The array of inhaled medicines available on the PBS for treating and managing airways disease is increasing, for both asthma and COPD. Along with a new combination product for asthma, this issue of NPS RADAR reviews two more inhaled medicines for COPD now listed on the PBS — umeclidinium (Incruse Ellipta) a long-acting anticholinergic, and a new combination product (Ultibro Breezhaler) delivering a fixed-dose combination (FDC) of indacaterol, a long-acting beta-2 receptor agonist, with glycopyrronium, a long-acting anticholinergic.
Indacaterol 110 micrograms / glycopyrronium 50 micrograms (Ultibro Breezhaler 110/50) is a fixed-dose combination for providing maintenance bronchodilation for 24 hours after a once-daily dose in patients with chronic obstructive pulmonary disease. The long-acting beta-2 agonist / long-acting muscarinic antagonist combination bronchodilator provides a single-inhaler alternative to a LABA and LAMA in two separate inhaler devices.
Fluticasone furoate 100 or 200 micrograms with vilanterol 25 micrograms is a fixed-dose combination preventer containing a combination of the medium- or high-dose inhaled corticosteroid fluticasone and the long-acting beta-2 agonist vilanterol for asthma control in people aged ≥ 12 years. These two components are not currently available individually for treating asthma.
Umeclidinium bromide is a long-acting anticholinergic (or long-acting muscarinic-receptor antagonist [LAMA]) now PBS listed for maintenance treatment of COPD in adults. This is a Restricted Benefit listing for people with COPD — the same restriction as for the other three LAMAs currently listed on the PBS.
Rapid change in options for treating and managing COPD, including increasing availability of FDC products, and the bewildering list of brand names for active ingredients and their corresponding proprietary devices, has potential to create confusion. To help prescribers keep pace with these changes, this article provides a summary of current PBS-listed single-agent and FDC products for use in COPD, including two new products listed on the PBS — umeclidinium (Incruse Ellipta) a long-acting anticholinergic, and a new combination product (Ultibro Breezhaler) delivering a fixed-dose combination (FDC) of indacaterol, a long-acting beta-2 receptor agonist, with glycopyrronium, a long-acting anticholinergic.
From 1 October 2014 the note to the PBS listing for varenicline tartrate has changed to permit another course of varenicline (instead of buproprion) in patients who did not stop smoking after an initial 12- or 24-week treatment course, provided that 6 months have elapsed between starting the previous course of varenicline and the subsequent course.
In April 2014 the Product Information for strontium ranelate (Protos) was updated with a black-box warning. Data on the risk of adverse cardiovascular events has now also been amended within the Product Information.