Manufacturers to Voluntarily Cap Prices on Numerous Inhalers

Three of the four major inhaler manufacturers in the United States have announced the implementation of an inhaler price cap, which is set to take effect this year. Many inhalers have high costs, with uninsured or high-deductible health plan (HDHP) patients often paying $200 to $600 for a one-month supply. However, the price of inhalers in the U.S. is greater than that of inhalers internationally. The discussion about implementing a price cap follows action taken earlier this year by the Senate Committee on Health, Education, Labor, and Pensions (HELP) and several Democratic senators. In January, they contacted the CEOs of AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, and Teva to inform them of an investigation into inhaler prices in the U.S.

Now, Boehringer Ingelheim, AstraZeneca, and GlaxoSmithKline have pledged to cap out-of-pocket inhaler costs at $35 per month. Starting June 1, 2024, retail pharmacy patients who have commercial insurance or are uninsured will only pay a maximum of $35 per month for Boehringer Ingelheim and AstraZeneca inhalers. The $35 price cap on inhalers produced by GlaxoSmithKline will take effect no later than January 1, 2025. Please see the tables below for more information regarding products subject to the price cap. Of note, this price cap does not apply to patients enrolled in federal government insurance programs, such as Medicare.

Inhaler Price Cap

Inhaler list prices, which are the initial prices set by manufacturers prior to any discounts or rebates, may also be subject to change. Manufacturers have recently lowered the list prices of some, but not all, of the inhalers subject to the price cap. The estimated list price of a drug to wholesalers or other purchasers is known as the wholesale acquisition cost (WAC). As of January 1, 2024, several inhalers have decreased their published WAC prices, with a 50 percent decrease for Advair Diskus, a 20 percent decrease for Advair HFA, and a 40 percent decrease for Symbicort. Additionally, list prices for Spiriva HandiHaler and Atrovent HFA are expected to decrease soon.

Asthma affects more than 26 million Americans, resulting in $50 billion in healthcare costs each year. Meanwhile, approximately 16 million Americans have a diagnosis of chronic obstructive pulmonary disease (COPD), with annual medical costs reaching around $24 billion, including $11.9 billion in prescription drug expenses. Social disparities, such as those affecting geriatric, low-income, and certain minority populations, may put patients at a greater risk of developing these conditions and may also increase their likelihood of facing cost barriers. The high cost of inhalers acts as a significant barrier to treatment; patients who struggle to afford their medications may resort to rationing their supply or discontinuing therapy altogether.

With the implementation of the price cap, AstraZeneca, Boehringer Ingelheim, and GlaxoSmithKline have stated that patients will still be eligible to benefit from discounts, rebates, and patient assistance programs. The improved affordability of inhalers is expected to reduce the financial burden on patients with asthma and COPD, particularly those who are uninsured or underinsured.

Posted: April 2024

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