Respiratory Health Association Endorses HB 4504/SB3203 – Capping the Cost of Co-Pays for Prescription Inhalers

Since 2000, many asthma patients have used Flovent as their go-to inhaler. However, in January 2024, drugmaker GSK announced the discontinuation of Flovent, in favor of producing a generic version. Prescription inhalers contain medications that prevent and treat symptoms – include coughing, shortness of breath, wheezing, and chest tightness- for people living with acute respiratory conditions and chronic lung diseases, like asthma and COPD. Poor adherence or not using inhaler as prescribed can exacerbate symptoms, leading to higher risks of breathing difficulties and asthma attacks, a decrease in quality of life and increases in school/work absenteeism emergency department visits, hospitalizations, and even death.

According to GoodRx and NPR, a Flovent inhaler which cost $230 a decade ago, last retailed at $340. The new generic version costs around $310, allowing GSK to sell the drug without a history of price hikes and limiting their risk of price hike penalties. According to a nationwide CDC-funded study, the annual per-person medical cost of asthma is $3,266, of which $1,830 is for prescriptions. HB 4504 and SB 3203 amend the Insurance Code to require health plans to limit co-pays for prescription inhalers for a covered person to $25 per 30-day supply. Additionally, the bill prevents prescription inhalers from being subject to a deductible.

People with chronic lung disease often need two to three inhalers. Financial barriers to inhalers increase the chance a patient will experience exacerbated symptoms and increase the risk of death. These financial barriers also increase the state’s healthcare costs, especially for hospitalizations. A 2022 poll found about 1 in 4 adults who take prescription drugs reported difficulty affording their costs, including about 1 in 3 who take 4 or more prescriptions. For children with asthma specifically, research has found associations between higher cost sharing for asthma medications and higher rates of asthma hospitalizations.

More than 1.4 million people in Illinois have chronic lung disease, including 160,000 children with asthma. Asthma is a leading cause of missed work and school days nationwide. One in three Illinois children with asthma report having symptoms in the last 14 days. In 2017, 1 in 4 Illinois children with asthma reported missing a day of school or day care in the past month due to asthma, costing $53.6 million annually and affecting student learning. According to the U.S. Centers for Disease Control and Prevention (CDC), “deaths due to asthma are rare and are thought to be largely preventable.” Yet in 2021, there were 124 asthma-related deaths, the sixth highest rate in the nation. In Illinois, the death rate for Black people with asthma is 5.5 times higher than for White people. Passing bills SB3203 and HB4504, which are supported by nearly 20 public health organizations and hospital systems statewide, would ensure access to life-saving inhalers for all and cap their costs and prioritize the well-being of every individual.