Clinician perspectives on the discontinuation of brand name Flovent in pediatric asthma care

OBJECTIVE: In 2024, brand-name Flovent (fluticasone propionate), the most widely prescribed inhaled corticosteroid (ICS) in the United States, was discontinued, eliminating a key treatment option for pediatric asthma. There have yet to be reports describing pediatric clinicians' experiences with this abrupt loss of a mainstay therapy for one of the most common chronic diseases in children. The study aimed to examine the experience of pediatric clinicians with the discontinuation of Flovent for asthma management. METHODS: A web-based survey was disseminated via pediatric and pediatric pulmonary networks, both regionally and nationally, to pediatric primary care and subspecialty physicians and advanced practice practitioners. The survey assessed clinician awareness, preparedness, and the clinical impact of Flovent discontinuation. RESULTS: Among 226 respondents, 71% were aware of the Flovent discontinuation in advance; however, 79% felt unprepared or very unprepared once it went into effect. Clinicians reported significant disruptions in prescribing and clinical workflow, with 56% describing the impact on their practice as severe. Factors most frequently cited as causing moderate or severe burden included prescribing alternate ICS therapy, including insurance authorization requirements (90%), pharmacy shortages (85%), and difficulty finding age-appropriate alternatives (82%). In free-text responses, clinicians described perceived worsening asthma control and increased acute healthcare utilization following the discontinuation, particularly among younger patients. CONCLUSIONS: Pediatric clinicians who care for children with asthma reported significant disruptions to patient care following the discontinuation of Flovent. These findings underscore the need for systems-level support of clinicians during major formulary transitions to minimize disruptions, particularly within pediatric asthma.