Little Relief for Asthmatics

  • This commonly-prescribed albuterol asthma inhaler will soon be a relic of America's medical past. The federal government fears the device's chlorofluorocarbon-based (CFC) propellent harms the ozone layer. (Photo by Shawn Allee)

We usually expect environmental
regulations to make us healthier in the
long run. Well, there’s one coming down
that some people aren’t so sure about.
Reporter Shawn Allee says it has to do
with propellants in asthma medicine:

Transcript

We usually expect environmental
regulations to make us healthier in the
long run. Well, there’s one coming down
that some people aren’t so sure about.
Reporter Shawn Allee says it has to do
with propellants in asthma medicine:

Maureen Damitz struggles with asthma.

She’s got it and two of her kids do, too.

But fighting it is also a career.

Damitz is with the Respiratory Health Association of Metropolitan Chicago – it’s the
nerve center for asthma issues in her area.

She says recently, pharmacies have been running out of a familiar asthma inhaler.

“Our phones started ringing off the walls months ago. All of a sudden patients
started getting these new inhalers, and no one was prepared for that.”

The old-standby has been the albuterol inhaler – it’s for quick relief.

Damitz says there is a cheap generic, but it’s got a propellant with Chloro-fluoro-carbons
or CFCs.

And, the government’s banning CFC albuterol inhalers.

Damitz says some patients will miss them.

“When you’re spraying it, it comes out with quite a blast.”

(puff, puff)

“People mistake that as, ‘it forces it into my lungs’; it doesn’t, it’s just the type of
propellant.”

Three new inhalers have the same medicine but a different propellant, known as HFA.

“The new HFA comes out much softer and its warmer when it comes out. They
mistake that as, ‘Oh, my medication doesn’t work.’”

Damitz says studies show the new inhalers work just as well or better than old ones, but
some patients report just the opposite.

Regardless, no one will have a choice soon. By January, no pharmacy can sell albuterol
inhalers with CFC propellents.

Why?

“Originally it arose from the concern that CFC’s were damaging the atmosphere.”

Dr. Nicholas Gross is an asthma specialist.

He says CFCs used to be in many things – refrigerators, air conditioners, and asthma
inhalers.

But CFCs deplete the ozone layer in the upper atmosphere. That lets more solar radiation
through and causes skin cancer.

The government banned CFCs in most products.

But drug companies got exemptions and were slow to develop alternative propellants.

In 2005, the government asked a medical panel to speed things up.

“They were concerned nothing much was changing. It looked like companies were
going to keep claiming exemptions indefinitely, so they asked what we would
recommend they should do about that.”

Gross and other panelists found three competing albuterol inhalers with new propellents.

So, they recommended a ban start next year. Now, Dr. Gross regrets that ban.

“One thing I don’t think anybody paid enough attention to was the fact that it was
going to be much more expensive in the HFA version than the CFC version.”

CFC-based albuterol inhalers cost about thirteen bucks a pop.

New HFA ones cost three times that.

There won’t be a generic inhaler with the new propellant until 2010.

Dr. Gross worries some patients will go without.

“I think it’s very difficult for the FDA to turn around and rescind itself. It means
somebody made a mistake and in government that’s not something you’re allowed
to admit.”

But, the FDA is sticking with the ban.

One asthma expert is more at ease with the transition.

He’s Paul Greenberger – head of the Academy of Allergy, Asthma and Immunology.

He says if patients puff through new, expensive albuterol inhalers quickly – there might
be something wrong with how they’re using them.

“We don’t want people using them everyday if they can help it. We have to take a
look at their overall asthma control – do they need better therapy, frankly than
these albuterol inhalers?”

Of course, that might mean a doctor’s visit and new meds.

Dr. Greenberger says all of this is expensive, but he still supports a ban on CFC albuterol
inhalers.

He says if patients get treatment that’s also better for the atmosphere, well, that’s
priceless.

For The Environment Report, I’m Shawn Allee.

Related Links

Fda to Phase Out Cfcs in Inhalers?

The U.S. Food and Drug Administration may soon take a step that could help the ozone layer. Health officials say they might phase out certain types of asthma inhalers that use chlorofluorocarbons or CFCs. The Great Lakes Radio Consortium’s Christina Shockley has more:

Transcript

The U.S. Food and Drug Administration may soon take a step that could
help the ozone layer. Health officials say they might phase-out certain
types of asthma inhalers that use chlorofluorocarbons or CFCs. The Great
Lakes Radio Consortium’s Christina Shockley has more:


Since the early 1990’s, CFCs were banned from use in things such as car
air conditioners and aerosol cans. But they were still allowed to be used in
devices deemed medically necessary.


These include some types of asthma inhalers that contain very small
amounts of CFC gas to propel medicine into the lungs.


Now, health officials say there might be an alternative to the ozone-
depleting gas. They say hydrofluoroalkane, or HFA, gas works just as
well.


Doctor Robert Meyer evaluates drugs for the FDA. He says the new ban
may seem like a small step, but the overall picture matters most.


“We’re not really in the business of questioning whether this individual use
is in and of itself impacting much on the environment, we’re really looking
at the overall picture, and this action is a part of that picture.”


The FDA is asking the public for feedback on the possible phase-out.


For the Great Lakes Radio Consortium, I’m Christina Shockley.

Related Links