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COPD patients with Medicare Part D 'struggle with inhaler costs'

Many patients with chronic obstructive pulmonary disease (COPD) who have Medicare Part D struggle to pay for medication and inhalers, it has been suggested. A report published in the Journal of the American Medical Association (JAMA) revealed one in nine Medicare beneficiaries have COPD. The Medicare Part D Plans' Coverage and Cost-Sharing for Acute Rescue and Preventive Inhalers for Chronic Obstructive Pulmonary Disease report revealed nearly one-third of Medicare beneficiaries do not use their inhalers due to concerns over the cost. 

COPD refers to a number of diseases causing breathing-related problems and blockages in the airway. Among the most common conditions are emphysema and chronic bronchitis. Smoking is one of the main risk factors for patients developing COPD. According to the Centers for Disease Control and Prevention, the condition affects more than 15 million Americans and is the third leading cause of death in the United States.

The report in JAMA noted COPD inhaler costs have "increased dramatically" since 2008, attributing this in part to a ban on chlorofluorocarbon propellants, which reduced the number generic medication options available, leaving more expensive branded drugs as the only option for many patients. The authors of the study concluded the findings "call into question whether Part D continues to adequately support beneficiaries in the face of rapidly rising drug prices". They suggested Medicare and Part D plans should consider the potentially adverse effect of high inhaler costs on Medicare beneficiaries withe COPD. 

Speaking to Kaiser Health News, Brian Stigall, MD, of Hill Country Medical Associates in New Braunfels, Texas, echoed the findings of the report. He asserted that inhalers are unaffordable for many of his patients and this could have a negative effect on the health of patients with COPD. The high costs result in many skipping treatments and not taking their medicinal inhalers. Without these, he said, "they are going to end up back in the hospital and they're going to end up seeing me much more often".  

Inhalers and oxygen therapy are among the most common treatments for patients with COPD. A number of different inhalers are used to alleviate the symptoms of COPD, including anticholinergics such as the branded Spiriva (tiotopium) and the beta-agonist/corticosteroid Breo Ellipta (fluticasone/vilanterol), which reduces inflammation and improves airflow to the lungs. Accuneb, a beta agonist may also be used to to relax muscles in the airway. It is available as a generic albuterol inhaler and in branded forms, such as Proair HFA and Ventolin HFA inhalers.

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