Flovent asthma inhalers pulled from shelves and replaced with generic Jan. 1

Mary Walrath-Holdridge, USA TODAY
Updated ·6 min read

One of the most widely-used asthma and breathing treatments for over 20 years is being taken off the shelves in 2024, potentially leaving patients, healthcare providers and insurers scrambling.

Pharmaceutical manufacturer GlaxoSmithKline (GSK) announced that as of Jan. 1 it would no longer produce the asthma inhaler Flovent, one of the most popular preventive and maintenance treatments for asthma and pediatric asthma for decades.

The company will instead produce authorized generic versions of the inhalers, which it said will look and work the same but will simply not be branded with the Flovent name.

While GSK said the decision was made to offer a "potentially lower cost alternative" to patients who rely on the medication, experts have raised some concerns regarding the switch, including lower rates of insurance coverage, supply and prescription disruptions and pharmacy delays.

Doctors are suggesting people currently undergoing asthma treatment prepare for the switch and any potential hiccups, as it is important to maintain care with minimal interruption. Here's what we know about the switch so far.

GSK discontinues Flovent

In an email statement to USA TODAY, GSK said the company had launched the authorized generics of Flovent products in May 2022 and Oct. 2023 in conjunction with Prasco but are making the switch to utilizing only these generics starting Jan. 1, 2024.

"GSK will discontinue manufacturing branded Flovent HFA (all strengths) and branded Flovent Diskus (all strengths) for the US market," the pharmaceutical company said, as the generic alternatives work the same for a potentially lower cost. According to GSK, the non-name brand medications come in the same style of packaging with the same dosages and instructions as Flovent-branded products.

"These authorized generics will provide patients in the US with potentially lower cost alternatives of these medically important products," said GSK, and the change is the result of a commitment "to ensuring the affordability of our medicines."

While GSK has said the generics "may potentially be a lower-cost alternative to patients, depending on their insurance coverage and benefit design," reports have pointed out that the switch happened as a new provision to the 2021 American Rescue Plan Act came into play, which removes the cap on how much companies pay in rebates to Medicare if they have raised the prices of medications at a rate surpassing inflammation.

Past price hikes at a rate of almost 50% since 2014 may have left Flovent vulnerable to these Medicare costs, but a "new" medication without a history of such changes would not be. According to GoodRX data, the Flovent HFA inhaler 110mcg ran $337.77 per package on Dec. 1, 2023, and the Flovent diskus inhaler 100mcg cost $264.26.

According to CNN, the new authorized generic of Flovent HFA is set at $177.99, a markedly cheaper price on paper.

"It's important to keep in mind that the list price is not the price most people usually pay as it does not include discounts, rebates, and other price adjustments to wholesalers or any other customer," GSK likewise said.

However, the change poses a different kind of affordability problem: availability through insurance.

Insurance concerns

Melanie Carver, Chief Mission Officer of the Asthma and Allergy Foundation of America (AAFA), told USA TODAY that access to the authorized generic will depend on a person’s health insurance and pharmacy benefits.

"While we hope most plans will replace the brand name Flovent with the authorized generic – we will have to wait and see if that doesn’t happen and causes challenges for patients to get the medicine they need," she said. "For some people, the out-of-pocket costs may unexpectedly be higher with the generic if their plan doesn’t have the authorized generics on their preferred drug lists."

Carver advised that the inhalers and the medicine inside them, fluticasone, will remain the same after the branding change. Disruptions in treatment may still occur due to pharmacy and insurance delays, however. She also clarified that there are no direct substitutes for the fluticasone HFA and fluticasone diskus other than the authorized generics, as other inhalers may have different medicines, uses or doses.

"It is really important for people with asthma to continue their asthma control medicines, especially during respiratory illness season," said Carver. "Fluticasone works by controlling inflammation and swelling in the airways to prevent asthma attacks. Pharmacy delays can put a person with asthma at risk of worsening inflammation. It’s a good idea to check your insurance now to see if the authorized generic fluticasone will be covered by your plan."

Some major insurers and pharmacies err toward keeping name-brand medications such as ArmonAir Digihaler and Arnuity Ellipta on their preferred drug lists, meaning GSK's ostensibly lower-cost generic may no longer be available to patients. In some cases, this will simply mean speaking to your pharmacist to be re-trained on how to use a different brand or type of inhaler or treatment.

In some other cases, however, finding and using an alternative is not that simple.

"Although Flovent is an asthma medication, the HFA version (metered dose inhaler) is also used off-label for the treatment of eosinophilic esophagitis (EoE), a chronic allergic inflammatory condition in the esophagus," said Carver.

It is the standard of care and most common treatment for children with EoE, she said and works by being sprayed via the inhaler into the mouth and the aerosolized fluticasone then being swallowed. However, some insurers do not offer a proper alternative for this treatment.

"Some insurers are transitioning to breath-actuated inhalers (like the diskus versions) on their preferred drug lists, but these are not appropriate for the treatment of EoE," she said.

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What to do if you use Flovent

Some experts have expressed concern that the new generic alternative to Flovent won't be as widely covered by insurance.
Some experts have expressed concern that the new generic alternative to Flovent won't be as widely covered by insurance.

What should you do if you or a loved one rely on Flovent? Get in touch with your doctor and insurers ahead of time, get that refill done ASAP and establish a clear path forward for ongoing treatment after the switch.

"If your insurance plan will not cover the authorized generic fluticasone, there are other inhaler options for the treatment of asthma," said Carver. "Check with your doctor on what dose to take if you are prescribed this medicine and ask them to show you how to use these inhalers."

AAFA suggests some of the following steps to prepare for the change:

  • Refill your current Flovent prescription as soon as possible.

  • Talk with your doctor about other asthma medicines. Some brand name options may include ArmonAir Digihaler and Arnuity Ellipta.

    • ArmonAir Digihaler is an alternative for Flovent Diskus. The formulation is the same but have slightly different doses available.

    • Arnuity Ellipta is an inhaled steroid but not a direct substitute for Flovent HFA or Flovent Diskus. Check with your doctor on what dose to take if you are prescribed this medicine.

  • Consider an authorized generic.

    • A generic fluticasone metered dose inhaler is available by RPK pharmaceuticals with the same doses as Flovent HFA.

  • Check with your insurance to find out what other asthma medicines they cover.

This article originally appeared on USA TODAY: Discontinued Flovent inhalers replaced with generics starting Jan. 1