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Inhaled Corticosteroids

Drug - Inhaled Corticosteroids

January 2016

Therapeutic area - Respiratory/Asthma

Drugs

Preferred Nonpreferred
Asmanex Twisthaler (mometasone furoate)
Flovent HFA (fluticasone propionate)
Flovent Diskus (fluticasone propionate)
Pulmicort Flexhaler (budesonide)
Pulmicort Respules (budesonide inhalation suspension)
QVAR (beclomethasone)
Alvesco (ciclesonide)
Asmanex HFA (mometasone furoate)
budesonide inhalation solution
Arnuity Ellipta (fluticasone furoate)

Approval criteria

The following criteria applies to all nonpreferred inhaled corticosteroids:

  • Patient has a diagnosis of asthma AND
  • Patient has tried and failed a trial of two of the preferred products. Trials must be at least two weeks in duration of continuous daily use.

Note: Failure is defined as no improvement or worsening in asthma symptoms after at least two weeks of continued daily use of the inhaled corticosteroid.

Expected side effects of any agent within the class are not considered failure. Expected side effects include: 

  • bad taste
  • dysphonia
  • oropharyngeal candidiasis
  • cough
  • sore throat

Exceptions
See Grandfathering Criteria for patient-specific exceptions.

Quantity limit

One inhaler per month

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411

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