Now the environuts are endangering people's lives...

http://www.azcentral.com/news/green/...3inhalers.html

Asthma sufferers concerned over new inhalers

by John Faherty - Dec. 3, 2008 12:00 AM
The Arizona Republic

At the end of this month, the inhalers that millions of people with asthma use to control their symptoms will no longer be available.

Those inhalers can prevent an asthma attack or relieve symptoms once one has begun.

The problem is that the inhalers propel the medication with chlorofluorocarbons, which deplete the ozone layer.

Effective Dec. 31, drug companies will no longer be able to manufacture or sell the CFC inhalers.

"This is the first time that an effective medication has been removed from the market in the USA for an environmental issue," said Dr. Ira Feingold of the American College of Allergy, Asthma and Immunology.

The inhalers are being replaced by non-CFC inhalers.

The new inhalers provide the same medicine but with subtle differences.

Those differences have some patient-advocacy groups concerned.

"The big struggle is not the effectiveness of the drug," said Nancy Sander, founder of Allergy and Asthma Network Mothers of Asthmatics. "The problem is education. There was no plan to inform the patients."

The new inhalers use propellants called hydrofluoroalkanes, or HFAs. The three primary differences between the two mechanisms are that the new inhalers:


"? Provide a softer spray, which may lead some patients to think they are not getting their correct dosage.


"? Need to be cleaned more frequently.


"? Are more expensive.

The first two issues should be manageable over time, said Judy Harris, a certified pulmonary nurse practitioner with Phoenix Children's Hospital.

"We started the transition at least a year and a half ago," Harris said. "There was some confusion because the inhaler looked different, and it tasted different. But once we talked people through it, there were no problems."

Four of Melvina Perez's five children have asthma.

"None of my kids have said anything," said Perez, of Phoenix. "The only difference was the color (of the inhaler)."

The importance in the difference in the spray, however, should not be diminished, according to Sander.

"The speed at which you inhale has to be very slow and deliberate," she said. "It's a subtle change, but it can be confusing to patients."

Sander's organization has received calls from patients who believe they were not receiving the medicine they needed.

"This is a big deal when you are needing help trying to breathe," she said.

The cost issue could be the hardest for patients.

The Breathmobile is a Phoenix Children's Hospital recreational vehicle that goes from school to school, treating students and informing patients.

Nurses on the Breathmobile give away most of their medicine but keep track of the lowest costs for inhalers.

They have found that the cost for a generic CFC inhaler is about $22.

The cost for a low-priced new inhaler is $35.

The new inhalers are available as brand-name drugs only. That means they may be more costly under insurance plans that typically have higher co-pay charges for name-brand prescription drugs than generic versions. It will be years before new generic inhalers are available.

Asthma-advocacy groups, like AANMA and ACAAI, have been urging Congress and the Bush administration to demand that the new inhalers be covered equally by insurance companies. That has not happened yet.

A cost increase could be a burden for some families, but Feingold stressed that a patient who is properly managing asthma - with exercise, nutrition and sometimes preventive medicine - should not need to use an inhaler frequently.

A single canister should last months.

"If you are going to take a big hit financially, you are doing something wrong," Feingold said. "You should be in better control."

The four drug companies that distribute the inhalers - GlaxoSmithKline, Schering-Plough, Teva Specialty Pharmaceuticals and Sepracor - all provide coupons and give-away programs to help decrease costs for patients.

The reason for the change in the inhalers goes back to 1987 and the Montreal Protocol on Substances that Deplete the Ozone Layer.

This multinational treaty started the effort to eliminate the production and use of ozone-depleting substances.

The CFCs used in inhalers were permitted until now, in part, because their effect on the environment was minimal and in order to give drug manufacturers enough time to develop alternative propellants.

The new inhalers contain hydrofluoroalkanes as a propellant. HFAs do not harm the ozone.

my mom has to us inhalers. I'll be sure to tell her to stock pile the good ones. This is the absolute most ridiculous [censored] i've ever heard of in my life.These idiots will kill 1000's of people before it's over trying to safe some plants and animals. What's the next thing they're going to take away ?

This is old news, heard about this on the news about awhile ago.

I should stockpile what I can at my next appointment

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Milk3</div><div class="ubbcode-body"> What's the next thing they're going to take away ? </div></div>

Get used to it. these types of decisions was made on November 4th.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Coach</div><div class="ubbcode-body"><div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Milk3</div><div class="ubbcode-body"> What's the next thing they're going to take away ? </div></div>

Get used to it. these types of decisions was made on November 4th. </div></div>


Yep won't be long now, the cost won't matter because it will be free to everyone along with all doctor visits.

Who was it that used to say," Healthcare isn't a right"?

Yes, I found it- tough ta-ta's Bob, you were the one with that phrase....Flip-flopping? A career in politics, perhaps? [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/grin.gif[/img]
Or a change of heart? Can't pay, don't deserve...isn't that what you said?


