Limited Coverage Drugs – fluticasone furoate in combination with umeclidinium and vilanterol

Generic Name

fluticasone furoate-umeclidinium-vilanterol


fluticasone furoate 100 mcg/umeclidinium 62.5 mcg/vilanterol 25 mcg


dry powder for oral inhalation

Special Authority Criteria

Approval Period

Diagnosis of moderate to very severe1 chronic obstructive pulmonary disease (COPD) where spirometry measures are as follows:

  • A post-bronchodilator fixed ratio of forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) < 0.70


  • A post-bronchodilator FEV1 < 80% predicted


Who have a history of exacerbations as follows:

  • History of ≥ 2 moderate exacerbations defined as requiring a prescribed antibiotic and/or using systemic glucocorticoids in the previous 12 months


  • History of ≥ 1 severe exacerbation defined as requiring a hospital admission or emergency department visit in the previous 12 months


Inadequate response after a minimum 6-month trial of either

  • a combination of long-acting muscarinic receptor antagonist (LAMA) and long-acting beta agonist (LABA)


  • a combination of inhaled corticosteroids (ICS) and LABA


1Moderate to very severe COPD is defined as follows:

  • Moderate COPD is defined as 50% < FEV1 < 80% predicted
  • Severe COPD is defined as 30% < FEV1 < 50% predicted
  • Very severe COPD is defined as FEV1 < 30% predicted


Practitioner Exemptions

  • Respirologists are invited to apply for individual specialist exemption from completing SA form. A Collaborative Prescribing Agreement is available for respirologists practicing in B.C. by invitation only.

Special Notes

  • In remote areas, where spirometry access is limited, spirometry measurements are to be provided within 6 months.

Special Authority Request Form(s)