Clickable Table
| Generic Name | Brand Name | Strength | Dosing | 90 Day Cost | Coverage | Comments | Category 1 | Category 2 |
|---|---|---|---|---|---|---|---|---|
| Montelukast | Singulair | 10 mg | QD | $55 | BC - SA / NIHB - Covered | E Respiratory | Leukotriene Receptor Antagonist | |
| Fluticasone/Vilanterol | Breo Ellipta (30) | 100/25 mcg | 1 pf qd | $325 | BC / NIHB - SA | E Respiratory | Long-acting beta-agonist/Corticosteroid Combos | |
| Fluticasone furoate/Umeclidinium/Vilanterol | Trelegy Ellipta (30) | 100/62.5/25 mcg | 1 pf qd | $470 | BC / NIHB - SA | E Respiratory | Long-acting beta-agonist/long acting muscarinic antagonist/Corticosteroid Combos | |
| Budesonide/Formoterol | Symbicort (120) | 200/6 mcg | 1 pf qd | $175 | BC / NIHB - SA | E Respiratory | Long-acting beta-agonist/Corticosteroid Combos | |
| Beclomethasone | Qvar (200) | 100 mcg | 1 pf bid | $85 | BC / NIHB - Covered | E Respiratory | Corticosteroids | |
| Fluticasone/Salmeterol | Advair MDI (120) | 250/25 mcg | 1 pf bid | $280 | BC / NIHB - SA | E Respiratory | Long-acting beta-agonist/Corticosteroid Combos | |
| Glycopyrronium/Indacaterol | Ultibro (30) | 50/110 mcg | 1 pf qd | $270 | BC / NIHB - Covered | E Respiratory | Long-acting Anti-cholinergic/Long-acting Beta-agonist Combos | |
| Salbutamol | Ventolin (200) | 100 mcg | 4 pfs/d | $25 | BC / NIHB - Covered | E Respiratory |
Bronchodilators / Anti-cholingergics
Puffers differ in their ‘doses’ (puffs) per device, so comparing costs is difficult. The 90 day cost was calculated by: 1. Determining the total number of doses over 90 days (using the stated dosing frequency). 2. Multiplying by the calculated cost per dose 3.Adding the dispensing fee and markup. This will not be exactly what patients pay for these products but allows for a more fair comparison between therapies. Brackets next to brand name indicate number of doses per device.
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| Glycopyrronium | Seebri (30) | 50 mcg | 1 pf qd | $195 | BC / NIHB - Covered | E Respiratory |
Bronchodilators / Anti-cholingergics
Puffers differ in their ‘doses’ (puffs) per device, so comparing costs is difficult. The 90 day cost was calculated by: 1. Determining the total number of doses over 90 days (using the stated dosing frequency). 2. Multiplying by the calculated cost per dose 3.Adding the dispensing fee and markup. This will not be exactly what patients pay for these products but allows for a more fair comparison between therapies. Brackets next to brand name indicate number of doses per device.
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| Ipratropium | Atrovent (200) | 200 mcg | 1 pf qid | $35 | BC / NIHB - Covered | E Respiratory |
Bronchodilators / Anti-cholingergics
Puffers differ in their ‘doses’ (puffs) per device, so comparing costs is difficult. The 90 day cost was calculated by: 1. Determining the total number of doses over 90 days (using the stated dosing frequency). 2. Multiplying by the calculated cost per dose 3.Adding the dispensing fee and markup. This will not be exactly what patients pay for these products but allows for a more fair comparison between therapies. Brackets next to brand name indicate number of doses per device.
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| Fluticasone | Flovent (120) | 125 mcg | 1 pf bid | $55 | BC / NIHB - Covered | E Respiratory | Corticosteroids | |
| Budesonide | Pulmicort (200) | 200 mcg | 1 pf bid | $85 | BC / NIHB - Covered | E Respiratory | Corticosteroids | |
| Fluticasone/Salmeterol | Advair Diskus (60) | 250/50 mcg | 1 pf bid | $180 | BC / NIHB - SA | E Respiratory | Long-acting beta-agonist/Corticosteroid Combos | |
| Tiotropium | Spiriva (30) | 18 mcg | 1 pf qd | $110 | BC / NIHB - Covered | E Respiratory |
Bronchodilators / Anti-cholingergics
Puffers differ in their ‘doses’ (puffs) per device, so comparing costs is difficult. The 90 day cost was calculated by: 1. Determining the total number of doses over 90 days (using the stated dosing frequency). 2. Multiplying by the calculated cost per dose 3.Adding the dispensing fee and markup. This will not be exactly what patients pay for these products but allows for a more fair comparison between therapies. Brackets next to brand name indicate number of doses per device.
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| Fluticasone | Flovent (120) | 250 mcg | 1 pf bid | $90 | BC / NIHB - Covered | E Respiratory | Corticosteroids |