parry, director of Clinical Pharmacy Programs at Geisinger Medical Center in Danville, said the only thing being changed is the gas that is used to actually move the drug out of the inhaler into the lungs.
The gas previously used has been chlorofluorocarbons, of CFCs.
A treaty — the Montreal Protocol — was signed three years ago in an attempt to eliminate CFC propellents because they are associated with damaging the ozone layer, Parry said.
“In that process, the Food and Drug Administration made a resolution that said by the end of this year, companies had to switch to an alternative propellent,” he said.
Now, inhalers will be manufactured with hydrofluoroalkane, or HFA, which doesn’t affect the ozone layer and breaks down quickly once in the atmosphere, Parry said.
The new inhalers do feel different than the former CFC ones, in the way that they are not as powerful of a propellent.
Previously, users felt a strong blast in the back of their throat, which doesn’t happen with the new inhalers.
The air also isn’t cold, which the former was.
“It works the same, but patients need to understand it’s going to feel different,” Parry said. “Some associate the cold blast in their throat as being effective. It isn’t. They think the new ones aren’t working, but they are.”
Kistler said the same amount of active ingredient is being used, despite the small propellent sensation.
He added that often the old inhalers would cause a cough — the new ones don’t.
“It doesn’t feel like you are getting the dose,” Kistler said. “Not as big of volume is going into the mouth. It’s about half the amount, even though you’re getting as much active ingredient.”
An additional difference between the new and old brands is that the new types have a counter on them to track how many doses have been used and how many are left.
“The new inhalers have a lot more propellent than drug,” said Parry, “so you have to pay attention to the counter because you can literally be using the inhaler without drug left.”
He added in that situation, it is not harmful other than the fact that the patient is not getting the medicine needed for asthma.
When the counter reaches zero, the patient knows they need a new one.
The new inhalers also come with instructions on special cleaning requirements, he said.
“Because the propellent isn’t as strong, not much force of pressure is behind,” he said. “You need to keep it clean because if something is obstructing it, it won’t get through.”
Parry said each is designed differently and has specific instructions.
The old inhalers will no longer be manufactured come the beginning of the new year, but can be sold if businesses still have some in stock. Once they are sold out, patients will be required to buy the new brand.
“When they’re gone,” Kistler said, “they’re gone.”
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