Helping Parents and Kids Find an Alternative to Flovent

Asthma requires proper management and treatment to control and normalize lung and airway functioning and symptoms, which sometimes may require using anti-inflammatory corticosteroid inhalers. One common medication prescribed to children with asthma is Flovent, an inhaled corticosteroid that helps to reduce inflammation in the airways, making it easier to breathe. So when Flovent was recently taken off the shelves, millions of parents were left in the lurch, scrambling to figure out what to do. 

Edith Bracho-Sanchez, MD, Assistant Professor of Pediatrics at Columbia University Irving Medical Center and creator of "The Stuff That Matters for Kids' Health" podcast, discusses what parents and doctors can do about the inhaler medication problem and its effect on providers and patients.

What is Flovent, and why was it removed from the market?

Edith Bracho-Sanchez: Flovent is an inhaler that controls asthma flare-ups or episodes by reducing inflammation in the lungs and airways when triggered. Nothing was wrong with the medication, so it is not being recalled. However, it is not being manufactured anymore by the company GSK. Simply put, it has been taken off the market in brand name form. 

Does the generic work as well?

EB-S: GSK is replacing the Flovent brand name with the generic medication, called fluticasone. The problem is not that the medication is not effective now that it is being sold as a generic; the problem has been that some health insurance companies are not covering the cost of it in the generic form right now, and if they do, it comes with a higher co-payment.

What are the alternatives to Flovent?

EB-S:  There are alternatives, but they may not always be appropriate for young children. The options include dry powder inhalers, which are delivered via breath-actuated pumps, as well as nebulized corticosteroids. Neither one of these is great for kids. Breath-actuated pumps involve deep breathing and holding the breath, which is tough for young kids, and nebulized treatments may require children to be treated twice a day for approximately 10-15 minutes at a time. Honestly, the fluticasone inhaler, or a medication known as Asmanex, which is delivered in the same way, are your best bet for younger children. These are the medications that reliably get into their lungs and control their asthma.

What has been the effect to families and patients?

EB-S: This has been very scary for patients and their families. Together, we can try to order refills while we find alternatives as needed.

What happens if your child cannot get the medication?

EB-S:  Contact your pediatrician. We understand the seriousness of the situation and will do everything we can to make sure your child's asthma stays under control. 

Does it make sense for parents to talk to their insurance companies about this issue?  

EB-S: You can certainly call and see if you can get to the root of the issue. But at the end of the day, when the medication is not covered, a “prior authorization request” or a different prescription from your doctor may be needed.

What else can parents and doctors do?

EB-S: Any change in medication should be done under the guidance of a healthcare professional. We can recommend changes to your child’s medication regimen based on his or her child's asthma severity and overall health.