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Nearly twenty million Americans live with asthma, which constricts passageways in the lungs, often after a sudden increase in physical activity. And about 52 million prescriptions a year are filled for inhalers containing the drug albuterol, to treat asthma attacks when they occur.

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Now, thanks to concerns about the ozone layer that prompted a phase-out of CFC's, or chlorofluorocarbons, that started in the eighties, albuterol inhalers will have to be CFC-free by the end of 2008. That means the commonly used propellant will be replaced with a new type, hydrofluoroalkane, or HFA. University of Florida experts fear that asthma sufferers will think the new inhalers are less effective because products containing HFA taste different and deliver a less forceful puff. But in a March 2007 issue of the New England Journal of Medicine, experts from the University of Florida, George Washington University and the Food and Drug Administration who reviewed medical literature on the new inhalers conclude that albuterol inhalers using HFA are just as effective as the old dispensers.

Dr. Leslie Hendeles / UF pharmacist

"The bottom line is that the new HFA replacements feel differently and taste differently but they have the same efficacy, the same benefit and same safety as the CFC albuterol inhalers."

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Most of the new inhalers won't be equipped with a counter to tell users when they're running low on medicine, so they'll need to have a second inhaler on standby. And because the H-F-A / albuterol combination is a new formula, it will not be available in a cheaper generic brand until 2012. For now, patients can expect to pay as much as three times more when filling their prescription for the new inhalers.

Dr. Leslie Hendeles / UF pharmacist

"The health-care system will spend about $1.2 billion per year more as a result of the withdrawal of the generic albuterol."

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At the University of Florida Health Science Center, I'm Mike Garrison