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EPA Bans CFC-Based Asthma Inhalers
bonch writes "The EPA has banned over-the-counter asthma inhalers as part of an agreement with other nations to avoid using chlorofluorocarbons, a substance once used in aerosol sprays. Alternative albuterol inhalers cost almost three times as much as the $20 epinephrine inhalers sold by online retailers."
Government, EPA...what a bunch of idiots. Here we have an inexpensive asthma product, that helps MILLIONS of people each day, and now thanks to the government, it will costs those people MORE for a different product. One of the scariest things ever said was... "I'm from the federal government, and I'm here to HELP you".
That's utter bullshit. The amount of compressed gas in asthma inhalers is minuscule. Even when you multiply that by thousands, the amount would be extremely modest. Besides, negative health outcomes by people who don't have inhalers they need (because they can't afford the 'green' ones) would far, far exceed any damage to the ozone layer.
God damn hippies.
This is actually extremely old news. A treaty was signed over a decade ago to ban various uses of CFCs in phases. The OTC epinephrine inhalers were pulled off of the market by the manufacturer some time ago due to a different reason (which I forget), then they decided to not restart production on it because CFC inhalers would be banned as of 1/1/2010.
Anyone that has asthma will tell you that things dramatically changed for them in 2010 when their old albuterol (fast-acting, for emergencies) inhalers were reformulated to not include CFCs (dubbed HFA, aka Hydrofluoroalkane) . Most HFA-using patients state that they cannot "feel" the aerosol or that it doesn't work nearly as well as the CFC-based ones.*
Point being, CFC inhalers haven't been around for a couple of years and we knew they were going away over a decade ago!
(*From my professional experience.)
TFA doesn't explain why changing the propellant chemical means that the active medical ingredient has to change as well. Why can't epinephrine be delivered via a non-CFC propellant?
I recommend not going to Walgreens or CVS - go to an independent pharmacy, you'll get better care there anyways and cheaper prices. Then, don't get Proventil or Proair, get Ventolin! Ventolin is the cheapest and Glaskosmith-Kline has $15 rebate checks they give to pharmacies sometimes (and no, I don't work for ANY Pharmas). You also may want to check their website because they have programs you can enroll in to get your meds for cheap/free, plus they may even have some coupons you can use there.
Since this has been the plan for YEARS NOW, I don't think you're correct.
The lobbying was in delaying the change.
But hey, don't let facts and common sense stop you from using a pop culture fad belief as an excuse to rant.
The Kruger Dunning explains most post on
This contradicts my instincts about the chemistry of our atmosphere. Just who performed these "laboratory studies"? If they were funded by government money in any way then they are probably part of the vast left-wing conspiracy to debunk my gut feelings.
The cost of unleaded gasoline was astronomical in the early 1970s - because unleaded gasoline was produced in relatively small batches and could not compete at scale with leaded gasoline. When leaded gasoline was banned, we were all told that we'd be paying more for gasoline. In fact, the price of unleaded gasoline production fell. The important thing is that the mean blood lead level in 1975 was 15.5 g/dl. The mean blood lead level today is less than 2g/dl. Urban IQs are rising. What does this mean for phasing CFCs out of inhalers? I don't know, but the people who scream every time a new technology has to make transition to scale tend not to make the world any better.
Gently reply
The new inhaler with no insurance? $60. Before? $30
Less pressure, not as effective in getting the meds to my lungs.
I now order them from mexico, same old good stuff that works.
here's a novel idea - why are albuterol inhalers (I've had them for 20 years now) prescription at all? they want to do this? MAKE ALBUTEROL OVER THE COUNTER!
CS majors know the time/space tradeoff, but they never get taught the 3rd, crucial, tradeoff of the set: comprehension!
gee, one you can count, the other you can't. And by the way, as an asthma sufferer, fuck you. Try sleeping when breathing through a straw, see how it feels. This is a money grab by those with a prescription pad. Otherwise, why not produce Ephedrine OTC inhalers with environmentally friendlier gasses? Oh right, money.
CS majors know the time/space tradeoff, but they never get taught the 3rd, crucial, tradeoff of the set: comprehension!
being propagated through the media. Probably written by some anti regulation type; or it's plain shoddy 'reporting'.
a) There is a non- CFC primatine mist coming out.
http://www.empr.com/update-on-primatene-mist-discontinuation/article/208381/
b) this has been a phased roll out since 2008
c) albuterol was the first to be regulated to be CFC free.
d) The corporation the make CFC products stalled in making a replacement in order to maximize there profits, and probably to make regulation seem bad.
e) the only impact CFC inhalers, not over the cuonter inhalers. So you will see OTC inhalers, probably soon.
