LAMA/LABA Combination
Drug - Inhaled LAMA/LABA Combination (Long-Acting Antimuscarinic Antagonist/Long-Acting Beta2 Agonist)
October 2017
Therapeutic area - COPD
Preferred
- Stiolto Respimat (tiotropium/olodaterol) [Boehringer Ingelheim]
Nonpreferred
- Anoro Ellipta (umeclidinium/vilanterol) [GSK]
- Bevespi Aerosphere (glycopyrrolate/formoterol) [AstraZeneca]
- Utibron Neohaler (glycopyrrolate/indacaterol) [Sunovion]
Approval criteria for nonpreferred products
- Patient must be 18 years of age or older AND
- Patient has a diagnosis of COPD AND
- Patient has tried and failed the preferred product
Quantity limits
1 inhaler per 30-day supply
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411