Long-Acting Muscarinic Antagonists (LAMAs)
Drug - Long-Acting Muscarinic Antagonists (LAMAs)
July 2019
Therapeutic area - COPD/Asthma
Preferred
- Spiriva Handihaler
- Spiriva Respimat
- Tudorza Pressair
Nonpreferred
- Incruse Ellipta
- Seebri Neohaler
- Lonhala Magnair
- Yupelri
Approval criteria for nonpreferred products
- Patient must be at least 18 years of age AND
- Patient has a diagnosis of COPD AND
- Patient has tried and failed two preferred products OR has a contraindication to two preferred products substantiated by supporting documentation submitted at time of request AND
- If the request is for Lonhala Magnair, the patient also has tried and failed Seebri Neohaler OR has a contraindication to Seebri Neohaler substantiated by supporting documentation submitted at time of request
Quantity limits
- Inhaler: 1 inhaler per 30-day supply
- Lonhala Magnair Starter Kit: 1 starter kit per year
- Lonhala Magnair Refill Kit: 1 refill kit per 30-day supply
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411