Whoever wrote that article should be slapped up side the head for sowing discontent in the populace with factual lies.
The Kruger Dunning explains most post on
here's a novel idea - why are albuterol inhalers (I've had them for 20 years now) prescription at all? they want to do this? MAKE ALBUTEROL OVER THE COUNTER!
The answer is in the question.
The lifetime of pharma patents is 21 years + extra time for other things.
Patents on non-CFC albuterol inhalers started expiring in 2009.
More patents will expire over the next few years and non-CFC generics will show up within the next 5 years.
Until those patents run out, it won't be over the counter and it won't be generic.
[Fuck Beta]
o0t!
This contradicts my instincts about the chemistry of our atmosphere. Just who performed these "laboratory studies"? If they were funded by government money in any way then they are probably part of the vast left-wing conspiracy to debunk my gut feelings.
Alright, comrades, the jig's up. BitHive caught us red (of course) handed. Now everyone will know about our scheme:
(1) Threaten everyone with gut debunking.
(2) They start hollerin' for single payer.
(3) ???
(4) Redistribute wealth!
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
If the US had a decent health care system this would NOT be an issue.
Aren't you happy that you are able to sacrifice your health, though, for the good of the planet?
Comrade Captain Planet demands we much all offer our lives for him.
Well last I hear the ozone layer was clearing up, and considering the number of countries that have yet to ban CFC's, I think it is more important that people get the opportunity to breathe.
FDA should fast track the other inhalers, and the EPA should hold off on the ban until they are available. People WILL die without access to inhalers, Another year of cfc's is a drop in the bucket, and there is no evidence that it will kill anyone. Hell they have been warning us about the ozone layer for at least 15 years now, and no one has died yet, another year to get a medicine to the people wont make a difference in the long run.
NOTE: I am against doing things that destroy our habitat, but this seems like a situation that could be better handled. I consider myself a nature lover, and dont want to see the earth get destroyed by our actions. This will do relatively little to the environment and will prevent people from dying. Time to weigh the costs here.
You are entitled to your own opinions, not your own facts.
For gods sake stop screaming "EPA are idiots" and check for once that epinephrine inhalers are not recommended in general due to the side effects of the DRUG. This is why FDA refused the CFC exception for epinephrine. So yes, other inhalers might be more expensive but a) you get rid of ozone destroying CFC as most countries have meanwhile completely abandoned and results show slowly in the layer. And b) people stop using over-the-counter self medication that is not recommended by the National Heart, Lung, and Blood Institute’s Expert Panel Report 3 asthma guidelines.
"Although over-the-counter epinephrine inhalers have been on the market for decades and can relieve acute asthma symptoms, these medications are known to have serious side effects when used in higher doses. In addition, they are not recommended by the National Heart, Lung, and Blood Institute’s Expert Panel Report 3 asthma guidelines. As a result, last year the U.S. Food and Drug Administration (FDA) denied the request for “essential-use” designation for these chlorofluorocarbon (CFC)-propelled devices. The ruling means that epinephrine inhalers will become unavailable in the United States after Dec. 31, 2011.
According to several lung experts, the coming change provides the perfect opportunity for respiratory patients to talk with their doctor or respiratory therapist about epinephrine’s downsides and learn why it is a good thing these inhalers are being removed from the market."
http://www.yourlunghealth.org/healthy_living/aah/04.09/articles/inhalers/
Or you could just see your doctor, maybe manage your asthma better. Maybe have a prescription available in your wallet if you really need it. If you're running to the 24 hour pharmacy in the middle of the night chances are you're doing it wrong.
Get a peak flow meter, learn how to use it. Works great for most people and gives them a 12-24 hour window of alert time before you really get symptomatic.
Faster! Faster! Faster would be better!
Anyone that has asthma will tell you that things dramatically changed for them in 2010 when their old albuterol (fast-acting, for emergencies) inhalers were reformulated to not include CFCs (dubbed HFA, aka Hydrofluoroalkane) . Most HFA-using patients state that they cannot "feel" the aerosol or that it doesn't work nearly as well as the CFC-based ones.*
There are a number of significant differences between CFC and HFC inhalers. One is that most drugs are less soluble in HFCs than CFCs; newer HFCs inhalers are generally formulated using a suspension of solid particles in propellant (this may have something to do with the clogging & self-depletion problems reported with HFC inhalers). There might also be issues given the density differences between CFCs and HFCs -- I would expect the heavier gas would do a better job carrying the medication deeper down into the lungs.
