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To the Editor It was with apprehension that I read the interesting and sobering analysis by Jena et al1 and commentaries2,3 on the health care and/or cost consequences of the decision of the US Food and Drug Administration (FDA) to ban chlorofluorocarbon (CFC)-based metered-dose inhalers (MDI) in order for the United States to comply fully with the Montreal Protocol. I participated as a panel member of the FDA advisory committee meeting in 2004 and chaired a follow-up meeting in 2005 convened to discuss the issues ahead of their final ruling later that year.
Swenson ER. The True Environmental Cost of Chlorofluorocarbon-Based Inhalers. JAMA Intern Med. 2015;175(11):1867. doi:10.1001/jamainternmed.2015.5237