Healthy returns: Drugmakers are capping inhaler prices at $35 in a win for some patients

A woman using an inhaler.

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Good afternoon! Inhalers will soon be much cheaper for some Americans.

Three of the world’s largest inhaler makers have agreed to cap the out-of-pocket price of their inhalation products and similar inhaled drugs at $35 a month for certain US patients.

British drugmaker GlaxoSmithKline announced its cost cap last week following similar moves by AstraZeneca and privately held Boehringer Ingelheim.

But there’s a catch: Teva Pharmaceuticals, another major inhaler maker, hasn’t made a similar commitment.

The cost caps for 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 the four companies charge more for inhalers in the US than in other countries.

It adds to years of political scrutiny and public outrage the broader pharmaceutical industry has faced over high health care costs in the U.S. Last year, Eli Lilly, Novo Nordisk and Sanofi decided to cut the cost of certain 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 conditions that affect their breathing, such as asthma or chronic obstructive pulmonary disorder, or COPD, often use inhalers. They may use daily inhalers to prevent or manage their symptoms and quick-acting inhalers at times when their breathing gets 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 price, the Senate aid committee said in a statement in January.

Here’s what the panel says drug makers have been charging for some of their inhaler products:

In addition to price differences, the panel argued that the companies improperly extended their product monopolies.

The committee argued 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 the signing of agreements with generic manufacturers to avoid cheaper competition. Generic inhalers can cost as little as $30.

School nurse Keri Personnete holds an inhaler for a child 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 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 caps come after GSK stopped making the Flovent HFA and Flovent Diskus asthma inhalers in early January. The company replaced them with ‘authorised generic’ versions of the inhaler, which are identical apart from the brand name.

The company’s price cap will specifically benefit patients taking those 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 inhaler 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.

It’s the same day that Boehringer Ingeleim’s out-of-pocket limit for all of its inhaler products will go into effect.

Boehringer Ingelheim’s cap will apply to the “most vulnerable patients,” including those who are uninsured or uninsured. The limit applies to its Atrovent HFA, Combivent Respimat and Spiriva products, among others.

Sanders applauded all three companies for announcing their cost 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 waiting to see if Teva announces its own cap.

Feel free to send tips, suggestions, story ideas and data to Annika at annikakim.constantino@nbcuni.com.

The latest in health technology

Digital diabetes management tools drive up healthcare spending, not improve patient outcomes, report finds

Many digital diabetes management Tools aren’t all it’s cracked up to be, a new report published by the Peterson Health Technology Institute (PHTI) found.

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 explored whether tools from DarioHealth, Glooko, Omada, Perry Health, Teladoc’s Livongo, Verily’s Onduo, Vida and Virta make a meaningful difference for patients with type 2 diabetes.

All of these companies claim that their digital diabetes tools help people manage their blood glucose, 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-continuous glucose monitor, which patients use to measure their blood sugar pricking his fingers.

PHTI found that these digital diabetes management tools “do not provide meaningful clinical benefits,” the report said. For example, the solutions typically only help patients record “small reductions” 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 diabetes management methods increase net healthcare spending for health plans, providers and self-insured employers.

“These tools do not replace other care that people with diabetes receive,” Caroline Pearson, executive director of PHTI, told CNBC in an interview. “Once you factor in the cost of the technology, you don’t see enough savings with any clinical benefit to offset that additional price.”

The institute conducted its analysis of these diabetes management tools by reviewing existing published literature, such as scientific articles, as well as data submitted by the companies themselves, according to the report.

PHTI’s report drew mixed responses from doctors and digital health experts. The Digital Therapeutics Alliance, whose members include DarioHealth, criticized the framing of the institute’s analysis.

The group said the limited selection of solutions and stakeholders, as well as PHTI’s reliance on predictive models, could have been improved. He called for more “transparency and inclusiveness” in future reports.

“DTA disagrees with the conclusions drawn, 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.

While PHTI evaluated solutions that connect to non-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 glucometers are now “much more common” in the US, according to the report.

Pearson said there are some bright spots in the report, such as Virta’s tool for nutritional ketosis, which is a diet that often requires a substantial lifestyle change. Technology is also evolving, Pearson added, so he believes the advent of continuous glucose and GLP-1 monitors could “drastically” change how diabetes is managed.

But for now, he said the initial response to PHTI’s report has been 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 paying for digital tools, they should make people better,” Pearson said.

You can read the full report here.

Feel free to send tips, suggestions, story ideas and facts to Ashley at ashley.capoot@nbcuni.com.

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