Most of our patients are treated with inhaler therapy. As physicians we are very aware of the cost of this type of treatment. We frequently need to make adjustments in care based on cost. Sadly, we have no control over the cost of the various inhalers on the market.

I recently came across a study which looked at the way in which drug companies extend the patents on their products to control their exclusivity and price structure.

How this is done is complicated but often involves switching active ingredients and propellants between devices. Extending the patents delays the development of generic products which results in increased medical costs.

The study looked at 39 inhalers between 2000 and 2021. Manufactures earned $178.1 billion dollars over this period of time with $67.2 billion (38%) occurring during the initial patent period and $110.3 billion (62%) after the initial patents expired and new, extended ones were in place. The bottom line is that manufactures made more money after the initial patents ran out by extending the patent life manipulating active ingredients and propellants between devices.

Drug companies involved in the development of current inhaler drugs certainly have helped physicians provide better help to their patients but costs to the system and individual patients prevent some from getting the help they need. The current patent system rewards minor changes to inhaler devices and ingredients which delays the development of more cost effective equivalents.

I do not see any movement to change the current situation