Sending Office: Honorable Eliot L. Engel
Sent By:

Protect COVID-19 Patients from Shortages of Essential Medications: Ensure Supply of Albuterol Inhalers

Deadline: Wednesday, April 22 at 5pm

Endorsing Organizations: American Lung Association and Asthma and Allergy Foundation of America

45 Current Signers: Brian Fitzpatrick, Jerrold Nadler, Ted Yoho, James McGovern, Nanette Diaz Barragan, Ayanna Pressley, Raul Grijalva, Sheila Jackson Lee, Eleanor Holmes Norton, Jahana Hayes, Cindy Axne, Ted Deutch, Jamie Raskin, Nydia
Velazquez, Juan Vargas, Ro Khanna, John Larson, Barbara Lee, Hank Johnson, Linda Sanche, Ruben Gallego, Jose Serrano, Don Beyer, Stephen Lynch, Tom Suozzi, Emanuel Cleaver, Tony Cardenas, Peter DeFazio, Danny Davis, Rashida Tlaib, Norma Torres, Bobby Rush,
Sean Patrick Maloney, Judy Chu, Grace Meng, Mary Gay Scanlon, Steve Cohen, Lisa Blunt Rochester, Adriano Espaillat, Yvette Clarke, Angie Craig, Kendra Horn, Harley Rouda, Frederica Wilson, Debbie Dingell and Pramila Jayapal

Dear Colleague:

We invite you to join us on this bipartisan letter to the Food and Drug Administration (FDA) about shortages of albuterol inhalers, medications that are critical to asthma management.

To treat patients experiencing breathing problems associated with COVID-19, clinicians often prescribe albuterol inhalers. With increasing cases of coronavirus, demand for these inhalers will likely also grow. This growth in demand could make it difficult
for the nearly 25 million Americans living with asthma—who have an elevated risk of serious illness from COVID-19—to access this lifesaving medication.

This bipartisan letter urges the FDA to work with stakeholders and patient advocates to take proactive action to ensure that there are enough albuterol inhalers for individuals living with asthma and those battling coronavirus.

If you have any questions, please contact Sahil Chaudhary ( with Congressman Eliot Engel or Mark Ratner (
with Congressman Fred Upton.

If you would like to sign onto this letter, please fill out this google form:




Eliot L. Engel                                                             Fred Upton

Co-Chair of the Asthma & Allergy Caucus               Co-Chair of the Asthma & Allergy Caucus


TJ Cox                                                                        Peter T. King

Member of Congress                                                  Member of Congress

Stephen Hahn, M.D.

Commissioner of Food and Drugs

U.S. Food and Drug Administration

Department of Health and Human Services

5630 Fishers Lane

Rockville, MD 20852


Dear Commissioner Hahn:

We are writing to express our serious concern regarding asthma drug shortages in the context of the COVID-19 pandemic. As detailed in the
New York Times on April 2, demand has increased sharply for a number of drugs used to treat COVID-19, including albuterol, a drug used to treat respiratory issues. Hospitals have been ordering albuterol inhalers to treat breathing problems in COVID-19
patients because administering albuterol by nebulizers, which are commonly used in hospitals, can disseminate the virus to others. 

However, many adults and children with asthma rely on albuterol inhalers as a rescue medication to treat asthma attacks, as do patients with chronic obstructive pulmonary disease. We are concerned that the increased demand for albuterol from hospitals, combined
with recommendations that patients seek extended supplies of their prescription medications, are making it harder for people with asthma to access albuterol. Without albuterol, people are more likely to experience asthma attacks that they cannot control, potentially
increasing hospitalizations.

One in thirteen individuals in the U.S. – nearly 25 million people – are living with asthma. The CDC has determined that people with moderate or severe asthma may be at higher risk of serious illness due to COVID-19. Preliminary analysis of U.S. COVID-19
cases with data available on underlying conditions indeed reflects that people with chronic lung disease, including asthma, are among those at higher risk of severe health outcomes. Over 4 million Americans living with asthma are also 65 years old or older,
likely rendering them particularly vulnerable to COVID-19 complications and death. It is important that people with asthma have access to their regular medications to keep their symptoms well controlled and optimize their baseline health. We are already hearing
from the asthma community about challenges in filling their prescriptions, including for albuterol and other inhalers.

We would like to work with the FDA to mitigate the impact of any localized or general drug shortages on asthma patients. In addition to shortages caused by increased demand, we share the growing concern that the pandemic will affect global supply chains.
We support the use of albuterol and other important medications to treat patients with COVID-19, and therefore, we believe that specific attention must be paid to the availability of the drug for existing uses. Our hope is that state, federal, and private
sector efforts to protect access to asthma drugs can be developed before any official shortage is recorded.




Knvul Sheikh, “Essential Drug Supplies for Virus Patients Are Running Low.”  New York Times, April 2, 2020.  Available at

CDC, “Most Recent National Asthma Data” (Updated March 24, 2020).  Available at

CDC, “People with Moderate to Severe Asthma” (April 2, 2020).  Available at

Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020. MMWR Morb Mortal Wkly Rep 2020;69:382–386. DOI:

CDC, “Most Recent National Asthma Data” (Updated March 24, 2020).  Available at

American Academy of Allergy, Asthma and Immunology, “COVID-19 and Asthma:  What Patients Need to Know” (March 23, 2020). Available at

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