Asthma can be life-altering and expensive to manage. Use these advanced tips to save money on asthma treatment.
Asthma can be expensive and at times difficult to manage effectively. Steroids are the standard go-to treatment by most doctors. Some people do well on this, while others find the side effects intolerable. Other options such as oral medications can have their own risks, some of them severe. Biologic drugs are usually reserved for people with poorly controlled asthma that isn’t responding to other drugs. These can be expensive and can weaken your immune system.
Know Your Triggers
Knowing your asthma triggers can be useful for preventing a flare-up or asthma attack before it happens. Triggers like dust mites can be managed by cleaning, reducing the amount of dust that can build up, and adding air filtration. Often times controlling the trigger is more effective than adding more medication to counter it. When cold air is a trigger, many have found filtration masks or a scarf over your nose and mouth can be enough to prevent or reduce an attack.
Other tactics depending on your triggers might include HEPA filter air purifiers (without ozone as that can actually cause breathing problems), or MERV grade furnace and central AC filters. Newer model forced air heat or central air systems can be purchased with highly efficient dc blower motors. This allows for constant filtration and circulation of the air in the house without running up your electric bill. This can create a comfortable indoor environment that avoids outdoor triggers like pollen, pollution, and fire smoke.
Non-Steroid Medications
Cromolyn sodium inhalers and inhalation capsules were removed from the market in recent years. The FDA noted that there was no problem with safety or effectiveness. With this being one of the few non-steroid asthma treatments that are not a biologic, the removal of this from the market has severely limited patient options.
Leukotriene inhibitors are a non-steroid option that can reduce asthma and allergy symptoms. One brand of these, Singulair comes with a black box warning for some severe psychiatric effects including aggression, depression, agitation, sleep disturbances, suicidal thoughts, and suicide. Zafirlukast (Accolate) was discontinued by the manufacturer in 2018 though they claimed it was not for safety reasons. Zileuton extended release is still available after the normal release version was taken off the market. This drug does have a warning about potential liver toxicity in some people.
Theophylline had been more commonly used in the past for asthma. Most doctors appear reluctant to prescribe it now. It does have some very serious potential side effects. The general line of thinking has been that steroids are safer, causing many to no longer consider this medication as a first-line treatment.
Over-the-counter bronchial dilators like Primatene and Bronkaid have been around for decades. Many doctors dissuade patients from using these in favor of steroid-based preventative medications. These over-the-counter options contain epinephrine. Excessive amounts can cause serious cardiovascular problems.
Allergic Asthma
If your asthma is caused by allergies, keeping your allergies under control may drastically improve your asthma symptoms, leading to less need for asthma medications. Using a nasal spray such as Astepro or Nasalcrom can help reduce post-nasal drip that can worsen asthma symptoms.
Over-the-counter oral antihistamines such as Allegra, Zyrtec, Zyzal, and Claritin may reduce allergy symptoms enough to improve asthma symptoms. Allergy shots might also be an option if the allergy trigger is something specific. Shots over time reduce the allergic reaction to the substance and should reduce the resulting asthma flare-ups.
Steroid Medications
Steroid-based asthma medications are the go-to option most doctors prescribe before trying anything else. They typically resolve symptoms and are an easy fix for doctors. Many people do well on these inhaled medications with minimal side effects, others find the side effects somewhere between problematic and debilitating.
Aim for the least amount of steroid medication to keep your asthma symptoms under control. This may be by adjusting the dose or selecting a different medication with fewer side effects. If your asthma problems are seasonal you may be able to only take these medications during the times of the year when you have flare-ups. Most doctors are willing to work with you to find the right combination to control asthma without causing other problems.
In some situations, oral steroid medications such as prednisone are needed to control a severe asthma flare-up. These can have more side effects than inhaled steroids and are not something you want to take long-term. Steroids can cause various problematic side effects such as weight gain and high blood pressure. Longer-term use can cause diabetes.
Seeing A Doctor
Most asthma treatments require seeing a doctor. The associated cost for people without insurance or insurance with limited coverage can be a problem. Less complicated asthma problems may be able to be treated by telehealth or doc-in-a-box primary care physician. This usually involves lower costs and fewer opportunities for surprise bills.
If your asthma problems are new or poorly controlled your doctor may want to see you periodically to check your progress. For people with well-controlled long-term asthma, this may not be necessary. Some clinics use this as an income generator, requiring any patient with asthma on their medical records to come in every 4 months for an “evaluation”.
In one clinic that required this, the evaluation consisted of using the same peak flow meter people are sent home with to take a reading and having them fill out a questionnaire. This made the clinic over $350 per patient to essentially do nothing of substance. Add in what it typically takes for someone to attend an in-person doctor’s appointment. Time off of work, travel time to and from the clinic plus the time for the appointment, possibly needing to arrange child care and to pay for a ride there and back.
If you do have more problematic asthma, a specialist may be your best option. Ask people you know for referrals, and check asthma support groups or online reviews. When checking online reviews go back through a number of years. We found one specialist clinic in a different specialty that was posting fake reviews to their Google reviews every few months to bury the horrible reviews from patients. It was easy to spot the fake reviews that were written like marketing blurbs for the clinic.