BUDESONIDE/ GLYCOPYRROLATE/ FORMOTEROL INHL,ORAL
Clinical Criteria Summary
Exclusion Criteria
- Diagnosis of asthma
Inclusion Criteria (All must be fulfilled)
- Initial prescription is by or in consult with a VA/VA Community Care pulmonologist or designated expert
- Diagnosis of chronic obstructive pulmonary disease (post-bronchodilator ratio of FEV1/FVC less than 70%)
- Receiving ICS/LABA or LAMA/LABA but requires additional maintenance treatment for uncontrolled COPD symptoms and/or exacerbations
- If currently receiving an ICS, patient is NOT a candidate for ICS de-escalation
Additional Inclusion Criteria (At least one must be met)
- Documented difficulty adhering to 3-drug therapy via 2 separate inhalers (ICS/LABA + LAMA or LABA/LAMA + ICS)
- Unable to use multiple inhalers due to underlying conditions (e.g., cognitive deficits, dexterity or visual impairment, etc.)
- Uncontrolled COPD symptoms and/or exacerbations while using formulary LABA/LAMA + ICS or ICS/LABA + LAMA
Adjudication & Clinical Considerations
- Additional inclusion criteria do not apply to patients already using 3 different/separate inhalation products
- Patients doing well on 3-drug therapy via 2 separate inhalers should not be switched solely for convenience; cases adjudicated case-by-case
- Assess adherence and inhaler technique and provide any needed patient education before switching to Breztri