What do Asthma and COPD inhalers have in common with Mexican food fast food?

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A 67 year old man came to see me recently, he had COPD, and found that it was getting harder to breathe. “I wanted to make sure that I’m on the right inhaler. My doctor switched me from Advair to Breo– is that better?

GSK would certainly say so, in fact their reps often do. Speaking with drug reps about their inhalers often makes me think of food. Actually I think of food quite often, but that’s more of a personal issue. Thinking of inhalers for COPD and asthma make me think of cheap Mexican food, specifically of the fast food variety. I think it has less to do with my poor dietary habits than the fact that I believe expensive inhalers have quite a lot in common with cheap Mexican food. 

Thinking about that patient’s question from the perspective of cheap Mexican fast food, switching from advair to Breo would be like ordering  one beefy rice burrito, only to be provided with two; but they would keep you full all day. Surely that’s an upgrade if there ever was one, and one which I endorsed. The problem though, and the real reason why he was asking, was not because he doubted the expertise of the prescribing physician but something else entirely. “It’s costing me $450 for 3 months. That’s more than triple what  the other one was. I guess I’ll pay for it if you think it’s worth it”

This was an especially unexpected twist, and not of the tasty cinnamon kind. No, that kind of dough busts straight out of the fast food genre into those fancy big-city restaurants, where it’s been said that they don’t even serve french fries. Like, you can’t even order them.  Continue reading “What do Asthma and COPD inhalers have in common with Mexican food fast food?”