Editing Inhaler (section)

==Price and availability==

In the United States, pharmaceutical manufacturers use legal and regulatory strategies to keep inhaler prices artificially high. There has been little innovation in inhaler technology for decades {{mdash}} the most recent drug to be approved by the FDA for treating asthma or COPD via a novel [[Biological target|target of action]] was [[Ipratropium bromide]] in 1986. Since then, manufacturers have used small changes to drug delivery mechanisms, or have switched active ingredients from one inhaler device to another (a strategy known as a "[[Evergreening#Product hopping|device hop]]") to keep patents active. This has the effect of limiting competition, keeping inhalers expensive.<ref>{{cite journal |title=Patents And Regulatory Exclusivities On Inhalers For Asthma And COPD, 1986–2020 |date=May 17, 2022 |first1=William B. |last1=Feldman |first2=Doni |last2=Bloomfield |first3=Reed F. |last3=Beall |first4=Aaron S. |last4=Kesselheim |doi=10.1377/hlthaff.2021.01874 |journal=Health Affairs |volume=41 |number=6 |pages=787–796 |pmid=35579925 |pmc=10328096 }}</ref> Because of high prices, patients sometimes skip doses or give up using their inhalers.