A repeated cross-sectional study
Background
Several new respiratory inhalers have recently entered the market, including combination therapy products and generic alternatives.
Objective
This study examined the cost and utilization of publicly dispensed respiratory inhalers in Ontario, Canada, and the impact of new market entrants on these trends.
Methods
We conducted a repeated cross-sectional study among provincial drug program beneficiaries dispensed a respiratory inhaler between January 1, 2003, and March 31, 2023.
Results
Between Q1 2003 and Q1 2023, public payer spending on respiratory inhalers rose by 160% (from $26.2M to $68.1M), while the number of people receiving inhalers increased by 92% (from 155,893 to 299,418). In Q1 2023, half of the total spending ($33.8M) was for ICS/LABA inhalers.
Per-beneficiary spending rose steadily from 2003 to Q1 2015, peaking at $248 per person. It then declined through Q2 2018 ($206), before rising again and leveling off in Q3 2019 at $216 per person.
Conclusion
Public formulary listing of combination therapy inhalers, namely LAMA/LABA in Q2 of 2015, coincided with a significant decline in per-beneficiary spending on respiratory inhalers.
Citation
Garg R, Wang T, Tadrous M, Antoniou T, Gomes T. (2025). Trends in the cost and utilization of publicly funded dispensed respiratory inhalers in Ontario, Canada: A repeated cross-sectional study. Pharmacoepidemiology and Drug Safety.
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Date Released: April 8, 2025