OPINION

Banning of CFC Inhalers - Another Stupid Ban

August 19, 2008
paul7anderson

Earlier I commented on banning tin in solder (Problems implementing the Restrictions of Hazardous Substances). The August 2008 issue of Scientific American carries an article about the problems about to happen with the banning of chlorofluorocarbons (CFC) driven inhalers. Here, just as in removing tin from solder, banning a known hazardous material from a trivial use can cause very significant consequences. Emily Harrison in her article "Changes In the Air" gives the history. She goes on to explain why one member of the FDA advisory committee, Nicholas J. Gross of the Stritch-Layola School of Medicine has publicly regretted the decision, recanting his support and requesting the ban be pushed back until 2010 when the first patents on replacement propellants hydrofluoroalkane (HFA) expire. Gross noted that the decision had nothing to do with the environment, Albuterol inhalers contributed less than 0.1% of the CFC released when the treaty was signed. "It's a symbolic issue", Gross remarks.

To quote Harrison's article

"Some skeptics instead point to the billions of dollars to be gained by the three companies holding patents on the available HFA albuterol inhalers, namely Glaxo-SmithKline, Schering-Plough and Teva. Although the FDA advisory committee recognized that the expenses would go up, Hendeles says it also believed that the companies would help defray the added costs for individuals. Fims, for instance, had committed to donating a million HFA inhalers around the country, According to Hendeles, Glaxo-SmithKline did not follow through, although Schering-Plough and Teva did. Glaxo-SmithKline did not resond to requests for comment." (emphasis added)

It might be noted that Leslie Hendeles of the University of Florida has pointed out there are differences in the mechanics and maintance. The HFC inhalers must be primed more carefully and rinsed to accomodate the stickier HFC. The HFC inhalers run out suddenly without warning that it is getting low. This, of course, now puts the patients themselves at increased risk. Who is responsible if a person dies due to an acute asthma attack because they did not know their inhaler was going to run out suddenly? Hendeles points out that pharmicists may not warn patients and doctors do not know.

The HFC inhalers cost three times more than generic CFC inhalers.

Just as removing tin from solder, replacing CFC with hydrofluoroalkane (HFA) gives an inferior product at greater cost.

Clearly, someone profits from doing something that is not in the best interests of the user or the medical community. Profiting from doing harm to society is ordinarily some kind of crime.

To quote Harrison

"The main public health issue in this decision may be the side effects of the economics, not the drug chemistry. Multiple studies have shown that raising costs leads to poorer adherence to treatment. One study discovered that patients took 30% less anti-asthma medication when their co-pay doubled. In the case of of a chronic disease such as asthma, it is particularly difficult to get people to follow regular treatment plans, "generally speaking, for any reson you you don't take a medicine, cost makes it more likely" that you do not , comments Michael Chernew, a health policy expert at Harvard Medical School."" (emphasis added)

Harrison continues,

"Such choices to forgo medication could affect more than just the patients themselves. "For example," Hendeles points out, "in a pregnant mother with untreated asthma, less oxygen is delivered to the fetus, which can lead to congenital problems and premature birth." And considering that the disease disproportionately strikes the poor, what seems to be a good, responsible environmental decision might in the end exact an unexpected human toll."

This differs from the case of tin in solder, but perhaps not by much; removing lead from solder and replacing the less-expensive-lead with all-tin in solder was much more expensive than using the tin/lead solder that was doing a better job ar a lower cost. Here we are again being forced by government regulators that evidently need to suppliment their meager public-service salaries with hidden compensation from industries who benefit from their regulations to spend more money for an inferior product.

Who benefits? Certainly not the end user.

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Banning of CFC Inhalers - Another Stupid Ban

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Author: paul7anderson

 

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#1
Deepti Lamba
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August 19, 2008
09:18 PM

Very informative. Thanks for sharing Paul.

#2
cathyc
September 13, 2008
06:43 PM

I am not happy that I will be paying four times as much for an inferior product. What can I do.

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