My doctor put me on a mix of Pulmicort (corticosteroid) and Singulair three or four years ago, and my asthma has been under control ever since. This article makes me wonder if I really even need the Pulmicort. Anyway, yes, Singulair is great stuff.

How come Primatene is never cited in these studies? It's been around for years. Many, many people are using and like it. And it's OTC.

I have had asthma for over 60 years. Inhalers make me too jittery. I take Theo-24 once a day, every day. But more importantly, I use electronic air cleaners or purifiers in my bedroom, office and living room. The air cleaners do an excellent job of controlling asthma. Most doctors do not suggest using air purifiers to their patients. Air purifiers can be purchased at Home Depot or Lowes, as well as on-line. I prefer the HEPA filter type over the ionizer type. The ionizer type can create ozone which can trigger an asthma attack. I try not to take steroids because they shut down the immune system. Which make it hard to fight off infections and certain diseases.

Singulair is now the subject of an FDA warning concerning suicidal ideation, which could be another reason it is not pushed the way inhalers are.

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm166246.htm

I tried the Singulair years ago and it did not help me at all. I cannot take steroids at all, I have gone the gambit from heart palpitations to other more significant side effects and the doctors have said I cannot take them period. Managing my asthma comes down to managing my environment. The biggest triggers for me are aerosols, perfumes and pollens. The air purifiers help. The biggest set back as an asthmatic has been when the rescue inhalers went from CFC to HFC. They are not as effective and are expensive.

I wish the news would do an article on that and pressure the drug companies to lower their prices on those inhalers! It is not a brand name item, it was a generic item until the FDA forced them to change the delivery system. They did not create a whole new drug!

Iain Simpson, Principal Consultant - Drug Delivery, Sagentia Ltd

A very interesting and important study. I agree with Mr Price’s comments on the benefit of increased options for healthcare professionals, particularly as this helps meet the needs of different types of sufferers. I hope that the NHS will take the findings into account when they consider the efficiency of different treatment strategies for asthma.

However, I think it is also worth noting that the inhalers commonly in use today could also be considerably improved to reduce some of the challenges encountered in their use. In many cases the technology already exists and has been shown to improve compliance and clinical outcomes – the development of breath actuated inhalers is a case in point. And, as discussed in yesterday's Sagentia workshop at RDD, a major respiratory conference held this week in Berlin, opportunities exist to improve inhaler technology further, including the possibility of providing patients with direct feedback of correct usage.

As with many drugs, increased product cost may well be the main reason that the uptake of better inhaler technology has been limited. However, there is hope as we are gradually moving towards a healthcare system that is better equipped to look at cost-benefit trades-offs and which recognises that (drug) product cost is not an effective measure of total treatment cost in many situations.

Whilst oral tablets are appealing in terms of compliance, we should not forget that this approach often results in higher levels of drug in the bloodstream which do not directly treat the disease and can lead to unpleasant or even harmful side effects. Inhalers allow drugs to be targeted directly to the lung where they are most effective and hence can reduce side effects. They also provide faster onset of treatment which for example is critical in treating an actual asthma attack.

So for those of us working on the development of new inhalation technologies we can welcome the adoption of new non-inhaled treatments when they offer real benefit and still sleep easy at night knowing that inhaled drug delivery will continue to be an important treatment method for respiratory conditions as well as some other serious diseases.

One issue is that the medications like Singular can cost $50-$75/mon even with my drug plan. Imagine the cost for the uninsured... As a school nurse I promote preventative measures for asthma as much as possible- but they must be both affordable and accessible.

Current plans to cut medicaid and CHIPS will markedly increase ER visits for asthma sufferers, costing much more for everyone. Health care cost analysis for States need to include the cost of providing health care to the uninsured- both immediately and long term. Dialysis is WAY more expensive than insulin. Storkes and Heart Attacks far more expensive than hypertensive medication. Pennywise and pound foolish. Rational debate is sorely lacking- as is listening to public health expert testimony & analysis.