Availability of Xopenex and Brovana for Medicare Patients

So you just got a prescription for a new nebulizer medication and now you are having trouble filling it at your local provider. If you are a Medicare patient on Xopenex or Brovana this can be a familiar situation. It can be frustrating to understand why such an important drug is not available everywhere. All aerosol medications are covered by Medicare Part B rather than the Part D prescription plans. Recent Medicare reimbursement cut backs on Xopenex (Levalbuterol), a popular brand name drug that is similar to Albuterol, have made it difficult for many providers to continue carrying the drug. Xopenex is a very useful drug in that it has fewer side effects than Albuterol. However, the reimbursement is so small that it often is less than the cost of providing the drug itself. Most pharmacies simply cannot afford to carry it.

Brovana is another medication that is difficult to find. Usually used in place of Albuterol or Xopenex, this is a relatively new drug in the marketplace. It is so new in fact, that Medicare does not have definite pricing listed for it. This makes it a risk to potential providers because it is a very expensive drug and the actual payment from Medicare is unknown. One of the reasons it is so expensive is that it is a refrigerated drug requiring additional cost to keep it in stock. Medicare also has strict requirements for patient coverage. Each patient must have a certain diagnosis (usually chronic bronchitis, COPD, or emphysema) and the coverage of Albuterol and Xopenex are limited if Brovana is taken with them.

There is still the possibility that you can still get these particular drugs from some providers. The company that makes the medication has offered a rebate program for providers that can help with the financial loss. However, the time and work required for submitting the rebates means that only a few providers are currently taking the risk.