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I used to take advair to control my asthma. I can't afford to take it. Is their a generic or cheaper medication I could discuss with my doctor?

Is this true?

GlaxoSmithKline …."over the past few years, while they lowered the price 10% in France over the same time period.  So over the past 5 years, Advair went from being 3x as expensive in the US as it is in  Europe, to 5x as expensive.

And before you think that France is somehow subsidizing the purchase, they’re not. France simply negotiated with GlaxoSmithKline, and the company agreed to charge the French FIVE TIMES LESS THAN IT CHARGES AMERICANS."

 

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  • Kathy P

    Welcome Risu – I'm not aware of any generics of Advair. There are other drugs in that "class" (a LABA plus corticosteroid). You could check to see what the co-pay is with your insurance and then discuss the options with your doctor.

    Here are – have you seen these?

  • Pizzamike54

    Just talked to a rep today about it, and it's about to go generic, so they are about to start pushing Breo, a new branded drug that apparently is SOOO much better so they can continue to charge 400 a pop for it, but at least we know the end is coming soon.  They were laying off a bunch of people that sold it he said and keeping a few to sell the newer drug but it must be soon because he said they were "dropping" it.  No telling how many tens of thousands of dollars they've gotten out of me for the last fifteen years.  I must admit though, it's been a miracle drug for me, pretty much taking me off the rescue inhalers completely for over 10 years now, and I was taking them 3-5 times a day.  They definitely have side effects, but what doesn't, but my quality of life has been much better on Advair than any other drug in the past 20 years.

    Michael

  • Risu

    Thanks for the replies and help. I do still wonder if people in the USA are being exploited by the drug companies and if it is true that advair , for example, is so much cheaper in France as the article suggests.

     

  • Kathy P

    Thanks for sharing that info Michael – interesting for sure.

    The cost to individuals for medications has definitely risen in the US – and that's all meds, not just asthma meds. It's a growing concern.

  • Risu

    "Currently, generic Advair is available in Europe and elsewhere, with Cipla being the latest to its version of the inhaled therapy last September. Prior to that, Novartis' Sandoz unit gained from Danish regulators in 2013 for a generic formulation, dubbed AirFluSal Forspiro, that it licensed from Vectura. AirFluSal Forspiro is also available in other European countries, including , and , as well as in South Korea and Mexico."

    Why do we not have generic Advair in the USA? What can we do about it?

  • K8sMom2002

    Generics only come on the market when the patent expires — usually 20 years, but sometimes 25, if the government grants something called "patent restoration." While we see the ugly side of brand name drugs (those prices are definite ouches!), patents provide drug companies with protection for safeguarding their intellectual property — their invention, if you will. 

    Different governments have different policies about negotiating with pharmaceutical companies … I do wish the government here was free to negotiate drug prices, but Congress in its infinite wisdom has said no to that. I would highly recommend you contact your Member of Congress — the US House of Representatives member who represents your congressional district. They have to be re-elected every two years, and they are usually more responsive to such stories than members of the US Senate. Even if nothing can be done by the government (and you never know), at least your two cents would have been offered, and sometimes that's enough to change the mind (or at least open it) of your US Congressman or Congresswoman.

  • Jen

    Risu – I would definitely talk to your doctor.  There may be an alternative that would work for you.  They may also have advair coupons.  

  • Risu

    Thank you for your suggestions. I have tried talking to my doctor and to pharmacists and to health insurance. None really help. My doctor had no idea of the cost of medication and so was no help. The pharmacist was no help except to say that there where other medications but all where expensive and the insurance company was no help except to say that if my doctor prescribed advair for me then he had to do the paper work with the insurance company if I wanted any benefit, which was nothing until I had met the deductible, which is a significant amount. Coupons I have looked into and they do not seem to be a good long term solution they do not do anything about the cost of medication for all. I do appreciate the advice to lobby Congress. Lobbying Congress is proportional to the number of people who lobby on the issue. I am sure I am not the only one facing this issue. Organizations have a louder voice than individuals. I would like to suggest that AAFA take up this issue for all asthmatics and lobby congress and drug companies on our behalf/ A letter could be drafted and distributed to members for signing and forwarding to Congress,a facebook suitable picture message could composed and posted on facebook for members and friends to share in the hope of raising support and awareness with family, friends and the public and personal experiences could be shared in social media.  

