Limited Coverage Drugs – fluticasone furoate in combination with umeclidinium and vilanterol
Generic Name |
fluticasone furoate-umeclidinium-vilanterol |
---|---|
Strength |
fluticasone furoate 100 mcg/umeclidinium 62.5 mcg/vilanterol 25 mcg |
Form |
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:
AND
AND Who have a history of exacerbations as follows:
OR
AND Inadequate response after a minimum 6-month trial of either
OR
Notes: 1Moderate to very severe COPD is defined as follows:
|
Indefinite |
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)