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considered umeclidinium to be no worse than tiotropium in the treatment of COPD based on indirect comparisons of two unpublished umeclidinium trials and 16 tiotropium trials with placebo as a common comparator.3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 Rotahaler 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 Turbuhaler |
|
| 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)
References
- GlaxoSmithKline Australia Pty Ltd. Incruse Ellipta Product Information. 2014. [Online] (accessed 5 September 2014).
- Australian Government Department of Health. July 2014 PBAC Outcomes \u2013 Positive Recommendations. 2014. [Online] (accessed 5 September 2014).
- Australian Government Department of Health. Public Summary Document \u2013 Umeclidinium (as bromide), 62.5 microgram/actuation inhalation: powder for 30 actuations, Incruse Ellipta, 2014. [Online] (accessed 5 November 2014).
- Boehringer Ingelheim Pty Ltd. Spiriva Product Information. 2013. (accessed 5\u00a0September 2014). (accessed 5 September 2014).
- Novartis Pharmaceuticals Australia Pty Ltd. Seebri Breezhaler Product Information. 2012. [Online] (accessed 8 September 2014).
- A. Menarini Australia Pty Ltd. Bretaris Genuair Product Information. 2014. [Online] (accessed 8 September 2014).
- Abramson M, Crockett AJ, Dabscheck E, et al. The COPDX Plan: Australian and New Zealand Guidelines for the management of chronic obstructive pulmonary disease 2014. Lung Foundation Australia. [Online] (accessed 8 September 2014).
- National Prescribing Service Limited. Glycopronium (Seebri) for chronic obstructive pulmonary disease. NPS RADAR April 2014. [Online] (accessed 8 September 2014).