Popular inhaler Flovent to be discontinued, replaced with generic; doctors expect confusion

The new year is a time for fresh starts — and it certainly will be one for people who rely on the asthma inhaler Flovent.

The widely used maintenance prescription inhaler is being discontinued in January, and it will be replaced with an authorized generic — a medicine that is the same as Flovent but without the branding.

The manufacturer, GlaxoSmithKline, is discontinuing production of Flovent HFA and Flovent Diskus. According to a statement from the Asthma and Allergy Foundation of America, the company expects supply of the old Flovent products to be used up by early 2024. The authorized generics will be manufactured by GSK and distributed by Prasco LLC.

The change isn’t likely to mean a difference in treatment for most patients, as the generic has the same contents, doctors say.

“Many people do have hesitancy with generics, but oftentimes, they’re made by the same company,” said Dr. Thomas Mertz with Allergy and Asthma Associates of Pittsburgh. “It may appear a little different, but it’s usually the same medicine.”

However, the switchover has the potential to cause some insurance confusion. Some insurance companies have previously not covered generic versions of drugs such as Flovent because a brand name version is available.

“I think hopefully after the first of the year, insurances will update, but for some reason, the insurances weren’t covering the generic when the brand wasn’t available. That’s the biggest hangup,” Mertz said.

News of the switch came nearly out of nowhere for many, said Dr. Tariq Cheema, Allegheny Health Network pulmonologist and director of the AHN Breathing Disorder Center.

“I just heard about it (Thursday.) It’s a complete surprise,” he said. “Because this news is so fresh, we haven’t even had time to process it.”

Cheema encourages people who use Flovent to call their doctors and insurance companies to get more information. Doctors and pharmacies aren’t sure yet how insurance will cover the generic drug, or whether patients will need to swap over to a different name-brand inhaler, but will find out more in the coming weeks.

“People react to inhalers differently,” he noted. “There may be a subset of patients out there that don’t tolerate a different inhaler. But for most people, if you can substitute Flovent with one of the other inhalers out there, they should be OK.”

The timing of the announcement at the end of the year and right before a long weekend makes things more confusing, he said. Respiratory viruses such as covid and RSV also are spiking, adding pressure on people with asthma.

“If you could pick the worst time to do this, it would be right now,” he said.

However, he expects doctors and insurance companies to have more answers soon.

“I think it will get sorted out,” he said. “I don’t’ expect this to be a long-term situation at all. It will get sorted out, but there will be inconvenience associated with this for sure, no doubt about that.”

Hope for a smooth transition

Mertz isn’t too worried about the switchover. The beginning of the year is already a time that people historically have had to refresh their prescriptions, he said.

“If there is an insurance issue with the patient and they have to switch to a different inhaler, that’s not something we haven’t had to deal with other inhalers over the years,” he said. “That is commonplace — it is something that is expected that we do that, usually in January.”

At Town & Country Pharmacy in New Kensington, pharmacist Nicholas Roperti emphasized that generic medications are just as effective as name brands.

“It won’t affect the patient getting the correct drug because it’s still the same active ingredients,” he said.

Pharmacists won’t know for sure whether the generic is covered, or whether patients will need to swap to a different brand until next week, he said. They also won’t know whether the generic will be cheaper — but it usually is.

“Normally, when it is a generic, it is a lower copay,” he said.

Alex Rothey, pharmacist at Hilltop Pharmacy in Pittsburgh’s Allentown neighborhood, doesn’t expect the switchover to be “a huge change on the consumer side.” She also anticipates that patients may end up paying less on their copay with a generic version of the drug.

“We’ll know more by (Monday, Jan. 1 ),” she said. “The hope is that nothing much will change, but in the end, the big savings should hopefully be passed on.”

A spokesperson for CVS Pharmacy said the chain is aware of Flovent’s discontinuation.

“Our pharmacy teams will work with patients and prescribers to substitute the generic product or identify potential alternatives,” spokesperson Matt Blanchette said.