People suffering from lung disease are still being forced to switch to cheaper inhalers once or even several times a year, according to a survey by lung charity Longfonds.

People with asthma or other lung problems often react adversely to a different type of medication and frequent switches can lead to serious health problems. The charity, family doctors, pharmacists and insurers agreed two years ago to keep any changes in medication to a minimum of once every four years.

That is not happening, the Longfonds said. The survey, among 1071 patients, showed that 69% of the respondents had been put on a different inhaler in the last year,  29% of whom were told this was due their health insurer’s policies. In  21% of cases, pharmacists did not tell patients the reason for the switch at all.

Some 1.2 million people suffer from lung diseases in the Netherlands, which means hundreds of thousands could be affected by having to switch inhalers, the charity said.