Glaxo Smith Kline’s decision to discontinue a popular children’s asthma inhaler, Flovent, more than two years ago has caused disruptions for physicians and health consequences for families nationwide, according to a report released Monday by New Hampshire Senator Maggie Hassan.
The new information includes results from surveys conducted last year by physicians at Boston Children’s Hospital. They found signs that some children experienced worse asthma symptoms, more missed school, and had more severe flareups after switching to a Flovent alternative. More than a quarter of the 43 families surveyed reported higher out-of-pocket costs from alternative treatments.
“When Flovent was discontinued it was absolutely a huge shock to our system,” said Dr. Ashley Saint-Fleur, a pediatric pulmonologist at Children’s who helped conduct one of the surveys.
Relief for families is expected, though. This month, the Food and Drug Administration approved a generic version of Flovent that, the agency reported, should make the treatment widely affordable again.
Flovent had been a go-to treatment for millions of children with asthma because its safety was well documented. Its delivery system, a metered dose inhaler that allows users to inhale the aerosol drug with as many breaths as needed, is an important feature for younger children with smaller lungs.
GSK discontinued Flovent HFA in December 2023 in response to new federal price limits. The company introduced an authorized, virtually identical generic version of the inhaler that was pitched as a potential cost saver. For many families, though, the switch, which allowed GSK to circumvent the federal price limits, was more expensive and less likely to be covered by insurers.
GSK, meanwhile, saved an estimated $367.6 million it would have owed in Medicaid rebates if it had continued to sell its inhaler under the Flovent brand name, Hassan said Monday.
The New Hampshire Democrat, ranking member of the Senate Finance Subcommittee on Health Care, said GSK was an outlier in seeking to circumvent the Medicaid price limits. But she still plans to support legislation that would prevent other companies from exploiting the same loophole. She she did not provide specifics on what the legislation might include.
“It is really important that big pharma understands it cannot price gouge and get away with it,” Hassan said at a news conference Monday.
About 4.6 million children nationwide are diagnosed with asthma, the FDA reported.
The report Hassan released Monday included another study from Boston Children’s Hospital that found more than half of 226 clinicians reported their practices had difficulty obtaining prior authorization for other asthma treatments, something not needed for Flovent. They also said they faced product shortages and struggled to match patients with an age-appropriate alternative.
One pharmacy benefit manager reported, meanwhile, that the net cost for the authorized generic was five times higher than the cost of Flovent for the average customer by the first half of 2024.
Glaxo Smith Kline said in a statement Monday that it had provided its authorized generic for a program to give free medication to patients who cannot afford the medication, and capped out-of-pocket costs at $35 for eligible patients using the pharmaceutical company’s nine marketed inhalers.
“GSK has always been and will continue to be strongly committed to ensuring patients, especially children, have access to the medicines they need,” the company said.
GSK is not involved with negotiations over cost or insurance coverage for its authorized generic, the company said. Those decisions are made by the medication’s manufacturer, Prasco Laboratories. That company did not respond to a call for comment.
As recently as the latter half of last year, 12 percent of families reported they were still struggling to get proper asthma treatment for children due to cost, lack of availability, or lack of coverage.
Alia Hayes, a Hampstead, N.H., mother of two, described during Hassan’s news conference how her son, Burton, was affected by the Flovent discontinuation.
She had tried to wean him off Flovent in favor of another treatment well before GSK pulled its medication off the shelves Instead, cold symptoms put her son in an emergency room with an asthma attack. Her son’s dry cough as he fought for air, which she compared to the sound of a “barking seal,” is permanently burned into her memory, she said.
“No one told me as a parent my most difficult moments weren’t going to be about my choices,” she said, “but instead, trying to rectify situations caused by greedy pharmaceutical companies.”
Jason Laughlin can be reached at jason.laughlin@globe.com. Follow him @jasmlaughlin.