63 - “Left My Family Scrambling”: Caregiver Experiences Following Brand-Name Flovent Discontinuation in Children with Asthma

Publication Number: 3060.63

Ashley L. Saint-Fleur, Boston Children's Hospital, Boston, MA, United States; Robyn T. Cohen, Boston Medical Center/Boston University, Boston, MA, United States; Michelle Trivedi, UMass Memorial, Worcester, MA, United States; Gregory Sawicki, Boston Children's Hospital, Boston, MA, United States

Background: Inhaled corticosteroids (ICS) are a cornerstone of pediatric asthma management. In 2024, the most widely prescribed ICS for children in the United States, FloventTM HFA (fluticasone propionate), was discontinued by its manufacturer. This was an abrupt and major change for children with asthma and their caregivers, yet there are no studies examining the experiences of caregivers with this change.

Objective: We aimed to examine caregivers' experiences related to the Flovent discontinuation.

Design/Methods: Parents/caregivers of children with asthma at a children's hospital pediatric pulmonary clinic were approached to complete a cross-sectional web-based survey. The survey was also distributed electronically to a national asthma patient network. Recruitment occurred from March-September 2025. The survey assessed caregiver experiences, challenges, and perceptions related to their child's asthma management following the discontinuation of brand-name Flovent.

Results: Forty-three caregivers of children with asthma responded. Children's mean age was 8.6 years (range 4-13) and most families had commercial health insurance (58%). Twenty-four percent of respondents identified as Hispanic/Latino, 49% as White/Caucasian, 12% as Black/African-American, and 15% as More than one race. In 2024, caregivers reported frequent asthma exacerbations, including oral steroid use (27% with ≥2 courses), emergency or urgent care visits (18% with ≥2) and hospitalizations (12%). Caregivers cited personal impacts from the discontinuation of brand-name Flovent, with 79% indicating their child was switched to a different medication, 27% faced higher out-of-pocket costs, and 18% reported worsening of their child's asthma symptoms, with 18% citing missed school due to asthma. Caregivers also reported difficulty with new medications, including learning how to use them (36%), discussing the medications with their clinician (30%), and finding a pharmacy with them in stock (30%). Free text responses reflected frustration with access and insurance barriers, negative impact on child health and family wellbeing, and need for specialist involvement to manage their child's asthma.

Conclusion(s): Caregivers highlighted several impacts of brand-name Flovent's discontinuation on children with asthma and their families, including higher costs and perceived worsening of asthma symptoms. These findings highlight the challenges that arise for caregivers with discontinuation of widely used medications for common chronic diseases and suggests that health system level strategies are needed to support families during such major shifts in treatment options.

Table 1. Caregiver Free-Text Responses on the Impact of Brand-name Flovent Discontinuation