Three ways to ensure your child has the proper asthma medication

A woman holds a spacer attached to an asthma inhaler while a child takes in the medication.
The discontinuation of Flovent HFA has many families wondering what to do next. Fortunately, there are alternatives. (Image: AdobeStock)

Children who have asthma should always have access to medication. But a manufacturer’s decision to stop producing a popular asthma drug has many families scrambling to find alternative medications that are covered by health insurance.

Prescriptions sometimes change for families because a medication is discontinued or there are coverage changes by health insurers and pharmacies, says Dr. Jonathan Gaffin, director of Boston Children’s Severe Asthma Program. Usually, families, health care providers, and pharmacies have time to adjust. But Gaffin and other asthma specialists can’t remember a more seismic change in asthma care than the manufacturer of Flovent HFA stopping production of the widely used drug. It hasn’t helped that many health insurers aren’t fully covering the manufacturer’s authorized generic form of Flovent HFA, a drug called fluticasone, or that another alternative drug is in short supply.

“It has led to families feeling frustrated for not being able to get a medication that their child has used for a long time,” Gaffin says. “Even when we are able to prescribe a reasonable alternative, they can’t find a pharmacy that has it in stock. We’re worried that if kids are not getting their medication, there could be lapses in their asthma control.”

It’s a concerning time, but Gaffin and Erin Antonellis, an asthma clinical practice specialist, want families to know there are solutions. Here, they offer three tips on how families can navigate the change and ensure their child has the help they need, especially with allergy season starting.

Check drug coverage with your health insurer

If you’re having difficulty finding a replacement for Flovent HFA — an inhaled corticosteroid controller medication that decreases swelling and inflammation in the lungs — call your health insurer to learn which inhaled steroid medication is covered. Most insurers aren’t covering the cost of the generic fluticasone because it is expensive, Gaffin says, so that leaves only a handful of other drugs as replacements. To add confusion, some insurers will cover fluticasone for young children, but the maximum age differs per insurer, according to Antonellis.

That’s why it is imperative for families to first determine which asthma controller will be covered. Your insurer should have all the details. Every year, insurers update the list, or formulary, of prescription medications they will cover. It doesn’t hurt to check in with your insurer each year if they don’t first inform you about those updates, Antonellis says.

If a change is detrimental, ask your doctor for insurance authorization

Some children can adapt to a change in asthma medication, but others need to continue using a certain type to get the best results, Gaffin says. In these instances, ask your pediatrician if you qualify for an insurance authorization. If appropriate, the pediatrician will write a letter confirming your child needs to stick with their longstanding medication.

For example, metered-dose inhalers are easier to use for patients with developmental disabilities and young children who can’t generate enough force in their lungs to effectively take in medication from dry-powder inhalers. An insurance authorization will ensure they can continue using metered-dose inhalers, which can be used with a spacer or mask that allow a patient to breathe normally when taking the medication.

Let your doctor know if a new asthma inhaler isn’t effective

Asthma specialists and pediatricians don’t know yet if the discontinuation of Flovent HFA has prevented many children from staying ahead of their asthma, Gaffin says. For now, it’s something that clinicians will have to monitor patient by patient. Every child responds differently. If your child is showing signs that their asthma is not well-controlled with a new inhaler, contact your pediatrician and ask if your child should continue using the drug or try another one.

“Parents and providers should stay on top of a child’s health” Gaffin says. “But it is possible this big change might not affect how many children manage asthma. That would be great.” 

Learn more about the Severe Asthma Program.

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