COPD Medications Coverage Summary Non-Insured Health Benefits Coverage SABA Bricanyl turbuhaler Yes Yes
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1 COPD Medications Coverage Summary Drug Non-Insured Health Benefits Coverage SABA Bricanyl turbuhaler Yes Yes Ventolin MDI + generics Yes Yes Ventolin Diskus NO NO Yukon Pharmacare/Chronic Disease Program SAMA Atrovent MDI Yes Yes SABA/SAMA Combivent Respimat Yes Yes ICS**note to use Alvesco MDI Yes Yes only with LABA for Asmanex twisthaler Flovent MDI and diskus COPD Pulmicort turbuhaler Qvar MDI LABA Foradil Aerolizer Limited Use Exception Onbrez Breezhaler Limited Use Exception Oxeze turbuhaler Exception **though not indicated for COPD Serevent Diskus Limited Use Exception Striverdi Respimat NO NO LAMA Incruse Ellipta Limited Use Exception Seebri Breezhaler Limited Use Exception Spiriva Respimat and Handihaler Limited Use Exception Tudorza Genuair Limited Use Exception ICS/LABA Advair MDI and diskus Limited Use Exception Breo Ellipta Limited Use Exception Symbicort Turbuhaler Limited Use Exception Zenhale MDI Limited Use Exception LABA/LAMA Anoro Ellipta Limited Use Exception Duaklir Genuair Limited Use Exception Inspiolto Respimat Limited Use Exception Ultibro Breezhaler Limited Use Exception Methylxanthines Theophylline Yes Yes PDE-4 inhibitor Daxas (roflumilast) NO NO SABA: short acting beta agonist; SAMA: short acting muscarinic antagonist; ICS: inhaled corticosteroid; LABA: long acting beta agonist; LAMA: long acting muscarinic antagonist
2 Long Acting Beta Agonist (LABA): Drug NIHB Yukon Pharmacare/Chronic Disease Program Foradil Aerolizer (formoterol) Onbrez Breezhaler (Indacaterol) Oxeze turbuhaler (formoterol) Serevent Diskus (salmeterol) Striverdi Respimat (olodaterol) Not adequately controlled with either ipratropium, tiotropium or a short acting beta-agonist (SABA) Did not respond to trial of ipratropium OR did not have trial of ipratropium, but who have moderate-severe COPD as defined by spirometry Not adequately controlled with either ipratropium, tiotropium or a short acting beta-agonist (SABA) Not on formulary ***though not indicated for COPD Not on formulary
3 Long Acting Muscarinic Antagonist (LAMA): Drug NIHB Yukon Pharmacare/Chronic Disease Program Incruse Ellipta (umeclidinium) Seebri Breezhaler (glycopyrronium) Spiriva Handihaler (tiotropium) Spiriva Respimat (tiotropium) Tudorza Genuair (Aclidinium) Patients with spirometry measures of FEV1<65% AND FEV1/FVC<0.7 after 3 month trial of ipratropium at maximum dosage
4 LABA/LAMA (Long Acting Beta Agonist/Long Acting Muscarinic Antagonist): Drug NIHB Yukon Pharmacare/Chronic Disease Program Anoro Ellipta (umeclidinium/vilanterol) Duaklir Genuair (Aclidinium/formoterol) Inspiolto Respimat (tiotropum/olodaterol) Ultibro Breezhaler (Indacaterol/glycopyrronium) FEV1<60% and AND inadequate response FEV1<60% and AND inadequate response FEV1<60% and AND inadequate response FEV1<60% and AND inadequate response
5 ICS/LABA (Inhaled Corticosteroid/Long Acting Beta Agonist): Drug NIHB Yukon Pharmacare/Chronic Disease Program Advair MDI or diskus (fluticasone/salmeterol) Breo Ellipta (fluticasone furoate/vilanterol) Symbicort Turbuhaler (budesonide/formoterol) Zenhale MDI (mometasone/formoterol) OR OR OR FEV1<60% and FEV1<60% and FEV1<60% and Updated: Dec 12, 2017 NIHB Formulary: Yukon Pharmacare/Chronic Disease Program Formulary:
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II: Moderate Worsening airflow limitations Dyspnea on exertion, cough, and sputum production; patient usually seeks medical
Table 3.1. Classification of COPD Severity Stage Pulmonary Function Test Findings Symptoms I: Mild Mild airflow limitations +/ Chronic cough and sputum production; patient unaware of abnormal FEV 1 80%