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#239087 - 01/07/08 08:48 PM Re: WHAT A WONDERFUL COUNTRY WE LIVE IN!!!! [Re: R13]
NotSoSilentBob NotSoSilentBob
NOBAMA
Carpal Tunnel


Registered: 08/02/02
Posts: 9303
Loc: The ViewAskewniverse "Healthcare isn't a right."
_________________________

http://www.hostboard.com/LDPforum/ubbthr...true#Post239087

i don't have a dog in your all's race here but just because you are born doesn't mean that the government owes you free healthcare.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Coach</div><div class="ubbcode-body">i don't have a dog in your all's race here but just because you are born doesn't mean that the government owes you free healthcare. </div></div>


It does according to our (note I said our not your like the anti-Bush people did) new president.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Spuds</div><div class="ubbcode-body">Who was it that used to say," Healthcare isn't a right"? </div></div>

You can ask any intellectual person and they will say that healthcare is not a right its a Privilege. We need to think that way. It would be a great way to weed out the losers of this country by population control, not promote it.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Coach</div><div class="ubbcode-body"><div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Milk3</div><div class="ubbcode-body"> What's the next thing they're going to take away ? </div></div>

Get used to it. these types of decisions was made on November 4th. </div></div>

This issue was going on long before Obama was even running, so no it wasn't.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Spuds</div><div class="ubbcode-body">Yes, I found it- tough ta-ta's Bob, you were the one with that phrase....Flip-flopping? A career in politics, perhaps? [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/grin.gif[/img]
Or a change of heart? Can't pay, don't deserve...isn't that what you said?


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#239087 - 01/07/08 08:48 PM Re: WHAT A WONDERFUL COUNTRY WE LIVE IN!!!! [Re: R13]
NotSoSilentBob NotSoSilentBob
NOBAMA
Carpal Tunnel


Registered: 08/02/02
Posts: 9303
Loc: The ViewAskewniverse "Healthcare isn't a right."
_________________________

http://www.hostboard.com/LDPforum/ubbthr...true#Post239087
</div></div>

Yes, and what does that have to do with the topic at hand? This isn't a rights issue. This is an issue of a proven medication being removed from the market due to junk science.

No, your post said 2 of the 3 problems could be easily overcome-
"
"? Provide a softer spray, which may lead some patients to think they are not getting their correct dosage.


"? Need to be cleaned more frequently.


"? Are more expensive.

The first two issues should be manageable over time, said Judy Harris, a certified pulmonary nurse practitioner with Phoenix Children's Hospital."

So it went up 13 bucks a inhaler...that is what you said. If you can't pay...tough. Not my opinion, yours. Read'em and weep. You are doing a good job so far. Face it, you said it was fine as long as you were harping about someone else, but since you came up with this- it is different. [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/grin.gif[/img] And don't forget, Obama didn't vote this in by himself...he hasn't even taken office yet. Might wanna see Boosh.

Democrats do like to spend more than Republicans----people need to earn a little ever once in a while.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Burrhead</div><div class="ubbcode-body">Democrats do like to spend more than Republicans</div></div>


And this is a fact or opinion?

Check the national debt under RR, GB1 and GB2. But that has nothing to do with a guy that said we should pay for our healthcare , then talking about the cost of meds going up 13 bucks. [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/grin.gif[/img]

The National debt went up because the younger Bush had to fix all the behind the scenes Clinton blunders. And the spending is a proven fact.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Burrhead</div><div class="ubbcode-body">The National debt went up because the younger Bush had to fix all the behind the scenes Clinton blunders. And the spending is a proven fact. </div></div>
Sure and the other two saved us from...ourselves. [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/grin.gif[/img] Stupid wasted enough on a war we didn't need to bail out the thieves in finance.

Everyone was for the war when it started. Bush stuck to his beliefs. Clinton said Hussein needed to be taken out of power. He didn't have the guts to get it done. Just my opinion.

One bullet. [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/grin.gif[/img]

very misleading title bob


actually this is a good idea

if the non CFC inhalers work just as good, what is the big deal??


asthma people still get their fully capable inhalers, and we dont destroy the ozone layer?


oh yeah i forgot, anything that is environmentally safe is not good [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/smirk.gif[/img]

Seems like he passed over the good things about the new inhalers.
And from what I've read on them, the ones that are being banned are pretty bad for your heart also.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Burrhead</div><div class="ubbcode-body">The National debt went up because the younger Bush had to fix all the behind the scenes Clinton blunders. And the spending is a proven fact. </div></div>
Truth right here but they'll never admit it

Just wondering what environmentalists had to do with this?

That would be the change in the type of inhaler.

But an FDA panel set all this in motion back in 06'.

