Umeclidinium bromide is a long-acting anticholinergic (or long-acting muscarinic-receptor antagonist [LAMA]) now PBS listed for maintenance treatment of COPD in adults.1

This is a Restricted Benefit listing for people with COPD — the same restriction as for the other three LAMAs currently listed on the PBS (Table 1).2

The Pharmaceuticals Benefits Advisory Committee recommended the listing on the basis of cost-minimisation (ie, similar cost and efficacy) compared with aclidinium, which is listed on the PBS for the same indication, and also on the basis of non-inferiority to tiotropium.2

No head-to-head trials have been conducted comparing umeclidinium and tiotropium. The PBAC considered umeclidinium to be no worse than tiotropium in the treatment of COPD based on indirect comparisons of two unpublished umeclidinium trials and 16 tiotropium trials with placebo as a common comparator.3

Umeclidinium is inhaled once daily using the Ellipta device.1 Tiotropium4 and glycopyrronium5 are also for once-daily dosing in treatment of COPD. Aclidinium is the exception among the PBS-listed LAMAs, in that it requires twice-daily dosing.6

Table 1 PBS-listed inhaled bronchodilators for the treatment of COPD*
Abbreviation Active ingredient Medicine brand name Inhaler type or brand name
Short-acting bronchodilators
SABA Salbutamol sulfate Ventolin Metered-dose inhaler
Suitable nebuliser
Airomir Autohaler
Asmol Metered-dose inhaler
SABA Terbutaline sulfate Bricanyl Turbuhaler
SAMA Ipratropium bromide Atrovent Metered-dose inhaler
Suitable nebuliser
Aeron Suitable nebuliser
Ipratrin Suitable nebuliser
Long-acting bronchodilators
LABA Indacaterol maleate Onbrez Breezhaler
LAMA Tiotropium bromide Spiriva HandiHaler
LAMA Glycopyrronium bromide Seebri Breezhaler
LAMA Aclidinium bromide Bretaris Genuair
LAMA Umeclidinium bromide Incruse Ellipta
FDC bronchodilators
ICS/LABA Budesonide/eformoterol fumarate dihydrate Symbicort Rapihaler
ICS/LABA Fluticasone propionate/salmeterol xinafoate Seretide Accuhaler
Metered-dose inhaler
ICS/LABA Fluticasone furoate/vilanterol trifenatate Breo Ellipta
LABA/LAMA Vilanterol trifenatate/umeclidinium bromide Anoro Ellipta
LABA/LAMA Indacaterol maleate/glycopyrronium bromide Ultibro Breezhaler

* Australian Government Department of Health, Pharmaceutical Benefits Scheme. [Online]
(accessed 8 September 2014)