Access and Insurance Coverage for Low-Emission Inhalers in Commercial Health Plans in the United States

1

Asthma and chronic obstructive pulmonary disease are primarily treated with inhalers, with access often determined by insurance formulary coverage.
2

Metered-dose inhalers (MDIs) produce significantly higher greenhouse gas emissions compared to dry powder inhalers (DPIs) and soft mist inhalers (SMIs).
3

Nearly all commercial plans cover propellant-containing MDIs, while only 33.2% cover propellant-free DPIs or SMIs for short-acting β2-agonists.
4

Lower-barrier access for propellant-free inhalers is substantially less common than for MDIs, particularly for short-acting β2-agonists.
5

The study highlights significant formulary barriers to propellant-free inhalers, especially among short-acting β2-agonists, affecting emissions reduction efforts.

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