West Coast Wildfires Spur an Increase in Asthma Medication Fills Nationwide

Tori Marsh
Tori Marsh, MPH, is on the Research Team at GoodRx, and is the resident expert on drug pricing and savings.
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Smoke from more than 50 massive wildfires across the Western United States is spreading, causing smoky skies, breathing challenges, and high prescription fill rates for asthma medications—even for cities in the Midwest and on the East Coast.

According to a nationally representative sample of prescriptions, fills for asthma medications this July and August were more than 20% higher than normal in Oregon, Washington, Montana and Northern California. In Southern California, which has been spared from a large wildfire this year, asthma prescriptions are running nearly 20% below normal this year. What’s more, fills increased by over 20% in parts of the Midwest and East Coast during July and August.

This analysis is based on a large sample of data from pharmacies and insurers, and compared the number of fills of asthma medications from July to August 2018 to the average of fills from 2015, 2016 and 2017  during the same time period. These three years constitute the “normal” pattern for asthma medication prescriptions. The data measures prescription fills for 26 asthma medications, including Qvar, Accuneb, Airduo, Advair, and Dulera. Fires shown in the map have devastated at least 20,000 acres in the United States and British Columbia.

Overall, surges in prescription fills for asthma medications track closely to the fire and smoke patterns seen throughout the country. One map from the National Oceanic and Atmospheric Administration (NOAA) observed wildfire smoke reaching as far as New York, with high concentrations hovering above the Northwest in addition to Minneapolis, Michigan, and the Dakotas.

NWS Burlington on Twitter

MeteorologicalMonday – We use satellite to detect where wildfire smoke is in the atmosphere. Thanks to @NOAA Earth System Research Lab we can project where its going to go and how dense it may be. Very useful for air quality, fire weather, and aviation forecasts. #vtwx #nywx https://t.co/vfo7Tjh77K

Scientists blame the spread of smoke on a slow-moving weather system that crept across the country during August. According to the National Weather Service, smoke and allergens from the fire were trapped in the atmosphere and transported through this system. With smoke reaching well beyond the east coast, it’s no surprise that fills for asthma medications increased this summer for much of the country.

While smoke from wildfires is merely a nuisance to some, to those with conditions like asthma and chronic obstructive pulmonary disorder (COPD), smoke from wildfires can be dangerous. Typically, inhalers are prescribed to help treat asthma and fill rates reveal some interesting regional patterns, especially in parts of the East Coast and Midwest.

Fills running higher in the West

Northern California, Oregon, Washington and Montana have seen 20 large wildfires this year. In Northern California alone, four large wildfires—the Carr Fire, Mendocino Complex Fire, Donnell Fire, and Ferguson Fire—burned nearly one million acres of land this summer, and the Mendocino Complex Fire is now the largest fire California has ever seen.

As a result, these regions saw a 10% to 20% increase in fills for asthma medications in July and August. Additionally, in some local areas around Washington and Northern California, fills for asthma medications are nearly 30% higher than the average number of fills for the past three years.

Fills in Southern California and Arizona are relatively low

So far, SoCal has been spared from a large fire this year, and cities like Los Angeles, San Diego and Phoenix are breathing easier. This year, the absence of large fires in Southern California and Arizona correspond with a nearly 20% decrease in asthma medication fills compared to the last three years.

Unfortunately, fire season isn’t quite over, so Southern California isn’t safe yet. In fact, California’s fire season lasted well into December last year with the Thomas Fire that burned over 250,000 acres in Ventura.

Fires in Vancouver are affecting asthma rates

Residents in Seattle, Portland and Missoula reported poor air quality and visibility in August, as smoke from the Cascades and British Columbia hung in the air. In British Columbia, multiple fires have spread smoke across Canada and the Northwestern United States, causing an uptick of asthma prescriptions throughout Washington, Oregon and Montana. One wildfire near Vancouver, the Tweedsmuir Complex Fire, has engulfed over 700,000 acres since it was started by four separate lighting strikes in early August and is still 0% contained.

Asthma prescriptions in the Midwest and East Coast also climbed

As mentioned above, meteorologists have observed a slow-moving weather system that has dispersed smoke across the country, and even states thousands of miles from the fires are getting hit hard. Fills for allergy medications are up by more than 20% in Michigan, Wisconsin and the Carolinas, and up by 10% in New York and Massachusetts. Not only are people in these states feeling this smoke in their lungs, but they are also seeing it. Multiple news outlets have reported about smokey skies in South Carolina, Michigan and New York—all cities that have higher-than-usual fill rates for allergy medications.


Co-contributors: Clement B. Feyt, MPH & Jeroen van Meijgaard, PhD
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Drugs included in this analysis: Accuneb, Advair, Airduo, albuterol, albuterol er, Arnuity Ellipta, Asmanex, Asmanex HFA, Brovana, Dulera, Flovent, fluticasone/salmeterol, Foradil, levalbuterol, metaproterenol, Perforomist, Proair, Proventil, Pulmicort, Qvar, Serevent, Symbicort, Ventolin, Vospire ER, Xopenex and Xopenex HFA
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