54 - Clinician Perspectives on the Discontinuation of Brand Name Flovent on Pediatric Asthma Care

Publication Number: 3051.54

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: In 2024, branded FloventTM HFA (fluticasone propionate), the most widely prescribed inhaled corticosteroid (ICS) for children in the US, was discontinued by its manufacturer, eliminating a key treatment option for pediatric asthma care.

Objective: The objective of this study was to examine the experience of pediatric providers amid the sudden loss of a mainstay therapy for one of the most common chronic diseases in children.

Design/Methods: A cross-sectional, web-based survey was distributed to pediatric clinicians (physicians and advanced practice practitioners) who prescribe asthma medication via regional and national pediatric and pediatric pulmonary networks. The survey assessed awareness, preparedness, and perceptions of the clinical and organizational impact of Flovent discontinuation.

Results: Of 226 clinician respondents, 49% were pediatric pulmonologists (n=106) and 48% were general pediatricians (n=103), with smaller proportions from internal medicine/pediatrics (1%), family medicine (1%), and allergy/immunology (1%). Respondents included 78% physicians and 22% advanced practice practitioners. Most respondents practiced in hospital-based or academic settings (53%), primarily in Urban areas (57%) in the Northeast region of the U.S. (79%). Though 71% of providers had been aware of the discontinuation before it occurred, 79% felt unprepared for the discontinuation. Clinicians reported substantial disruptions to prescribing and workflow, with 56% characterizing the impact as severe. Transitioning patients to alternate ICS therapy was described as burdensome, specifically with regards to obtaining insurance authorization (90%), medication shortages (85%), and identifying age-appropriate alternatives (82%). No significant differences in responses were observed between primary care and specialty clinicians. Free-text responses described that the Flovent discontinuation had led to worsened asthma control and increased acute healthcare utilization, particularly among younger patients.

Conclusion(s): Pediatric clinicians, including both primary care and specialists caring for children with asthma, experienced major disruptions to patient care after the discontinuation of brand-name Flovent. These findings highlight the need for systems-level support of clinicians during large scale changes in medication availability to reduce disruptions in providing care for children with asthma.

Table 1. Clinician Characteristics and Experiences with Brand-Name Flovent Discontinuation