  • K8sMom2002

    Hi, Risu … I definitely share your frustration with doctors not knowing how much prescriptions cost or how insurance plans are increasingly becoming "high deductible plans." Our DD's hem/onc prescribed a drug that wasn't on our insurance's formulary, and it was going to be $1200 a month (and she would need it every month), and we had a $10K family high deductible plan.  I did ask the pharmacist to talk to the insurance company and the doctor — we finally went back to a previous drug that worked as well but was only about $200 a month. We were very lucky that we had an alternative. Until the generic comes out, it sounds like you don't?

    Even if the coupons aren't a long-term solution, it helps save $$ in the short run, and that will lower the over-all monthly cost. Also, I'd definitely call GSK and see if they have any programs you may be eligible for. Sometimes pharmaceutical companies consider high deductible plans "no drug coverage" while you are still in the process of meeting your deductible, so you may be eligible for some of their discount plans, which can help. Also, doctors frequently get samples of medications — how about talking to your doctor again and explain that you are in need of the Blue Light Special due to your insurance and the cost of these meds? Sometimes they can provide you with several months' worth of samples or they know of programs that can assist you.

    Likewise with contacting your Congressman: I worked as a constituent service rep for two different Members of Congress for nearly a decade. I dealt with cases EXACTLY like yours, and it was those stories that really made a difference with my bosses. They could use those stories to sway other MOC (members of congress) when they debated and wheeled and dealed their way through legislation and bill mark-up (where the rubber REALLY meets the road — the consolidation of the Senate version and the House version of legislation into a final bill to be sent for a vote.) And sometimes that constituent services rep knows of local programs or pharmaceutical programs that can assist you in the short or long term, or they know of OTHER programs to provide things you are already paying for that will free up $$ for meds.

    I definitely agree that lobbying for a cause nets better results when there are more people behind you — the greater the numbers, the harder it is for Congress to ignore. This business of prescription drug prices has catapulted into the spotlight this campaign season on both sides of the aisle, and I truly believe we will see some changes coming. 

    In the meantime, let's concentrate on getting help for YOU. I'd definitely:

    • take advantage of even one or two coupons
    • call GSK to check for financial assistance/discount programs
    • call my doctor and my pharmacist AGAIN to see if anything could have changed or if your doctor could provide samples or perhaps re-jigger your other meds to help you save $$ (or even give you a discount on your office visits — I've had doctors do that for me when they couldn't do anything else.)
    • contact my Congressman's office to see if they can help and to share my story
    • figure out ways to save $$ everywhere else I could

    As a POFAK (parent of a food allergy kid) who also has other significant medical issues, I have to save $$ where I can, because allergy friendly food and prescriptions get to be pricey. I call it robbing Peter to pay Paul — it drives me crazy to have to do it, but must-needs, yanno? 

    What are some ways that you currently try to save $$? What are some monthly expenses that you have that perhaps we can help you see how to save $$ on that so that you can use it for meds? How can we help you brainstorm ways to save $$?

     We are here for you!

  • HikaControl

    I think once reason for expensive drugs here in the US is that they are made in the US. It is no secret that labor costs in the US are high. And people are pushing for higher minimum wage. Basically, there is a "manufacturing monopoly" in the US due to the "the foreigners are stealing our jobs" mentality as of late. You can't have cheap stuff but huge salary unless those that are making your products are robots.

    Ventolin by GSK in the Philippines (manufactured over there too) is about Php500. The Philippine government does not dictate prices, it just monitors pharmas to make sure they are not predatory. That is approximately less than $10. India also has a strong but inexpensive pharmaceutical industry.

    I think meds will be cheaper if US pharmaceuticals will be allowed to offshore production (manufacture in overseas plants, not through contractors though). The R&D can remain here in the US.

    I use ProAir and Qvar which are manufactured by Teva, an Israeli company. But the inhalers are manufactured in the US. Since the labor cost in the US is expensive, I am not surprising that these are expensive too. Even the generic prices back then were still expensive.

    I also like to add that Ventolin in the Philippines is OTC. They also have the rotahaler type which are cost saving for people who have mild intermittent asthma because you buy it when you need it, by the capsul, so you won't feel bad about throwing expired inhalers

  • HikaControl

    I lived in two countries and labor costs does really make a difference. I think the current minimum wage DAILY in the Philippines is Php500  – that translates to $10 a day. In the US, at least here in California, it is $10 or so PER HOUR. Per day, full time would be $80 minimum wage a day.

    I think labor costs are the main reason why prescriptions (even generic) and textbooks are expensive in the US on top of patent and copyright. Importation are almost not allowed for both. GSK can afford to sell $10 inhaler in the Philippines because labor costs are not as expensive. 

