Withdrawal of brand-name drug linked to discontinuation of inhaled steroid therapy among children using fluticasone propionate
By Elana Gotkine HealthDay Reporter
FRIDAY, May 2, 2025 (HealthDay News) — For children using fluticasone propionate, the withdrawal of the brand-name drug (Flovent) was associated with increased discontinuation of inhaled steroid therapy, according to a research letter published online April 26 in the Journal of the American Medical Association to coincide with the annual meeting of the Pediatric Academic Societies, held from April 24 to 28 in Honolulu.
Kao-Ping Chua, M.D., Ph.D., from the University of Michigan Medical School in Ann Arbor, and colleagues conducted a difference-in-differences analysis to examine whether the withdrawal of brand-name fluticasone propionate was associated with discontinuation of inhaled steroid therapy. The analyses included children aged 0 to 18 years with one or more dispensed inhaled steroid prescriptions in quarter 4 of 2021, 2022, and/or 2023. The treatment group included children for whom the only inhaled steroid prescriptions dispensed to them during these index quarters were for brand-name fluticasone propionate (1,980,963 person-years of data from 1,411,184 children), while the control group included children for whom the only inhaled steroid prescriptions dispensed during the index quarters were for other inhaled steroids, including the authorized generic fluticasone propionate (1,237,802 person-years of data from 969,268 children).
The researchers found that the treatment group experienced a 6.0 percentage point greater increase in the probability of having no inhaled steroid dispensing compared with the control group. Between 2021 and 2022, this probability increased 1.4 percentage points more in the control group versus the treatment group. Difference-in-differences estimates were larger among children aged 0 to 5 years versus older children and among Medicaid-insured children versus commercially insured children.
“Findings suggest that elimination of the Medicaid rebate cap was potentially associated with unintended consequences,” the authors write.
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