There are strong ethical reasons to consider switching patients with asthma and COPD onto alternative devices after the takeover of inhaler company Vectura by tobacco giant Philip Morris International, UK clinicians have argued.
In an article setting out the alternative options to 13 inhalers that use Vectura technology, Professor Nick Hopkinson, Professor of Respiratory Medicine at Imperial College, London, said the annual global death toll from smoking has been estimated to be 8.71 million.
He noted that the European Respiratory Society had stated that health professionals will avoid prescribing drugs from any company that enriches the tobacco industry due to the ethical implications.
And that patients were also likely to be reluctant to use devices linked to the tobacco industry.
The inhalers in question are used by 10 million patients worldwide, Professor Hopkinson notes with his co-author Dr Toby Capstick, Consultant Pharmacist in Respiratory Medicine at St James’s University Hospital in Leeds.
They include Flutiform, GSK Ellipta devices, some Novartis Breezhalers (Seebri, Ultibro and Enerzair), the article in the International Journal of Chronic Obstructive Disease says.
But there are several suitable alternatives that healthcare professionals can prescribe “to avoid directing income to the tobacco industry”, they conclude.
In some cases, this will mean a change in local prescribing policy or switching the patient to a different drug in the same class, which should only be done as part of shared decision making, Dr Hopkinson said.
Avoiding use of Vectura-linked inhalers in the first place or switching where possible reinforces the policy that the tobacco industry needs to be excluded from healthcare, the article argues.
“The objective is to avoid tobacco industry linked devices wherever possible rather than absolutely prohibit their use, to allow for the occasional instance where not using them would genuinely cause a deterioration in an individual patient’s condition,” they conclude.
And patients’ individual choices should also be respected, they add.
Speaking with the limbic, Professor Hopkinson said in his experience “when patients hear about this they don’t want their inhaled medication to be funding the tobacco industry and for most people there are alternatives”.
He added: “Switching does take time and it may not necessarily be the immediate priority so it may be more about what therapies to initiate all other things being equal.”
Professor Hopkinson noted that pharmaceutical companies who had partnered with Vectura to develop these devices had had this situation forced on them.