Warning on new asthma medicine

More than half a million New Zealand asthmatics who rely on Ventolin puffers face switching to a cheaper drug which users complain is prone to blocking inhalers.

The Government's medicine buyer, Pharmac, is to stop paying for Ventolin, used for 30 years, from July 1 in favour of a sole-supply contract for the cheaper drug Salamol.

The switch will save taxpayers $2 a patient, or about $1.7 million over an 18-month period.

However, a support group predicts a rise in asthma deaths following the change.

Concerns about Salamol include the presence of a small amount of alcohol and cases of the inhalers blocking when needed.

About 10 patients have complained to Pharmac about Salamol inhalers becoming blocked.

The agency is talking to the medicines regulator Medsafe about independent testing of the device by the Institute of Environmental Science and Research.

One asthma sufferer said yesterday that she had changed to Salamol but wanted to switch back as she got less relief from the new drug and the inhaler clogged until she washed it, effectively stopping her puffing in the medication.

If Ventolin does remain available, patients who want it will have to pay for it themselves.

GlaxoSmithKline New Zealand said it could continue supplying the country with Ventolin if there were enough users willing to pay for it.

Managing director Lisa Bright said the company would monitor demand from July 1.

The Government pays $6 before GST and mark-ups for each Ventolin inhaler, but Ms Bright would not say what the likely retail price would be after the subsidy ends.

Ruth Williams, general manager of Salamol's supplier, Asthma and Respiratory Foundation subsidiary Air Flow Products, said blockages could be avoided by regular washing, as recommended for both medicines.

CFC-free Salamol and its predecessor had been sold in Britain for 18 years, showing it was "an effective, proven and trusted inhaler".

But the Asthma New Zealand patient support group highlighted a small British study which found that one in five Salamol inhalers - but no Ventolin inhalers - clogged even when washed, shaken and primed.

Asthma New Zealand said Ventolin users had never needed to wash their inhalers.

The group's executive director, Gerry Hanna, said the number of people dying from asthma attacks would inevitably increase because of problems with Salamol.

Despite it containing the same active ingredient - salbutamol - as Ventolin, some people were intolerant of different medicines and would have no state-funded alternative salbutamol.

It was expected that alcoholics and parents of some children would also object to the presence of alcohol, Mr Hanna said, and relying on a sole supplier created risks like those experienced with the flu vaccine.

Chronic asthma sufferer Ian Lindsay, 56, of Auckland, said he had been using Ventolin up to four times a day since he was diagnosed with the condition 24 years ago.

"I've had a couple of close shaves; not recently, but when I was trying to get control of asthma.

"If I hadn't had Ventolin, I would have been dead."

He said he wanted to remain on Ventolin and planned to stockpile it.

Pharmac's chief executive, Wayne McNee, said the agency had "absolute confidence" in Salamol and he knew of no evidence it was associated with increased asthma deaths.

While risks existed in sole-supply contracts, Air Flow had proven itself to be a reliable supplier, he said.

Those who did not wish to use Salamol could be prescribed Bricanyl, a state-funded reliever containing a different active ingredient.

The puffers

Ventolin

* Relieves breathlessness and wheezing.

* Used by 90 per cent of New Zealand's more than 600,000 asthma sufferers.

* Basic cost for Government: $6

Salamol

* Contains a small quantity of alcohol. Medsafe says it is interchangeable with Ventolin.

* Complaints that the inhaler clogs up.

Basic cost for Government: $4.