The newer inhalers have a shorter opened shelf-life, require more maintenance and record-keeping by the user, and at best under optimal conditions are roughly equivalent in efficacy.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: 722</div><div class="ubbcode-body">That would be the change in the type of inhaler. </div></div>
lol

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: NotSoSilentBob</div><div class="ubbcode-body">The newer inhalers have a shorter opened shelf-life, require more maintenance and record-keeping by the user, and at best under optimal conditions are roughly equivalent in efficacy. </div></div>
Record keeping? [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/grin.gif[/img]

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Spuds</div><div class="ubbcode-body"><div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: NotSoSilentBob</div><div class="ubbcode-body">The newer inhalers have a shorter opened shelf-life, require more maintenance and record-keeping by the user, and at best under optimal conditions are roughly equivalent in efficacy. </div></div>
Record keeping? [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/grin.gif[/img]</div></div>
The amount of usage has to be recorded to know when it runs out. There are only so many dosages per inhaler. With the current inhalers many can tell by taste, but with the new ones not so much because of how different it is.

The ones I know about come with a counter on the bottle. easy records.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Spuds</div><div class="ubbcode-body">The ones I know about come with a counter on the bottle. easy records.</div></div>
I've never had one with a counter, and the two I have in my purse right now don't have counters.
Are you thinking about the older OTC inhalers perhaps?

No, within the last year. Perhaps you should ask the doc, it would make things easier. But probably a little more costly.

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Spuds</div><div class="ubbcode-body">No, within the last year. Perhaps you should ask the doc, it would make things easier.</div></div>
Is this albuterol or qvar?

I'm thinking it's albuterol. One of the guys at work is at about 60% lung function and has asthma and carries one all the time. When it gets close to 100 doses, he puts another one in the lunch. Proventil, I think.

These inhalers use a chemical propellant to force a measured dose of medication out of the inhaler. They consist of a pressurized canister containing medication, a mouthpiece and a metering valve that dispenses the correct dose of medication. The medication is released either by squeezing the canister or by inhaling. You may find it easier to use a hand-actuated inhaler with a spacer "? a short tube that attaches to the inhaler. Using a hand-actuated inhaler to release the medication into the chamber gives you time to inhale more slowly. It decreases the amount of medicine that's deposited on the back of your throat and increases the amount that ultimately reaches your lungs.

Some metered dose inhalers have counters so that you know how many doses remain. If there is no counter, you have to track of the number of doses you've used so that you know when the inhaler is out of medication.

The chemical propellant in metered dose inhalers has traditionally been a chlorofluorocarbon (CFC). But after an international agreement to ban CFCs because they damage the ozone layer, other propellants such as hydrofluoroalkane (HFA) are now used instead. The dose of medication released by an HFA inhaler may feel softer and warmer than the dose released by a CFC inhaler. If you're used to a CFC inhaler, it may not seem like a complete dose "? even though the medication is reaching your lungs

http://www.mayoclinic.com/health/ast...halers/HQ01081

The difference is not clinically significant at the usual 2-inhalation dose, but after 12 inhalations with an HFA MDI higher plasma levels of albuterol have been observed than with CFC MDIs. At usual doses, adverse reactions are similar for both CFC- and HFA-propelled albuterol MDIs. At higher doses, the HFA albuterol MDIs have been associated with more systemic beta agonist effects, such as tachycardia, than have the CFC albuterol MDIs. "Pharmacists can reassure patients that they work the same and have the same safety profile," Hendeles said.

There is a product available called the Doser. This is a dose counter that can be attached to MDIs to keep track of how many inhalations have been used. The Doser also tracks how often an MDI has been used over a 30-day period. Hendeles said the Doser costs about $30. The Doser may be helpful for some patients, but what they really need is something that counts both priming and inhaled sprays, Sander said. Her organization asked the FDA to write guidance to industry that manufacturers put counters on their devices. The FDA has done so, and Sander has learned that Schering and Teva are working on adding dose counters to their products.

So far, he said, about 65 percent of patients have been switched to HFA albuterol MDIs. While encouraging, that still leaves over a third of patients who have not. Also, the percentage does not seem to be evenly distributed across the country. Binaso noted that the percentage of patients still using CFC albuterol MDIs in Southern states, for example, could be much higher than 35 percent.

The HFA albuterol MDIs cost more than the generic CFC albuterol MDIs, and a generic albuterol HFA MDI will not be available until 2012 or later, Hendeles said. Programs are already in place to help patients pay the higher cost of the brand-name HFA inhalers. Most insurance companies will pay for at least one of the albuterol HFA MDIs. But even at the preferred brand level, the co-pay for the HFA product will be higher than for a generic albuterol MDI. Hendeles suggests that pharmacists help patients by checking with their insurance companies to see which albuterol HFA product is preferred and then have prescriptions changed accordingly. All three manufacturers of albuterol HFA MDIs have established assistance programs to supply inhalers to uninsured patients who meet certain income limits. In the end, Hendeles said, the cost of the albuterol HFAs should not be a huge issue. Albuterol is a short-acting beta agonist (SABA) and is intended for use on an as-needed basis. Ideally, SABA inhalers should last for months, so patients should only have to pay for them a few times a year.

http://www.modernmedicine.com/modern...date=&pageID=2