Readout of HHS Officials’ Meeting with Private Sector and Patient Advocacy Leaders to Improve National Access to Important Asthma Medications

On Tuesday, January 23, 2024, officials from the U.S. Department of Health and Human Services (HHS), including those from Centers for Medicare & Medicaid Services (CMS), met with representatives from leading patient advocacy organizations, provider groups, and health insurers to discuss solutions that help guarantee nationwide access to medications that help manage asthma and eosinophilic esophagitis in children.

At the beginning of 2024, Glaxo Smith Kline stopped manufacturing its Flovent HFA inhaler and transitioned to an authorized generic version of the drug. Many pharmacy benefit managers (PBMs), however, have not given the authorized generic preferred placement in their formularies. As a result, HHS and CMS have heard from patients, parents, doctors, and pharmacists across the country about challenges they are facing in accessing specific inhaler types and medications appropriate for individuals with specific conditions, including children under age 12 with asthma, and children and adults with a specific kind of esophagitis. The specific inhaler type is important for effective drug delivery for children and other individuals with certain conditions. In response, HHS and CMS have been in regular communication with state Medicaid programs, health plans, providers, and families since being alerted to access challenges.

During the meeting, participants discussed how their members are encountering access issues, including confusion at the pharmacy counter when parents are picking up their kids’ asthma medication and high out-of-pocket costs for authorized alternatives to Flovent, and how drug companies’ decisions to discontinue their products rather than lowering prices is affecting patients. HHS and CMS officials used the meeting to start identifying solutions with meeting participants to eliminate access barriers so patients can easily get an authorized generic or a sufficient substitute. At the end of the meeting, HHS further reiterated its commitment to continue working together with leading patient advocacy organizations, provider groups, and health insurers to develop additional solutions to ensure equitable access to critical medication and mitigate access challenges.

Organizations represented at Tuesday’s meeting included:

• American Academy of Pediatrics
• American College of Allergy, Asthma and Immunology
• American Lung Association
• America’s Health Insurance Plans (AHIP)
• Blue Cross Blue Shield Association (BCBSA)
• North American Society for Pediatric Gastroenterology, Hepatology & Nutrition
• Pharmaceutical Care Management Association (PCMA)