Access and Insurance Coverage for Low-Emission Inhalers in Commercial Health Plans in the United States
Clinical Scorecard: Access and Insurance Coverage for Low-Emission Inhalers in Commercial Health Plans in the United States
At a Glance
| Category | Detail |
|---|
| Condition | Asthma and Chronic Obstructive Pulmonary Disease |
| Key Mechanisms | Inhaler prescribing and insurance formulary coverage impact access to lower-emission inhalers. |
| Target Population | Patients with asthma and chronic obstructive pulmonary disease in the United States. |
| Care Setting | Commercial health plans in the United States. |
Key Highlights
- Nearly all commercial plans cover propellant-containing MDIs across therapeutic classes.
- Only 33.2% of plans cover a propellant-free DPI or SMI for SABAs.
- Lower-barrier access for propellant-free inhalers is substantially less common than for MDIs.
- 97% of inhaler-associated greenhouse gas emissions in the US derive from SABAs, ICS, and ICS-LABAs.
- Coverage obstacles favoring MDIs occur throughout the US insurance landscape.
Guideline-Based Recommendations
Diagnosis
Management
- Benefit design should facilitate clinically appropriate use of lower-emission inhalers.
Monitoring & Follow-up
Risks
- Respiratory-related hospitalizations may rise after transitioning to different inhaler devices.
Patient & Prescribing Data
Patients prescribed inhalers for asthma and chronic obstructive pulmonary disease.
Formulary patterns indicate barriers to propellant-free alternatives, particularly among SABAs.
Clinical Best Practices
- Place at least one propellant-free option in each class on preferred tiers.
- Limit utilization management for propellant-free inhalers.
Related Resources & Content
