We have a new op-ed out today in @washingtonpost examining the high costs of treating asthma and COPD in the US. Unless Congress and the FDA act to limit patent abuses on inhalers, we will likely waste billions of dollars in the coming years. 🧵👇 https://t.co/xS7jcOBMnj

"In vertical integration, when PBMs and pharmacies in pairs are all owned by the same company, it can lead to reduced choices at the pharmacy and bad outcomes for patients." @wbfeldman answers @RepChuyGarcia and explains how PBMs are raising costs for consumers.👇

Perspective by William B. Feldman, MD, DPhil, MPH (@wbfeldman), and Gregg Furie, MD: The Moral Injury of Inhaler Prescribing https://t.co/CvFzOARM69 #MedicalEthics #PublicHealth

Real-world evidence is a vital tool for informing treatment strategies in chronic obstructive pulmonary disease #COPD, write @wbfeldman and colleagues https://t.co/WWFfkHbjH9

To my fellow Docs, Nurses and Allied Health Professionals — Rise Up. We need more of us in elected positions. I will have your back, as will many others. This is how change happens. New, sane blood.

Many inhalers that are vital for patients with asthma or COPD are associated with societal harms that can worsen the very diseases the products are designed to treat. How can this dilemma be resolved? Read the full Perspective by William B. Feldman, MD, DPhil, MPH (@wbfeldman),

Weekend Briefing for February 22, 2025: New Images in Clinical Medicine: Laryngeal Involvement in Disseminated Cryptococcosis https://t.co/3MJhTjNHgS Three New Perspectives: 1️⃣ The Changing Approach to Addiction https://t.co/mrQZuKWVHU 2️⃣ The Moral Injury of Inhaler

Thanks as ever to Gregg Furie for his work and collaboration on these issues.

But one thing is clear: Only structural reform, and not individual decisions by even committed physicians, can ensure that patients with chronic respiratory disease have access to safe, effective, sustainable, and affordable therapy.

There are no easy answers here. We discuss some policy solutions in the piece.

…Loss of product exclusivity through patent expiration currently poses a much greater risk to revenue than climate related risks.” As with the last propellant transition, patients may be caught in the middle.

Here’s how AsraZeneca described the financial upside it sees: “Transitioning to new low GWP propellants as part of our Ambition Zero Carbon strategy will mitigate the financial risks posed to our MDI-based respiratory portfolio (e.g. Symbicort)...

New low carbon-inhalers are now under development, but these will be expensive and may be on-patent into the 2030s/2040s. Manufacturers earned billions from the last propellant transition (CFCs to HFAs) and could earn even more during this next round.

Many also have links to the tobacco industry; Phillip Morris International purchased an inhaler manufacturer in 2020 despite uproar by physicians.

Metered-dose inhalers are potent greenhouse gas emitters. Dry powder inhalers are better for the environment but are not suitable for all patients and not always available on formularies.

Our latest in @NEJM on the dilemmas of treating patients with chronic lung disease. https://t.co/hvQInflq0w

Thrilled to share our contribution to the @ATSBlueEditor in which we show a strong association between industry payments and the prescription of inhaled medicines 🧵

Bil and Shanon Schmidtknecht are filing a wrongful death and negligence lawsuit, accusing Optum Rx of illegally denying their son his “life-saving” inhaler.

Dems can win back some of the public’s trust by building an agenda around game-changing ideas *if* they address systemic issues like patent abuse at their root, rather than continuing to settle for legislation that is watered down and incremental at best.🧵

🚨 Just out today (online)! 🚨 Our results show that a common argument against #QALYs (based on the use of subgroup analyses) is not justified with empirical data. With co-authors: Leah Rand, @wbfeldman, and @akesselheim from @PORTAL_Research, @BrighamResearch, @harvardmed.

How did a twice daily metered dose inhaler, of budesonide-glycopyrrolate-formoterol, compare with a once daily dry powder inhaler, of fluticasone-umeclidinium-vilanterol, in patients with chronic obstructive pulmonary disease? New Research investigates https://t.co/t0AryGNPiE