Limited coverage drugs – indacaterol-mometasone furoate

Last updated on October 6, 2022

Generic name

indacaterol-mometasone furoate

Strength

150 mcg indacaterol - 80 mcg mometasone furoate
150 mcg indacaterol - 160 mcg mometasone furoate

150 mcg indacaterol - 320 mcg mometasone furoate

Form

powder hard capsules for inhalation

Special Authority criteria

Approval period

Diagnosis of asthma

AND

Inadequate response on optimal dose of an inhaled corticosteroid

Indefinite

Practitioner exemptions

Practitioners in the following specialties are not required to submit a Special Authority request for coverage:

  • Respirologists
  • Allergists

Special notes

  • None

Special Authority request form