Limited coverage drugs – tiotropium

Last updated on October 18, 2022

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Generic name	tiotropium (Handihaler^® ONLY)
Strength	18 mcg
Form	dry powder for oral inhalation

Special Authority criteria	Approval period
Diagnosis of chronic obstructive pulmonary disease (COPD) AND Failure after a minimum one-month trial of EACH of the regular benefit long-acting muscarinic receptor antagonist (LAMA) products (see notes)	Indefinite

Special Authority criteria

Approval period

Diagnosis of chronic obstructive pulmonary disease (COPD)

AND

Failure after a minimum one-month trial of EACH of the regular benefit long-acting muscarinic receptor antagonist (LAMA) products (see notes)

Indefinite

Practitioner exemptions

None

Special notes

The Regular Benefit LAMA products are the following:

tiotropium (Spiriva^® Respimat^®)
umeclidinium (Incruse^® Ellipta^®)

Special Authority requests

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HLTH 5362 - COPD form (PDF, 100KB)

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Limited coverage drugs – tiotropium

Practitioner exemptions

Special notes

Special Authority requests