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Annual health care costs related to chronic lung disease are estimated at \u20ac380 billion in the European Union, and $24\u2013$50 billion in the United States averaging to $4,000 in out-of-pocket costs per person in the U.S. A full-text literature search was conducted for English publications between January 1, 2005\u2013March 18, 2024. It returned over 5,000 publications that were further narrowed using key search words, resulting in 172 peer-reviewed articles. Using their experience and subject expertise, the authors further narrowed the peer-reviewed articles to 55 that were in their opinion relevant. Also, 38 recently published industry reports and news articles specific to downstream effects of inhaler market changes and the future impact were included. The literature suggests that individuals with chronic lung disease face increased challenges with access to inhaled medication due to rising medication costs, discontinuation of branded medications, introduction of generic medications not covered by insurance, exclusionary preferred drug list tactics that force health care providers into non-medical switching of medication or devices, and ongoing medication shortages. Providers experience ongoing hurdles in prescribing appropriate inhaled medications for individuals with chronic lung disease, including increased time and costs spent on administrative tasks due to inhaler denials, a loss of patient trust, and limits on their ability to prescribe appropriate inhaled medication for individuals with chronic lung disease.<\/jats:p>","DOI":"10.4187\/respcare.12024","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T10:05:25Z","timestamp":1729850725000},"page":"1448-1456","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Downstream Effects of Market Changes on Inhalers: Impacts on Individuals With Chronic Lung Disease"],"prefix":"10.1177","volume":"69","author":[{"given":"Joyce A","family":"Baker","sequence":"first","affiliation":[{"name":"Breathing Institute, Children\u2019s Hospital Colorado, Aurora, Colorado."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitzi L","family":"Cardona","sequence":"additional","affiliation":[{"name":"Asthma Center of Excellence, Children\u2019s Nebraska, Omaha, Nebraska."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laney D","family":"Brennan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Children\u2019s Hospital Colorado, Aurora, Colorado."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"e_1_3_2_2_2","volume-title":"Committee on a national surveillance system for cardiovascular and chronic lung disease. 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