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As of Jan. 1, thousands of asthma patients in the U.S. will no longer be able to get refills for Flovent — one of the most popular inhalers in the U.S. for nearly 30 years.

Flovent’s manufacturer, GSK, has discontinued both versions of the product — Flovent HFA, an inhalation aerosol, and Flovent Diskus, an inhalation powder — and replaced each with what is known as an “authorized generic,” essentially the same product sold under a private label. Prasco, a U.S. drugmaker specializing in authorized generics, will distribute the new inhaler, sold as fluticasone.

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The timing of the change is telling: Flovent’s price rose nearly 50% since 2014, according to GoodRx, leaving the drug vulnerable to the new Medicaid penalties going into effect as of this year for medications with price increases that outpace inflation. By discontinuing the brand-name inhaler but continuing to earn money from the authorized generic, GSK will be able to avoid paying a penalty.

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