From 1 December 2011 the Pharmaceutical Benefits Scheme listing of the fixed-dose combination of budesonide 400 micrograms with eformoterol 12 micrograms (400/12; Symbicort Turbuhaler) for asthma will be extended to include symptomatic treatment of moderate to severe chronic obstructive pulmonary disease (COPD).1
Under the new listing, budesonide with eformoterol (400/12) cannot be prescribed to initiate bronchodilator therapy for COPD.
The extended listing applies to adults with forced expiratory volume in 1 second (FEV1) ≤ 50% of predicted normal, with frequent symptoms despite long-acting bronchodilator use and/or a history of recurrent exacerbations.1
The listing does not apply to the fixed-dose combination of budesonide with eformoterol 100/6 or 200/6 inhalers.
The PBAC recommended the listing on a cost-minimisation basis — that is similar efficacy and cost — compared with fluticasone 250 micrograms with salmeterol 25 micrograms. The equi-effective doses are fluticasone 500 micrograms with salmeterol 50 micrograms twice daily, and budesonide 400 micrograms with eformoterol 12 micrograms twice daily.