Limited Coverage Drugs – salmeterol
Generic Name |
salmeterol |
|
---|---|---|
Strength |
50 mcg |
|
Form |
dry powder for oral inhalation |
Special Authority Criteria |
Approval Period |
---|---|
AND inadequate response on optimal dose of inhaled corticosteroid. |
Indefinite |
AND Contraindication or intolerance to a long-acting muscarinic receptor antagonist (LAMA) |
Indefinite |
Practitioner Exemptions
The following practitioners are not required to submit a Special Authority request form for coverage:
- Respirologists for asthma and COPD
- Allergists for asthma
Special Notes
- In remote areas, where spirometry access is limited, spirometry measurements are to be provided within 6 months.
Special Authority Request Form(s)