  • Risu

    you may have a point  I know little about the cost of labor but it seems to me the cost of labor in France can not be so much less than it is in the USA and information I found suggests that advair is much less expensive in France (see my first entry). It seems to me to questionable to lay the blame at the feet of greedy workers when other countries with a similar standard of living manage to provide the medication at a much more reasonable cost. Anyway I do not want this thread hijacked into a debate on wages or drug company profits. The issue is the cost of medication, in particular advair, is a serious hardship for asthma suffers and something should be  done not just finger pointing. I wonder if the AAFA lobbies congress as it was suggested individuals do in the very helpful post above by K8SMOM202? Surely lobbying by an association would have more effect?

  • HikaControl

    I'm am not putting the blame on the "greedy workers" but the deliberate of US monopoly on manufacturing of these medications. Unless most manufacturing are done by robots, you cannot expect prices to be low and have high wages.

    Technology is actually the biggest job killer, not offshoring as some people have been trying to make. Case in point, Foxconn in China replaced 60% of their workers with technology this year alone.

    This is an important point in the article you posted:

    "Yes, GlaxoSmithKline sells Advair for 1/5 the price in Paris, and if you try to bring that Advair home with you, and Customs finds it, it will be confiscated “for your own protection.” Because, apparently GlaxoSmithKline is such a dangerous company that we can’t trust the drugs they manufacture in Europe, but they’re such a great company that we can trust the drugs they manufacture in America, and pay five times the price for them!"

    There are parts in Europe that are cheaper than France, and we should bear in mind the European Union where they allow free trade among members. Southern and Eastern Europe are cheaper than Western Europe.

    The drug industry is very similar to the textbook industry. "International editions" are not allowed(almost illegal) even if the content is the same because publishers based in the US will lose their monopoly and the ability to charge $300 instead of $20 for a new textbook. It is the protectionism that hurts US consumers. 

    It seems to me that many people here in America "look down" on other countries by thinking they are not capable to making products that are "at par" with American-made, especially developing countries.

    If we import Ventolin, say from the GSK Philippines or GSK India, we'll probably be just paying under $30 — cheaper price for a brand name compared to the generics before the complete CFC ban (I believe they ran around $35). And the Philippine government does not practice price-control.

  • Kathy P

    Drug cost is something our advocacy arm is looking at very closely right now. I don't have any details on how/what, but we will keep our members updated with any efforts on this.

  • HikaControl

    Here is a price list I found in the Philippines. You can use the currency converter.

    I really wish the US doctors promote/encourage the rotahaler/rotacap salbutamol(albuterol) and make them over-the-counter. It's less wasteful for us who has mild intermittent asthma. It is more environmental friendly because it NEITHER uses CFC nor HFA and you do not have to discard the whole thing, just the empty capsules.

  • Jen

    Hi hika, 

    Welcome to AAFA's forums.  Glad to have you.  Interesting input from all.  No matter the cause, the rising cost of rx drugs is definitely an issue.  Hopefully the more people that lobby, advocate, etc, the sooner we can turn things around so meds are affordable for all.

  • HikaControl

    Jen,

    I think shifting to rotahalers will definitely bring down the costs, too even if they are US manufactured and more environmental friendly, or at least add it to the choice.I find it sad that most people here in the US are not that "creative" in cost-cutting. We just seem to want to just "cut" the cost, but not articulating how and why.

    The rotahaler was the one I constantly used when I was growing up in the Philippines because my asthma was not often and buying the inhaler can be a waste as I can go on for a year without having asthma attacks. The rotahalers/rotacaps are just as effective. They were also over-the-counter.

    Even if my insurance covers my medications at 100%, I feel bad when I throw out the inhalers I barely used because they're expired.

  • Jen

    Interesting thought on the rotohaler.  That would be great if it could be an easy solution to the problem.  As for throwing out barely used meds, I hear you.  That is me with my daughter's epipens.  I view it this way – they are like insurance.  We have them in case she has a reaction and has to use them.  I do, however, have a rather large collection of expired epi's in our med cabinet.  Perhaps I need to find some anaphylactic citrus fruit?  (good way to use expired epis for practice )

  • K8sMom2002

    HikaControl, I'm like you — I can go several months (if I mind my triggers) without having an asthma attack. But I look at it like Jen has said — it's an insurance policy that I'm very glad not to have to use!

    Another option that some patients have is to directly ask their doctor for samples — many pharmaceutical companies will provide samples to doctors, and I know doctors who purposefully save those samples for folks without prescription coverage. 

