Daliresp

Drug - Daliresp (roflumilast) [Forest]

March 2012

Therapeutic area - COPD

Approval criteria

• Patient has severe COPD associated with chronic bronchitis AND
• At least 1 COPD exacerbation requiring systemic corticosteroids or hospitalization in the previous year AND 
• At least a 20 pack-year smoking history AND
• Patient has tried combination regimens consisting of an inhaled-corticosteroid plus a long-acting beta-agonist and/or a long-acting anticholinergic, theophylline, short-acting beta-agonist, and/or short-acting anticholinergic

Exclusion criteria

Patient has moderate to severe liver impairment (Child-Pugh B or C).

Quantity limit

The recommended dosage for patients with COPD is one 500 mcg tablet per day, with or without food.

• Quantity Limit = 34 tablets

Background information

DALIRESP is indicated as a treatment to reduce the risk of COPD exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations.

Daliresp is subject to PA and quantity limit restrictions.

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411