The CFC inhaler ban is well underway and is due to be complete for all but over-the-counter epinephrine inhalers by the end of 2008. Epinephrine inhalers using CFCs will be off the market by the end of 2010. But many people with asthma wonder -- is the CFC inhaler ban just another way for drug companies to make money? It certainly seems so, when the new HFA inhalers cost so much more, and low-cost generics are no longer available.
A Little History
CFCs have been proven to reduce the level of ozone in the ozone atmospheric layer that protects us against harmful sun rays and the risk of skin cancer, cataracts and other health problems. By the late 1970s, CFCs were banned for use in aerosol sprays such as deodorants and hair spray.
In 1989, countries worldwide signed an international treaty, called The Montreal Protocol on Substances That Deplete the Ozone Layer, which is designed to protect the ozone layer from a variety of chemicals, which included CFCs. Certain substances containing CFCs were exempted from an immediate ban if they were defined as having "essential use" and no immediate replacement was available. This included asthma inhalers, for a time.
Drug companies were required, though, to start gearing up and finding effective substitutes for the CFC propellants used in asthma inhalers as quickly as they could. HFA inhalers are the result.
The Montreal Protocol on Substances That Deplete the Ozone Layer: Full Report [PDF]
The Reality of the Transition
Countries worldwide must comply with the Montreal Protocol. This is a governmental initiative based solely on an effort to protect our environment. Even third-world countries are expected to comply with the protocol. It is not driven by United States big business, as some people have theorized in forums and comments on this site and elsewhere.
It has been costly for drug companies to gear up for the transition; doing so includes conducting research to find a viable CFC substitute and making changes to their manufacturing and processes. It has also been costly for the consumer, both in terms of greatly increased pricing of the new inhalers and in terms of increases in medical expenses to treat side effects and loss of asthma control.
Despite all this, the change from CFC to HFA-powered inhalers is not likely to be reversed, even with the public outcry. It may be hard to believe that the little puffs from your old CFC inhalers could emit enough CFCs to harm the ozone layer significantly. But scientists do believe that CFCs represent a substantial threat, and the world's governmental leaders have concurred.
Focus on What You Can Change
There is an old adage: "You can't fight city hall." That may apply here. You might add your name to a petition circulating on the Web to "save our CFC inhalers." It's doubtful that the petition is going to have any significant effect on policy, but it may be worth a try.
A better use of your efforts, though, might be to learn all you can about getting the most out of your new HFA inhaler. This is much more likely to reap immediate benefits to your quality of life and degree of asthma control. Here are a few articles to get you started in that direction:
- More Details on the "Why" of HFA Inhalers
- How HFA Inhalers Are Different
- Tips for Getting the Most From Your HFA Inhalers
Sources:
"FDA Proposing Phase Out of CFCs in Metered-Dose Inhalers for Epinephrine." U.S. Food and Drug Administration; 23 January 08. <http://www.fda.gov/bbs/topics/NEWS/2007/NEW01706.html>
"Topic of the Month - May - Transition to HFA Inhalers." American Academy of Allergy Asthma and Immunology; 23 January 2008. <http://www.aaaai.org/patients/topicofthemonth/0507/>
