Tarif Tip - Tiotropium Bromide 18mcg inhalation powder capsules

Tarif Tip - Tiotropium Bromide 18mcg inhalation powder capsules

Q: I have a prescription for Tiotropium bromide 18mcg inhalation powder capsules. We usually supply Spiriva® powder capsules but our PMR is suggesting a product called Tiogiva® 18mcg inhalation powder capsules. Can we supply these ones?

A: Tiogiva® 18mcg inhalation powder capsules are a recently launched product made by Glenmark Pharmaceuticals.

It has bioequivalence with Spiriva® powder capsules and delivers a dose that is equivalent to 10mcg of tiotropium.

Its licensed indication is as a maintenance bronchodilator treatment to relieve symptoms of patients with chronic obstructive pulmonary disease (COPD)

The capsules have their own inhalation device and are available as a complete pack with device or a refill pack of capsules alone. The capsules should only be used with the Tiogiva® inhaler device, as they are not compatible with the Spiriva Handihaler®.

Pricing

The current Drug Tariff price (June 2021) for tiotropium bromide 18mcg inhalation powder capsules is based on Spiriva®. Whilst currently pharmacists will not be out of pocket by supplying Spiriva® against a generic prescription, it would be reasonable to assume that the tariff price will be corrected to reflect the availability of generic versions.

Advice for Pharmacy teams

Pharmacists should ensure that patients:

• agree to a switch in their inhaler device
• are counselled on the correct use of the new device
• are counselled on potential taste differences

Prescribers should be advised that where they or their patients have a specific preference for one particular brand this should be specified on the prescription to ensure correct supply.

In the absence of a specific product being prescribed then either of the products could be supplied but pharmacists would need to ensure that patients are supplied with a complete pack of device and inhalation powder capsules initially.

In the interests of consistency and patient adherence to the prescribed treatment the same inhaler device should be supplied each time. A record should be made on the patient’s PMR of the correct device to supply.

Pharmacy support pack

There is another tiotropium bromide capsule product (Braltus®) that can be prescribed but this is listed as 10mcg inhalation powder capsules so although Tiogiva® inhalation powder capsules deliver this dose they cannot be dispensed for prescriptions for tiotropium bromide 10mcg inhalation powder capsules.