October 15, 2011


Primatene And The War on (Asthma) Drugs (Paul Ehrlich M.D. 10/15/2011, New Geography)

On December 31, 2011, Primatene Mist, the only over-the-counter asthma inhaler still available, will be taken off the market. The ban is being pointed to as an example of regulatory overreach by the Obama administration. As a physician and asthma specialist, I have been observing the Primatene controversy for -- without exaggeration -- decades, and have concluded that there's blame enough to share between both the pro and con government regulation camps, as well as the pharmaceutical and financial industries.

The official reason for the ban is the danger Primatene poses to the environment. I have always thought that extending the ban on chlorofluorocarbon propellants (CFCs) to medication was an example of regulatory overkill, because medication is such a small part of the problem. However, it does help to look at the context. Back in 1987, when Ronald Reagan was President and the Montreal Protocol was written, there was international consensus that we needed to do something about depletion of the ozone layer high in the atmosphere, which was causing problems for us here on earth. For many of the products releasing these gasses into the atmosphere -- car air-conditioners, hairspray, and deodorant, for example -- alternatives could plausibly be found. I wish we could find a way to relieve asthma attacks with a roll-on, but we can't.

Medical aerosols were given more time than other products, and, frankly, I don't think we've done a very good job of replacing them. The new inhalers don't deliver medication as efficiently as Primatene delivers its active ingredient. Still, anyone who looks at the timeline for the upcoming restriction can see that the key decisions were made in 2006 and in 2008. The current administration is following the timetable set by its predecessors.

The charges of over-regulation have been accompanied by newly expressed sympathies for the plight of poor people with asthma. I think the greater disservice was done recently when stronger air-quality regulations were postponed. The best way to treat asthma is to reduce its incidence, and air quality is one of the biggest factors. It's unfair to generalize, but I have a feeling that some of the people looking to demonize Big Government for regulating Primatene were also calling tighter air-quality regulations "job-killers" a few weeks ago.

It's not us, it's them, darn it!

Posted by at October 15, 2011 7:23 AM

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