Changing from Flovent to Pulmicort

Inhalers are a crucial medication for thousands of patients with asthma and other respiratory conditions. However, changes in pharmaceutical manufacturing and insurance coverage can lead to disruptions in access to these essential medications. One such example is the discontinuation of the branded asthma inhaler Flovent and its replacement with an authorized generic version. This transition has raised concerns among doctors and patients about potential delays in obtaining the new medication and navigating insurance coverage.

Understanding the discontinuation of Flovent

Flovent, manufactured by Glaxo Smith Kline (GSK), has been a widely used inhaled corticosteroid for the treatment of asthma for over two decades. However, GSK has decided to discontinue the production of branded Flovent HFA and Flovent Diskus in the United States. Instead, they are introducing an authorized generic version that contains the same active ingredient, but without the brand label.

The authorized generic versions of Flovent HFA and Flovent Diskus are identical to the brand name inhalers in terms of their device and medicine (fluticasone) but lack branding. They work in the same way and have the same dosing instructions. GSK’s intention behind this change is to provide potentially lower-cost alternatives for patients while ensuring the continuity of supply.

Insurance coverage challenges

While the authorized generic versions of Flovent offer the same therapeutic benefits as the brand-name inhalers, there may be differences in insurance coverage. Patients relying on Flovent may face challenges in getting the authorized generic fluticasone covered by their insurance plans. Each insurance provider has its own formulary and pharmacy benefits, which may not include the authorized generics.

To determine if the authorized generic fluticasone will be covered by your insurance, it is crucial to check with your insurance provider and review your plan’s preferred drug lists. Unfortunately, the lack of coverage for the authorized generic may lead to unexpected out-of-pocket costs for some patients. The change in medication and potential insurance hurdles can create difficulties, especially during the respiratory illness season.

Exploring Pulmicort as an alternatives to authorized generic fluticasone

If the authorized generic fluticasone is not covered by your insurance or you experience difficulties in accessing it, there are alternative inhalers available for the treatment of asthma. One such option is Pulmicort, a branded inhaler manufactured by AstraZeneca. Pulmicort contains the active ingredient budesonide and is considered an alternative to Flovent Diskus.

Flovent: An overview

Flovent, which contains the active ingredient fluticasone propionate, is available in several formulations, including Flovent HFA inhalers and Flovent Diskus. It is indicated for the control and prevention of asthma in individuals aged 4 and above. Flovent is available in different strengths, and the appropriate dosage should be determined by your healthcare provider.

Pulmicort: An overview

Pulmicort, on the other hand, contains the active ingredient budesonide and is available in various formulations, including Pulmicort Flexhaler and Pulmicort Respules. Pulmicort Flexhaler is an FDA-approved (Food and Drug Administration) drug for the maintenance treatment of asthma to prevent and control persistent asthma symptoms like shortness of breath, chest tightness, and wheezing in individuals of different age groups, depending on the specific formulation. Pulmicort should be used under the guidance of a healthcare professional who will determine the appropriate dosage for your specific needs.

Differences between Flovent and Pulmicort

Flovent and Pulmicort are both prescription drugs classed as inhaled corticosteroids and used for the control and prevention of asthma. However, there are several key differences between these medications. Understanding these differences can help you make an informed decision when considering a switch from Flovent to Pulmicort.

• Active ingredients: Flovent contains fluticasone propionate, while Pulmicort contains budesonide. The active ingredients in these medications belong to the same class of drugs but have different chemical structures
• Dosage forms: Flovent is available in both HFA inhaler and Diskus formulations, while Pulmicort is available as a Flexhaler or Respules. The choice of dosage form may depend on your individual preferences and the age of the patient.
  Flovent is available in three different strengths: 44 mcg, 110 mcg, and 220 mcg. This allows for more flexibility in dosing and allows healthcare providers to tailor the treatment to the individual’s needs.
  Pulmicort, on the other hand, is available in different formulations with varying strengths. The Pulmicort Flexhaler comes in two strengths: 90 mcg and 180 mcg. The Pulmicort Respules come in different strengths, including 0.25 mg/2mL, 0.5 mg/2mL, and 1 mg/2 mL. The dosage prescribed will depend on the healthcare provider’s recommendation.
• Strengths: Flovent is available in different strengths, including 44 mcg, 110 mcg, and 220 mcg for the HFA inhaler, and 50 mcg, 100 mcg, and 250 mcg for the Diskus. Pulmicort, on the other hand, is available in strengths of 90 mcg and 180 mcg for the Flexhaler, and 0.25 mg, 0.5 mg, and 1 mg for the Respules
• Age restrictions: The appropriate age for using Flovent and Pulmicort may vary depending on the specific formulation. Flovent is approved for use in individuals aged 4 and above, while Pulmicort is indicated for different age groups, ranging from 6 years and older for the Flexhaler to 12 months and older for the Respules
• Dosage recommendations: The recommended dosage of Flovent and Pulmicort may vary depending on individual factors, such as the severity of asthma symptoms and the patient’s age. It is important to follow the dosage instructions provided by your healthcare provider
• Method of administration: Flovent HFA inhalers and Pulmicort Flexhalers are both inhalation devices that deliver the medication directly into the lungs. However, the technique of using these devices may differ slightly. Pulmicort Respules, on the other hand, require the use of a nebulizer for administration
• Delivery devices
  Flovent is available in two different delivery devices: the Flovent HFA inhaler and the Flovent Diskus. The HFA inhaler is a metered-dose inhaler that delivers a specific amount of medication with each puff. The Diskus is a dry powder inhaler that requires the patient to manually load the dose before inhaling it.
  Pulmicort, on the other hand, is available in two different delivery devices: the Pulmicort Flexhaler and the Pulmicort Respules. The Flexhaler is a dry powder inhaler that delivers pre-measured doses of medication. The Respules are liquid formulations that are administered using a nebulizer
• Potential side effects
  Both Flovent and Pulmicort may cause similar side effects, such as throat irritation, hoarseness, and cough. These side effects are usually mild and can be minimized by rinsing the mouth after each use

