Medco gets wind of risks associated with LABAs

FRANKLIN LAKES, N.J. —The class of drugs known as long-acting beta agonists can provide many benefits to patients with asthma and chronic obstructive pulmonary disease, but medical experts have long warned of dangers in using the drugs alone. Still, according to data from a study last month, many patients continue using LABAs as a monotherapy despite the risks.

The Medco Research Institute and the Medco Pulmonary Therapeutic Resource Center, research arms of pharmacy benefit manager Medco Health Solutions, found that close to one-third of patients using LABAs use them without other controller medications. And this, according to experts, puts them at risk of worsening disease symptoms or even death. LABAs include such drugs as GlaxoSmithKline’s Serevent (salmeterol xinafoate) and Foradil (formoterol fumarate) by Merck and Novartis.

The researchers found that 31% of patients prescribed either drug didn’t use them together with controller medications, but those who received treatment from an allergist or pulmonologist were 43% less likely to use a LABA as a monotherapy than those who received treatment from a general practitioner. The study included patients who had continuous prescription drug coverage during 2009 but excluded patients with COPD while calculating the number of patients using LABAs alone by excluding those with overlapping days’ supplies of inhaled corticosteroids or leukotriene modifiers.

“We’ve identified a gap in care that needs to be shared with the medical community in order to improve patient health and reduce the rate of preventable hospitalizations and emergency room visits,” Medco Therapeutic Resource Centers president Peter Juhn said. “This study demonstrates that specialized care can significantly improve clinical outcomes when treating patients with asthma.”

The National Heart, Lung and Blood Institute, one of the National Institutes of Health, recommended in its asthma treatment guidelines that patients using LABAs should combine them with inhaled corticosteroids or leukotriene modifiers, and the Food and Drug Administration requires warnings on the drugs’ product labels advising against using them alone. Asthma attacks cause half a million hospitalizations, 217,000 visits to the emergency room and more than 4,000 deaths, according to Medco.

“Whether physicians are not following the prescribing guidelines for LABAs, or patients are not filling the prescriptions for their other controller medications, taking LABAs alone presents a significant safety risk for asthma patients, especially for children,” Medco Pulmonary Therapeutic Resource Center national practice leader Luis Salmun said. “Patients may feel like they are getting symptom relief from using LABAs alone, but they are actually masking the underlying inflammation, which could put them at serious risk for complications from the disease.”