Limited coverage drugs – fluticasone propionate in combination with salmeterol

Strengths

fluticasone propionate 100 mcg or 250 mcg or 500 mcg/salmeterol 50 mcg

fluticasone propionate 125 mcg or 250 mcg/salmeterol 25 mcg

Forms

dry powder for oral inhalation

suspension for oral inhalation

1. Diagnosis of asthma

AND

inadequate response on optimal dose of inhaled corticosteroid.

Indefinite

2. 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

AND

• A post-bronchodilator FEV₁ < 80% predicted 

AND

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

OR

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

AND

Inadequate response after a minimum 6-month trial of either:

• a long-acting muscarinic receptor antagonist (LAMA)

OR

• a long-acting beta agonist (LABA)

Indefinite