A 55 year old female has a history of asthma.  She has been on Flovent for a long time for her asthma and well controlled.  Insurance formularies change and preferred medications can lead to confusion for patients.  In this scenario, it lead to the patient using duplicate inhaled corticosteroids.  This patient actually had a change in her insurance as well and this particular insurance wanted the patient to be using Arnuity instead of the Flovent.

When she went to pick up the Flovent, she was given the Arnuity instead.  She did not understand or was not properly educated that the Arnuity was intended to replace the Flovent and lead to her using both of the inhalers for a period of time.

When she ran out of the Flovent, she went to the pharmacy to refill this medication and then did realize after discussing with the pharmacist that then Arnuity was meant to be used instead of the Flovent, not with the medication.  Could the pharmacy have done a better job here?  Of course.  Could the physician’s office have done a better job here? Of course.

Would it also have been ideal if this patient didn’t have to switch simply due to an insurance formulary?  Yes, I believe it would have been in the patient’s best interest not to switch in the first place since she appeared to be under good control.  It’s really important to pay attention when changes like this happen and make sure our patients understand why the change is happening and what they should do.

 
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