Primatene mist

I read with interest the article by Ho et al, 1 Ho JK Shaker M Greenhawt M Sadatsafavi M Abrams EM Oppenheimer J et al. Cost-effectiveness of budesonide-formoterol vs inhaled epinephrine in US adults with mild asthma. Ann Allergy Asthma Immunol. 2024; 132: 229-239.e3 Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar "Cost-effectiveness of budesonide-formoterol vs inhaled epinephrine in US adults with mild asthma." How interesting to see a cost analysis of using this over-the-counter (OTC) treatment compared with guidelines-based treatment! I agree with the authors that using OTC inhaled epinephrine is not evidence-based and can be dangerous, even deadly. 1 Ho JK Shaker M Greenhawt M Sadatsafavi M Abrams EM Oppenheimer J et al. Cost-effectiveness of budesonide-formoterol vs inhaled epinephrine in US adults with mild asthma. Ann Allergy Asthma Immunol. 2024; 132: 229-239.e3 Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar ,2 Sadreameli SC Brigham EP Patel A The surprising reintroduction of Primatene Mist in the United States. Ann Am Thorac Soc. 2019; 16: 1234-1236 Crossref PubMed Scopus (5) Google Scholar Current asthma guidelines suggest using bronchodilator only in conjunction with inhaled corticosteroid. 3 Reddel HK Bateman ED Schatz M Krishnan JA Cloutier MM A practical guide to implementing SMART in asthma management. J Allergy Clin Immunol Pract. 2022; 10: S31-S38 Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar