Drug blamed for asthma attacks

A new brand of inhalant may be behind a sharp rise in the number of children in hospital with life-threatening asthma attacks, say Asthma New Zealand and leading paediatricians.

State-funded Salamol costs only $4, but many young asthma sufferers refuse to puff it because of its alcoholic taste.

Rival inhalant Ventolin is subsidised at the same level but patients pay $3 to $12 because of higher manufacturing costs. Doctors suspect poorer families cannot afford to choose and are paying the price.

Starship Hospital specialists met Asthma Auckland late last year to discuss the alarming trend. Dr Cass Byrnes, Starship senior paediatric consultant, said the spike was unusual during summer.

"There was a definite increase over a number of months and there is nothing to really explain it."

Dr Byrnes said Salamol might not be the only factor, but she was concerned that some children refused to take the cheaper medicine.

"It's hard to encourage children when they don't like the taste. More concerning is the re-admissions, because these kids aren't taking the drugs."

Poorer families simply could not afford the more popular Ventolin, she said. Many might have four or five asthmatic children who each needed two inhalers - for school and home.

 

Dr Allen Liang, president of Asthma New Zealand, said two of his patients were taken to hospital last year after refusing to use Salamol because of the taste.

One was treated in the emergency department and the other admitted to a ward overnight.

Both recovered, but the $5000 price tag for an overnight stay at Starship would buy one patient Ventolin for several years, Dr Liang said.

Whangarei doctor Shane Reti has completed a scientific trial into Salamol, which is being peer-reviewed before it is submitted to the New Zealand Medical Journal.

Anecdotally, he said, children were rejecting the new drug and paying the price for being too poor to afford Ventolin.

Salamol is supplied by Air Flow Products, a subsidiary of the Asthma and Respiratory Foundation.

Professor Robin Taylor, medical director for the foundation, said it was too early to jump to conclusions.

No case could be made until the hospital asthma admissions for before and after Salamol were compared, he said.

He said any questions over safety were addressed by the Health Ministry and independent testing commissioned by Medsafe. "It is my opinion that the investigation was very thorough," Professor Taylor said.

Pharmac Medical director Dr Peter Moodie said patients and prescribers could have confidence in the effectiveness of Salamol.

He said Pharmac had heard "absolutely nothing" about children rejecting Salamol because of the taste. "There certainly is a different taste and I'm not sure this is a huge deterrent."

Pharmac was funding both inhalants at the same level and if children were getting sicker, there were other factors to consider, he said.

Preventive medicines and long-acting drugs needed to be taken regularly, rather than sucking on an inhaler as a last-minute reaction.

"Doctors and pharmacists should be assuring patients that Salamol works well," Dr Moodie said.