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Several U.S. lawmakers including Sen. Bernie Sanders (I-Vt.) are investigating the prices charged by four large drug companies for their asthma inhalers, arguing the devices unfairly cost Americans considerably more than what consumers pay in other countries.

The lawmakers maintained that the companies — AstraZeneca, GSK, Teva Pharmaceutical, and Boehringer Ingelheim — charge between $200 and $600 in the U.S. for their inhalers, which are typically purchased monthly, but sell them for a fraction of those prices elsewhere, even though the inhalers have been available for decades with few significant changes made.

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For instance, GSK charges $319 for Advair HFA in the U.S., but $26 for the same inhaler in the U.K., while Teva charges Americans $286 for its QVAR RediHaler, which costs $9 in Germany. And Boehringer Ingelheim charges $489 for Combivent Respimat in the U.S., but just $7 in France, according to a statement issued by Sanders (I-Vt.), who chairs the Senate health committee.

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