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Senator Baldwin, Colleagues Launch Investigation into Pharmaceutical Companies’ High Price of Asthma Inhalers

Asthma alone kills 3,500 people every year, and nearly all of these deaths are preventable with regular treatment and affordable care

WASHINGTON, D.C. – U.S. Senator Tammy Baldwin (D-WI), member of the Senate Committee on Health, Education, Labor, and Pensions (HELP), and three of her colleagues launched an investigation into the extremely high prices four large pharmaceutical companies charge for inhalers that 25 million Americans with asthma and 16 million Americans with chronic obstructive pulmonary disease (COPD) rely on to breathe. The Senators sent letters to the CEOs of the four biggest manufacturers of inhalers sold in the United States – AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline (GSK), and Teva – which charge between $200 and $600 for each inhaler, typically purchased monthly.

“The exorbitant price of inhalers for Americans is just another example of big pharmaceutical companies putting profits over people. While families struggle to afford this lifesaving device, these four companies are jacking up prices and turning record profits,” said Senator Baldwin. “No American who needs an inhaler to live a healthy life, especially children, should be forced to ration or forgo their medication because of cost. It is time we hold big pharmaceutical companies accountable for price gouging Americans.”

Inhalers have been available since the 1950s, and most of the drugs they use have been on the market for more than 25 years. In other countries, the exact same products are sold for far less. One of AstraZeneca’s inhalers, Breztri Aerosphere, costs $645 in the U.S. but just $49 in the U.K. Boehringer Ingelheim’s Combivent Respimat costs $489 in the U.S. but just $7 in France. GSK’s Advair HFA costs $319 in the U.S. but just $26 in the U.K, and Teva’s QVAR RediHaler costs $286 in the U.S. but just $9 in Germany.

In Wisconsin, over 500,000 people have asthma, or 1 in 11 adults. In 2018, Wisconsin saw 71 deaths due to asthma, with nearly 40 percent of those deaths being Wisconsinites 65 years or older. In Milwaukee, uncontrolled pediatric asthma consistently ranks within the top three causes of emergency department visits. Nationwide, asthma alone kills 3,500 people every year, and nearly all of these deaths are preventable with regular treatment and affordable care

The prices charged in the U.S. drive massive revenues for these four companies. In the past five years, AstraZeneca, GSK, and Teva made more than $25 billion in revenue from inhalers alone (Boehringer Ingelheim does not provide public information on its U.S. inhaler revenues). That is part of a broader pattern: Between 2000 and 2021, manufacturers of all inhaler products in the U.S. brought in more than $178 billion in revenue.

Senator Baldwin joined Senators Bernie Sanders (I-VT), Ben Ray Luján (D-NM), and Ed Markey (D-MA), all members of the Senate HELP Committee, in launching the investigation.

In the letters sent, the senators wrote that the revenue figures from these companies, “are a direct result of the outrageous prices the companies charge. These prices force patients, especially the uninsured and underinsured, to ration doses or abandon their prescriptions altogether. The results are predictable and devastating. Without consistent access to inhalers, people with asthma and COPD are more likely to get sick, to be hospitalized, and to die. Asthma alone kills 3,500 people every year, and nearly all of these deaths are preventable with regular treatment and affordable care. This cannot be allowed to continue.”

“In addition to being exposed to unhealthy environments, people who live in poor and underserved communities have limited access to primary care providers and specialists who can diagnose their asthma and treat their symptoms,” the senators continued. “As a result, not only are they more likely to have asthma, they are also more likely to need costly emergency care.”

In their letters to AstraZeneca, Boehringer Ingelheim, GSK, and Teva, Senators Baldwin, Sanders, Luján, and Markey requested that the companies provide information and documents on the internal decisions that ensure their inhalers do not face competition and can continue to bring in massive revenues, including on the following:

  • How executives decide to add new features to old inhalers or to move patients off of old products and onto new products, both of which are common tactics to keep lower-cost generic competitors off the market.
  • Whether the companies have evidence that their new products have any real clinical benefits compared to the old products.
  • For the companies to provide the costs involved in manufacturing their inhalers and for information about their patient assistance programs – which provide free or discounted inhalers to patients – including how much the companies deduct from their corporate taxes for operating those programs.
  • Finally, the letters request information on how much the companies spend on research and development for asthma and COPD.

These letters build on previous efforts by Senator Baldwin and the HELP Committee to lower the costs of life-saving medications for Americans. In March, the Committee held a hearing on Moderna’s decision to increase the price of the COVID-19 vaccine, which was developed through a partnership with the National Institutes of Health (NIH). In May, the Committee held a hearing on the need to make insulin affordable for all Americans. And in November, the Senators joined all Democratic members of the HELP Committee in inviting the CEOs of three pharmaceutical companies to testify on the outrageously high cost of prescription drugs.

Read the letter to AstraZeneca, here.

Read the letter to Boehringer Ingelheim, here.

Read the letter to GSK, here.

Read the letter to Teva, here.