  • HikaControl

    I wonder why the government won't allow making albuterol without prescription, but they are pushing for the legalization of recreational marijuana which can make people hallucinate. I don't think one can even get "high" in albuterol

  • Kathy P

    Risu – did you ever figure out a solution for your meds? There is a list of ideas in this blog: 

  • Jen

    @Risu - checking in….stop by to let us know how things are going..

  • Risu

    I have not been able to figure out a real solution. Discussion with a friend led to a discussion with the doctor and a trial of singulair, or a generic thereof. I was surprised that the doctor did not suggest this when I first approached him but it was not till i asked if it would be worth a try that it was attempted. It seems to help but I am finding lately that for some reason I am getting symptoms and am thinking I might need to go back and re visit advair as my last advair which expires this month has given me a bit of relief. I am disappointed that far as I can see there is STILL no generic advair and no alternative to the crippling cost of the drug save asking for samples or using coupons which are not a long term solution and certainly not a solution to the problem of the cost of asthma medication to ordinary people. It seems to me that other countries can manage affordable medication through generics and rotohalers why cant America? Surely there must be some way to administer a dose of medication at a reasonable cost. Anyway I hoping that I do not have start advair again. I guess I will go back to the doc and see what he says. My advice to people who want to avoid poverty is to not get sick.

  • Risu

    I noticed Kathy posted on 6/15/16

    "Drug cost is something our advocacy arm is looking at very closely right now. I don't have any details on how/what, but we will keep our members updated with any efforts on this."

    Any efforts to update us on?

  • K8sMom2002

    Risu, that's a bummer that you still haven't figured out a long term solution. I'm glad the singulair is working for you. 

    Since you are still hoping to find assistance on Advair, have you checked out ?

    Have you tracked your symptoms to figure out what your are, to see if maybe controlling your exposure to them could help?

  • Pljohns

    I feel your pain on the $$$ of meds-my off label maintenance drugs run me $2200/month-the neb maintenance med is $900+ and the steroid to go with it is almost $800.  We won't even go there with all of the albuteral, budesonide and duoneb.  thankfully my old PCP wrote my last albuteral for the max they could give me so I'd get a ton more for the same copay.  It get like 6 boxes a time and there are 50 in each box.  There are no coupons for my maintenance med.  The PCP I use to work for had agreed to keep getting samples for me but after I left, she refused to keep it up-even though I had told her it was over $900/month out of pocket.  I have since cut my dose back to once daily instead of twice like I'm supposed to be using it.  I just can't afford it without samples and now that I don't work for my PCP, I have no one to get me samples.

    Something definitely needs to be done about the cost of meds.  I keep worrying that when I hit medicare age, there is no way I can afford these meds.

  • K8sMom2002

    PLJohns, that's some tough numbers. Could you contact the manufacturers to see if they have any patient assistance programs? 

  • Pljohns

    It is the same company and they are a small manufacturer-they do have pt. assistance, but we don't qualify.  It's amazing-you make too much money for help but not enough to afford their meds!  It is a royal pain. As long as I worked for my PCP, she would get me samples and they would send more than I would us a month so I stock piled it.  It has to be refrigerated so my downstairs refrigerator is FULL of it.

  • Pljohns

    I have seen a new pulmo once and wasn't thrilled with him.  At the moment I don't have a new PCP-my old one is the one I worked with that got super snotty after I no longer managed her practice and I'm waiting for the flu to clear some before I go to anyone else to establish care.  I don't want to go somewhere and get the flu just for being there!  Once I get established, I may ask if they could get samples for me.

  • Risu

    PL Johns  I agree the situation is bad. It is not a real solution to say that you should go cap in hand to drug companies and doctors to ask for medication. It is not right that sickness is a path to poverty. This is supposed to be a compassionate society with Christian values yet this country that claims to lead western world can not get into place a system that shares the load of sickness. Other countries have managed to do this but this country just does not get it. It is wrong that in the USA the cost of advair is 5 times what it is in France, not due to any subsidy but because the French government negotiated a deal with manufacturer – it is apparently ILLEGAL for the US govt. to enter into similar negotiations so the USA has become the cash cow for drug companies and we have a two tier system where if you can afford the drug you are fine if you can't you are hung out to dry. like national security and law and order health care should be the right and expectation of every person in this country. How would it be if your house was being robbed and you called the police and they refused to attend because you could not pay the fee? The whole point of a society is to band together and share the load and ensure a better standard for all – or have I got it wrong? Is the real point of a society just to provide consumers to feed the profits of companies? Anyway I know people who suggest coupons and free samples and assistance programs mean well but they are not addressing the problem of the failure of the system. I also ask again;

    I noticed Kathy posted on 6/15/16

    "Drug cost is something our advocacy arm is looking at very closely right now. I don't have any details on how/what, but we will keep our members updated with any efforts on this."

