Catching your breath with the right inhaler therapy

It’s very common for RxLive clinical pharmacists to consult with patients who have asthma or COPD. There are many types of inhalers on the market, with a variety of dosing considerations and costs, so this blog will provide a quick overview of available inhaler therapies, costs and links to pertinent resources for further information.

Inhaler availability on the market for asthma 


Pharmacist’s Letter
has a useful chart that provides inhaled corticosteroid dose comparisons based on clinical trials in asthma without a spacer. Below is a preview of the chart; for those with a subscription to the publication, the full chart can be found at ​Inhaled Corticosteroid Dose Comparison in Asthma.

Also, one of my favorite quick reference guides is the ​Asthma Care Quick Reference​ guideline from the National Asthma Education and Prevention Program, which also has a few tables with relative strengths and role in treatment.  

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Relative costs for asthma inhalers 

It’s no secret that inhalers are expensive. Above is a chart to help you make a quick cost comparison for inhaled corticosteroids regardless of insurance coverage — which of course should always be evaluated.  

Costs for inhaled corticosteroid and long-acting beta-agonist combinations can be found in the table immediately below at right.

Even though GoodRx or a similar coupon or discount program may seem like the best option for a patient, it may not always be. I wrote a blog post explaining when GoodRx does and does not make sense, it’s not as straightforward as it seems. 

If a patient cannot afford their inhaler, generics are always a good option. Cash prices for generics include:

  • Levalbuterol and fluticasone/salmeterol — Under $100 per inhaler
  • Generic Ventolin — Around $30 an inhaler
  • Budesonide — An average of $176 per inhaler

For patients struggling to afford their medications, ​NeedyMeds​ is a useful site to check out cost-saving tools and programs. Also, our pharmacists have access to application forms for many patient savings programs which we can share with them during our private consults. 

Inhaler availability on the market for COPD 


Pharmacist’s Letter also has a chart that includes inhalation devices and nebulizers available for the treatment of COPD, dosing frequency and cost. As with the chart with asthma inhalers, it’s too large to include in this blog, but below is a preview; if you have a subscription, the full chart can be found at the link at the beginning of this paragraph. 

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Also, ​here’s ​a link to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 Pocket Guide. It covers more than just the medication guidelines, but you can skip to page 14 to review the COPD therapies available.  

Current generic availability 


As noted, the cost of inhalers can sometimes be cost-prohibitive for patients. Above are some suggested generics that could replace a brand-name drug.

Breathe easier


RxLive brings practices value by staying up-to-date on all of the different inhaler therapy options and helping patients understand which option is best for them. Please contact us at 1-866-234-4974 at any time to refer appropriate patients or so we can answer your questions.

Author avatar
Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.