Product Details
Pulmicort Nebuamp
Budesonide0.25 mg/mL
Suspension for Inhalation
DIN/PIN/NPN
01978918
Manufacturer
AstraZeneca
Formulary Listing Date
1996-10-01
Unit Price
0.5324
Amount MOH Pays
0.3593
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
R03BA02
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 02494272 | Taro-Budesonide | 0.3593 | 0.3593 |
| 01978918 | Pulmicort Nebuamp | 0.5324 | 0.3593 |
LU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| Note: For the vast majority of patients, a metered dose inhaler is the preferred therapy. Nebulizer therapy will be reimbursed for patients who are unable to use a metered dose inhaler, including an inhaler with a spacer attachment, or a turbuhaler. | ||
| 260 | Indefinite | Children aged 6 years or less; |
| 261 | Indefinite | Patients who have a tracheostomy; |
| 262 | Indefinite | Patients with cystic fibrosis in whom nebulizer therapy is indicated; |
| 263 | Indefinite | Patients with severe mental or physical disabilities; |
| 264 | Indefinite | Patients who have previously used nebulizer therapy within the last 12-month period. |