/.'ers are being characteristically reactionist. I use the new inhalers, and have done so for several years now. This story should be modded anti-government flamebait.
Furthermore, epinephrine inhalers are less effective than salabuterol inhalers, with more side effects (epinephrine can be very unpleasant). That's the real reason they're going away-- reformulating them for a new propellant is not worth the cost.
Quantitative proof or GTFO.
Well, I'll take a shot at it. Please excuse me if I miss a decimal point somewhere, corrections are welcome.
About 14g of material in a Primatene Mist Inhaler. Non-propellant mass is ascorbic acid, dehydrated alcohol (34%), hydrochloric acid, nitric acid, purified water (actual mass of drug is negligible). Don't know the breakdown, but guesstimating about 4g of CFC-12 and CFC-114 propellant per inhaler, since alcohol is ~1/3 mass, and ascorbic acid is listed before the alcohol (ingredients should be listed in order of descending weight, so at least 1/3 ascorbic acid).
In one of the recent news interviews about this, FDA spokesman estimated 1-2 million Primatene Mist users out there. Let's say 12 vials per year * 2mil users (I don't really know how many vials an asthmatic goes through), and call it 20 million vials. That would be 24,000kg of CFCs per year, or 24 metric tons.
For reference, reported peak production of CFC-12 was reached in 1988, at 421,002 metric tons (1000kg in a metric ton), and 8,938 metric tons in 2004 (last reported year). So total usage is not tiny, but still a small fraction of the overall CFC usage.
Are you familiar with the term, "boundary condition"?
Asthma inhalers are only one example of a much larger class of products that contain these ozone-destroying propellants. Is CFC-12 the only ingredient that can be used effectively for inhalers? Do inhalers have to use ANY propellant? Or do they include the propellant so that they can minimize the amount of the active ingredient so that the consumer needs to buy lots and lots of inhalers?
Do you remember how many different ways the EPA attacked the pollution in the Great Lakes a few decades ago? They approached it from hundreds of different directions, and for each one you could have said, "Why are they going after this one itty-bitty thing?".
But here we are in 2011, and the Great Lakes are no longer the open-air toilet that they were in the 1970s. You can catch beautiful salmon and lake trout off the coast of Gary, Indiana for chrissake. Cleveland doesn't smell like a decaying corpse any more.
The same arguments were made in the 1980s and 1990s about the EPA. Yesterday, one of the geniuses in the Republican debate, some guy who make his money selling cardboard pizzas, said, "The first thing I'd do after being elected is close down the EPA".
So it's finally happened. The Tea Party has driven the GOP so far over the cliff that they're coming out in favor of...pollution, people dying from lack of health care and executing innocent people. I hear they're planning a big campaign in favor of mercury in baby food and lead paint in pre-schools. They boo a question from a soldier serving in Iraq because he's gay. They consider police, firemen, schoolteachers and paramedics "bottom-feeders", "parasites" and "scum". Think about that for just a second. For them, domestic enemy number one is police, firemen, schoolteachers and paramedics. They have a plan for recruiting better teachers for our schools. And do you know what that plan is? They plan to recruit better teachers by taking away their collective bargaining rights, paying them less, reducing their benefits and making class sizes bigger. I'm not joking. That's what the most "moderate" of the GOP candidates said last night. Mitt Romney's plan to recruit higher-quality teachers is to make it a lot more unpleasant and less lucrative to be a schoolteacher. Guy's a friggin' genius. The number one thing the GOP likes about him is that he's a "job creator" except during his tenure at Bain & Company he laid off a lot more people than he hired and as governor of Massachusetts they were number 46 out of 50 in new jobs. And that other whiz kid, the down's syndrome-looking one from Texas (no, not Ron Paul, the other goof) who brags about his "Texas Miracle" which apparently was he somehow turned all the decent middle-class jobs into minimum wage jobs, and he did so by spending $25billion in federal tax money from the Obama stimulus.