    Any efforts to update us on?

    Should the aafa be doing more to effect change?

     

  • Jen

    Risu – That is a very good question.  I will see if I can get someone with more information to chime in.

  • Shea

    That is so weird (what you said: that other countries can negotiate deals with drug companies but the US cannot because it is illegal?) I am not keen on politics, but why would we make such a law? I know I have heard statistics like, that Americans pay the most for healthcare insurance and receive the least from it. I was all for universal healthcare here in the US. I think that it would just make us a better country because we would all feel a responsibility for one another's health and we would all have access to healthcare–it is so every man for himself out there sometimes and so many people fall into the cracks when it comes to being able to qualify for help. But, I also know that I feel truly blessed that I have found foundations and gateway programs and assistance from family to get the medications that I need to heal… so I can't really complain for myself. Some of the applications were so easy to fill out, but some I didn't or couldn't get.. but I always found one. I hope you find an affordable way to get the medication you need!!! I found mine by talking to doctors and nurses, or being referred from a program that I did not meet the criteria for.  

  • Risu

     I am glad you have found a way to get the medications you need. I think there are many who do not or who struggle. I am concerned for myself yes but even if I find a way to get my medication their will still be many who struggle. Sickness should not be a path to poverty nor should health care be determined by your income. I think we, through government programs, should  all responsible for health like we are all responsible, through taxes, for national defense and law and order. I am using a cheaper medication and finding it mostly adequate but I am becoming concerned that this is not a long term solution as there has been an recent increase in my use of my rescue inhaler. I am really hoping the USA will have generic advair soon – that would help me and many others.

     

  • Pljohns

    I totally agree-I've had to cut me maintenance meds to 1/2 dose-I only use it once a day and I can tell a difference-my peak flows are staying down about 40 points and my lungs feel more "twitchy" than usual and I"m hitting albuteral a lot more but albuteral is cheaper than my maintenance meds right now.  I called the pharma that makes Brovana and they have no discount programs now (never have on Brovana) and I don't qualify for patient assistance.  They gave me the name of some COPD assistance groups, but I don't have COPD so they won't help.  I see my doc in 2 weeks and we're going to have to have a discussion about meds.

  • Kathy P

    Risu – sorry, I didn't see your question til now. We've had some staffing changing in our advocacy department, so I'll have to check on that for you.

  • Risu

    Thanks Kathy P. I wondering if you have anything further to your post on 6/15/16

    "Drug cost is something our advocacy arm is looking at very closely right now. I don't have any details on how/what, but we will keep our members updated with any efforts on this."

    Any efforts to update us on?

    Should the aafa be doing more to effect change?

     I am wondering if you have any News from the advocacy department?

     

  • Kathy P

    Hi @Risu

    Asthma, especially severe asthma, may qualify as disability under US law. If someone qualifies for disability assistance, they receive Medicaid health insurance. AAFA has been and has opposed efforts to strip the program of funding.  Medicaid funding also helps fund Individualized Education Plans (IEPs) for students to ensure proper accommodations at school (see current – of which AAFA is a partner).

  • Risu

    Thanks Kathy for the information and it is good to know that AAFA is working in those areas and they are important but my inquiry was specifically about the cost of medication. You posted on 6/15/16:

    You posted on 6/15/16:

    "Drug cost is something our advocacy arm is looking at very closely right now. I don't have any details on how/what, but we will keep our members updated with any efforts on this."

    I am wondering what actions AAFA is taking in the Area of Drug cost specifically. 

    Is, for instance, AAFA doing anything to help with the introduction of a generic for Advair? It seems from what has been said earlier in this thread that others too are finding the costs of medication has an impact on their ability to get the medication they need and in the quantity they need. People are using rescue inhalers when they should be using preventatives, taking half doses of needed medication or skipping doses altogether and the reason is cost. The cost of medication in the USA is much higher than in other countries and one of the suggestions made earlier in the thread was that we write to and lobby congress. Yes a great idea and we all should I made the point that the AAFA could help in this by lobbying Congress directly on the matter and it could also help members lobby by encouraging them to do so using strategies like putting out a list of who to lobby and suggestions on how to lobby, setting up petitions and even having form letters people could download print and sign and send to Congress. I am curious as to know what action AAFA is taking so that I can support it. I suspect those with an interest in maintaining the high cost of drugs are lobbying hard to protect their interests.