The Impact of the US Food and Drug Administration Chlorofluorocarbon Ban on Out-of-pocket Costs and Use of Albuterol Inhalers Among Individuals With Asthma

Abstract

In March 2005, the US Food and Drug Administration (FDA) announced that the production and sale of all chlorofluorocarbon (CFC)-propelled albuterol inhalers would be banned effective December 31, 2008, in the United States.¹ This action stemmed from the 1987 Montreal protocol, in which 26 nations assembled and called for a worldwide reduction in use of ozone-depleting substances, such as CFCs, as well as subsequent amendments to the US Clean Air Act that banned use of nonessential products containing CFCs.^1,2 Before 2005, the FDA had recommended to the US Environmental Protection Agency that CFC albuterol inhalers should be considered essential medicines and therefore exempt from the Clean Air Act. However, the FDA reversed this policy in 2005 with the growing availability of 2 propelled albuterol inhalers that did not cause ozone depletion.² The result of this policy was the gradual elimination of generic CFC albuterol inhalers from the US market in the 2 years preceding December 31, 2008, and the availability of only branded hydrofluoroalkane (HFA) albuterol inhalers thereafter.