I'm sorry I got off on this rant. So back to my original point, fuck you and your Primatene Mist. Did you ever think that maybe if the air quality in the urban US wasn't so polluted that maybe we wouldn't have the current epidemic of asthma among children in the inner city? The EPA has been under attack by knuckleheads like you for a couple of decades now. They need to be made a lot stronger and more effective, not have their budget slashed every time the Republicans take over one or more branch of government.
I'm sorry for ranting, but my fuck you still stands.
You are welcome on my lawn.
Do inhalers have to use ANY propellant? Or do they include the propellant so that they can minimize the amount of the active ingredient so that the consumer needs to buy lots and lots of inhalers?
No you asshole. They use propellant because when you're having a fucking asthma attack, you can't generate enough negative pressure with your lungs to properly atomize the medicine!
LK
"Hi. This is my friend, Jack Shit, and you don't know him." - Lord Kano
My Dad died of COPD in 2005, and we knew about the upcoming CFC ban years before that. I can only assume that the makers of Primatine Mist had a replacement ready to go 10 years ago...the only reason to pretend they don't is to get a bump from customers hoarding their product before the 'drop dead' date.
I am not a crackpot.
Actually, engineers resolved the notion of the user powered pump quite some time ago. It's really cool, you just squeeze or depress the mechanism and out comes the product. For the lazy though they've come up with the ingenious notion of replacing the aerosol with carbon dioxide or nitrous oxide when used in human consumables. Either way there are alternatives to CFCs and most cost no different or even less than CFC propellant. The problem isn't the propellant it's the drug manufacturers that feel like charging more.
Two of my imaginary friends reproduced once
Athsmatic here in Australia - and AGREED! They did this to us nearly 10 years ago and the difference is noticable.
A friend brought one back from Greece still with CFC in it 5 years ago and I still remember getting a hit from it, it's SO MUCH BETTER. The non CFC variant is simply not as good - no it's not a placebo, it's been 10 damn years.
Do you seriously not see the irony in inhaler companies using ozone-depleting greenhouse gasses in their products? It's almost as bad as GE (PCB polluter extraordinaire) selling water purification systems.
That's not irony. That's a self-sustaining business model.
We really need your help
http://www.gofundme.com/help-sherry
I take it you've never used any of the environmentally friendly inhalers before, because they are fucking terrible. I've been using them for a few years (The EPA went apeshit insane on albuterol a few years ago, and I had no idea that there was an OTC alternative), and they get routinely clogged up by both dust and even dried medicine, and I can ensure you that this was never a problem with the old inhalers. Thankfully, my asthma is really mild and I rarely need these, but if I ever have a real emergency, I'm fucked.
I have used those along with several forms of liquid and several forms in pill. One day I mentioned to my specialist that the compressed air version of my medication worked better than the same chemical in powered form (also inhaled) and he replied that I was correct: the most effective way to get something into the blood stream is through the lungs and the most effective way to do that with with the compressed air versions.
Any doctor pushing a bronchodilator for anything other than the rare emergency use is simply incompetent . Lifestyle changes don't work in all cases although they do help depending on what the triggers are and I have found that relaxation techniques are a great way to avoid a panic attack and passing out but aren't entirely effective. In my case the magic treatment that finally got me off daily Ventolin, along with making sure my house is clean and avoiding smokers (even when they aren't smoking), was Alvesco and that is compressed air inhaled.
As an aside, I really worry about the US when I find out that an Albuterol inhaler there costs $20. My CFC free version of Ventolin cost me $12 in Canada and in Spain I pay less than 10 Euros. The Americans are getting ripped off.
So wait... your management of your asthma is to drive to a 24 hour store to buy an inhaler if you have an attack?
I assume the way you manage fires in your kitchen is to drive to a 24 hour store to buy a fire extinguisher if a fire breaks out.
If you have a condition serious enough to require intervention, you need to keep a prescription on you or near you at all times. I note you say you do "in a perfect world" but come on. This has been coming for many years but it was only a matter of time - salbutamol is more effective overall with fewer side effects and a single inhaler contains about 200 doses, so it's not like you'll be short.
If salbutamol doesn't work for you, then there are other options.
They considered swapping the epinephrine-only inhalers for ones with HCFCs in them, but the side effects of the drug as a whole mean they prefer to phase it out as an inhaler rather than change it to an HCFC version (not to mention that it would require re-approval by the FDA, making it expensive).
Getting ripped off is one of our most beloved and enduring institutions. That, and war-for-profit.
You are welcome on my lawn.