GSK Discontinues Flovent at 'Worst Possible Time of Year'

Flovent — a medication that helps thousands to breathe — has been discontinued by drug manufacturer GSK and will begin to disappear from pharmacy shelves on Jan. 1.

Instead of the branded asthma inhaler Flovent, GSK is making an "authorized generic" version, which is identical minus the branding.

Doctors who treat patients with asthma told CNN the generic drug will work just as well as the branded one. It doesn't seem to be as widely covered by insurers, however, which could mean patients have to obtain new prescriptions and work out coverage snafus at the "worst possible time of year," when respiratory illnesses are on the rise.

"This medication has been the most commonly used inhaled medication for the past 25 or 30 years," Dr. Robyn Cohen, a pediatric pulmonologist at Boston Medical Center, told CNN. "It's the one that, overwhelmingly, pediatricians reach for when they decide that their patient needs a daily preventive medication. … The fact that it's being discontinued is going to be a huge shock to the system for patients, for families and for doctors."

A spokeswoman for GSK said the company launched the authorized generics Flovent HFA, an inhalation aerosol and Flovent Diskus, an inhalation powder, in May 2022 and October 2023, and that it would discontinue manufacturing the branded versions in the U.S. on Jan. 1.

She told CNN the change is "part of our commitment to be ambitious for patients" and that the authorized generics "will provide patients in the U.S. with potentially lower cost alternatives of these medically important products."

Experts who follow the industry told the outlet that GSK is discontinuing the branded version at a time when a change in Medicaid rebates could force the company to pay huge penalties as a result of price increases on Flovent.

On Jan. 1, a cap on Medicaid rebates will be removed, which companies are required to pay if they hike medications to prices above inflation.

"Flovent Diskus has been on the market since 2000 and Flovent HFA since 2004, and GSK has hiked the price on both products numerous times since their launch," Dr. William Feldman, an associate physician in the Division of Pulmonary and Critical Care Medicine at Brigham and Women's Hospital, told CNN. "These are precisely the sort of drugs that will be affected by the new policy eliminating the Medicaid rebate cap."

Rebates were previously capped at the total price of a medication, so manufacturers wouldn't pay more than it costs back to Medicaid.

A provision in the 2021 American Rescue Plan Act removed that limit as of Jan. 1, so drugs that have seen large price increases over time could incur rebates to Medicaid that are greater than their price. Pharmaceutical companies would essentially be selling their drugs to Medicaid at a loss.

"Obviously pharma doesn't want to be selling at a loss on anything in its portfolio," Andrew Baum, an analyst who covers pharmaceutical stock for the financial firm Citi, told CNN. "So it seeks to evade impact by, one: discontinuation; two: authorized generic."

With insurance plans not widely covering the authorized Flovent generic, Cohen said "patients are going to need to get a brand new prescription for a completely different medication in the middle of the worst possible time of year, which is the winter respiratory virus season."

For decades, Flovent has been the most commonly used daily preventive anti-inflammatory medication for patients with chronic asthma, Cohen told CNN. Having that daily medicine on hand becomes even more critical during cold and flu season, she said, especially for children.

"Flu, COVID, RSV — all these circulating viruses that are going around right now — are one of the biggest, if not the biggest, triggers for asthma attacks in kids," Cohen said. "This is what leads to kids being in the emergency room."