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Limited Coverage Drugs - Special Authority Criteria
| Generic Name / Strength / Form |
| formoterol OR formoterol in combination with budesonide |
| Criteria |
Approval Period |
Diagnosis of asthma
PLUS
inadequate response on optimal dose of inhaled corticosteroid. |
Indefinite |
Practitioner Exemptions
- Allergists
- Respirologists
Special Notes
Online Forms (PDF)
Click on the link to complete a special authority request form.
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Last Revised: January 21, 2008
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