Asthma drug switch may be reviewed

Pharmac is considering delaying the demise of state-funded asthma drug Ventolin because of patients' complaints that the replacement inhalers clog up.

Blocked inhalers deliver no medicine, leaving patients without relief from breathlessness and wheezing. In the most severe attacks, some could be at greater risk of death.

The Government's medicines buyer had planned to stop paying for Ventolin inhalers, estimated to be used by 90 per cent of New Zealand's more than 600,000 asthma sufferers, from July 1.

In February it started paying for patients to receive Salamol, which contains the same active chemical, salbutamol, but a different propellant and other ingredients. The change will save taxpayers $2 per inhaler - about $1.7 million over 18 months.

But Pharmac's chief executive, Wayne McNee, said yesterday that it was considering deferring the sole-supply contract for Salamol for three months, until October 1, to assess the complaints about the inhalers blocking or not working.

Pharmac is also talking to drugs regulator Medsafe about commissioning independent testing of Salamol to see if it is up to scratch.

Andre North, who told in the Herald last August of the death of his 21-year-old partner Lisa Avenell during an asthma attack, said yesterday he was concerned by the reports about Salamol. Asthma was a bad enough problem in New Zealand without supplying drugs that did not work properly, he said.

Asthma New Zealand executive director Gerry Hanna urged Pharmac to re-open contract negotiations for asthma reliever drugs and offer to fund Ventolin - priced at $6 per inhaler before mark-ups and GST - at the same price as Salamol, $4.

Ventolin maker GlaxoSmithKline may stop supplying the product to New Zealand, but said this depended on how many patients wanted to pay.

The Weekend Herald continued to receive reports yesterday of Salamol inhalers clogging up or not providing asthma relief.

"It doesn't seem to have any effect," said one asthma sufferer. He had been switched, against his will, from a third type of salbutamol inhaler, which is scheduled to lose its partial subsidy on July 1.

Pharmacist Warren Flaunty, a Waitemata District Health Board member, said two patients had returned to his pharmacy yesterday due to blocked Salamol inhalers. They worked after washing.

He estimated six people had returned with blocked Salamol inhalers in the week to 10 days since the pharmacy had switched to them from Ventolin, which never clogged up.

Independent asthma researcher Dr Shaun Holt, who runs clinical trials for drug companies, including Glaxo, rejected Medsafe's assertion that the two medicines were interchangeable. People reacted differently because the mixtures were different, despite having the same active ingredient, he said.

"[Salamol] has only been available for a few weeks and I've already received reports from patients claiming it's not working.

"It's a very modest saving Pharmac are looking at. For the amount of hassle and potential clinical problems I don't think they have got the balance right."

Inhaler instructions

* Remove the medicine canister.
* Rinse the plastic inhaler device under warm running water.
* Dry inside and out, leaving it overnight if possible.
* If using it before dry, shake off excess water, test it, use it, then wash and dry again.