Switching from Flovent to Pulmicort

If you and your healthcare provider have decided to switch from Flovent to Pulmicort, it is important to follow a proper transition plan to ensure a seamless switch. Here are some important steps to consider:

• Consult your healthcare provider: Before making any changes to your asthma medication regimen, consult your healthcare provider for medical advice. They will assess your individual needs and guide you through the transition process
• Review your asthma control: Your healthcare provider will evaluate your current asthma control and determine if switching to Pulmicort is appropriate for you. They may consider factors such as the severity of your asthma attacks, symptoms, frequency of exacerbations, and any side effects experienced with Flovent
• Adjust the dosage: Your healthcare provider will determine the appropriate dosage of Pulmicort based on your individual needs. This may involve adjusting the strength and frequency of administration to achieve optimal asthma control
• Learn proper inhaler technique: If you are switching from Flovent HFA to Pulmicort Flexhaler, it is important to learn the proper inhaler technique. Your healthcare provider or a respiratory therapist can guide how to use the Flexhaler effectively
• Monitor your symptoms: As you transition from Flovent to Pulmicort, it is important to monitor your asthma symptoms closely. Keep track of any changes in symptom frequency, severity, or triggers, and report them to your healthcare provider
• Follow-up appointments: Regular follow-up appointments with your healthcare provider are essential during the transition period. These appointments will allow your healthcare provider to monitor your progress and make any necessary adjustments to your medication regimen

Taking action to ensure continuous treatment

Given the discontinuation of Flovent and potential challenges in accessing authorized generic or alternative medications, patients need to take proactive steps to ensure continuous treatment. Here are some actions you can take:

• Check with your doctor or pharmacist: Reach out to your healthcare provider or pharmacist to discuss the best next steps for your treatment. They can guide transitioning to the authorized generic or alternative inhalers
• Verify insurance coverage: Contact your insurance provider to confirm whether the authorized generic fluticasone or alternative inhalers are covered under your plan. If coverage is not available, inquire about the possibility of a formulary exception or appeal to ensure access to the necessary medication
• Stay informed: Stay updated on any changes in your prescription and be aware of the specific medicine you have been prescribed. Not all inhalers are used in the same way, so understanding the proper usage is crucial for effective treatment
• Prepare for a possible switch: If you need to switch to the authorized generic or an alternative inhaler, consult your doctor about appropriate dosing and seek training on how to administer the medication correctly. Familiarize yourself with the new inhaler to ensure a smooth transition

Advocating for patient needs

The discontinuation of Flovent and the challenges in accessing authorized generic or alternative inhalers raise concerns among doctors and advocacy groups. For patients with chronic respiratory conditions like asthma, having uninterrupted access to their daily preventive medications is crucial, particularly during the respiratory virus season.

Physicians urge patients to take action now, be proactive, and work with their healthcare providers to ensure a smooth transition and continuous access to appropriate medications. Advocacy groups are also working to raise awareness and support patients during this transition period.

Besides Pulmicort, other alternatives to Flovent to discuss with a healthcare professional are Asmanex HFA (mometasone), Qvar (beclomethasone dipropionate), Advair Diskus (fluticasone propionate and salmeterol, Symbicort (formoterol and budesonide), Dulera (mometasone-formoterol), Alvesco (ciclesonide) and Arnuity Ellipta (fluticasone furoate and vilanterol).

Conclusion

In conclusion, the discontinuation of Flovent and the introduction of an authorized generic version present challenges for patients and healthcare providers. Navigating insurance coverage, exploring alternative inhalers, and taking proactive steps are essential to ensure continuous treatment. By staying informed and working closely with healthcare professionals, patients can manage this transition and maintain control over their respiratory health.

Sources

• Flovent HFA and Flovent Diskus Asthma Medicines Being Discontinued – Asthma and Allergy Foundation of America
• Flovent: Doctors warn about asthma inhaler switch coming in January – CNN
• Comparative-Doses-Chart.pdf
• Inhaled Corticosteroids – AAAAI
• Comparison of the effect of high-dose inhaled budesonide and fluticasone on adrenal function in patients with severe chronic obstructive pulmonary disease – PMC