Inhalative corticosteroids - copayments in Germany

Question

Dear ladies and gentlemen,
the benefit of inhalative corticosteroids seems to be questionalbe in CF. As the course of my Cf illness is stable for many years however (on a quite low level; FEV1 about 1 l), and I do not want to endanger it, I inhale daily Flutide Forte [Gernman medical system](drug: fluticasone).
Unfortunately, due to the current copayments (in germany) I have to pay another 12 Euros per inhaler besides the usual copayments. Do you know less expensive alternatives to that drug - my CF-doctor and my pharmacist are of the opinion that there are no such alternatives. Furthermore, according to my experience, Flutide Forte (drug: fluticasone) is more accommodating for me than for example Pulmicort (drug: budesonide).
Yours sincerely and thank you for answering,

Answer

Dear questioner,
for the answer to your question I did consult our pharmacist Mrs. Dr. Eva-Maria Miserre, who is specialized in CF. Unfortunately we can only confirm, that there is no less expensive alterniative to the preparation of fluticasone you are taking at the moment. [German medical system]. There are only 2 preparations with this drug as a single substance from two different companies. There is no difference in the price ot these two preparations.
A less expensive alternative could only be achieved by changing to another corticoide (e.g. budesonide). As you experienced incompatibilities in one of the budesonide preparations, we recommend to talk to your CF-doctor in order to test another budesonide preparation if necessary and/or to draw the corresponding consequences for the decision for fluticasone or budesonide (or no inhalative corticosteroide?) in your basis therapy regimen.
Yours sincerely,
Yours
Dr. Christina Smaczny

01.05.2008