Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC accept Symbicort SMART

The Scottish Medicines Consortium (SMC) has accepted budesonide/formoterol dry powder inhalers (Symbicort SMART®) for use, in adults, for the regular treatment of asthma as maintenance and reliever therapy.

The Summary of Product Characteristics was recently updated to include two treatment approaches with the combination of budesonide and formoterol. The first approach is to use the combination inhaler as regular maintenance treatment with a separate rapid-acting bronchodilator as rescue therapy. The second approach is to use the combination inhaler as regular maintenance treatment and as needed in response to symptoms.

This new approach is possible, within the license, with the 100mcg budesonide/6mcg formoterol and the 200mcg budesonide/6mcg formoterol inhalers. It should be noted that this approach is not recommended for anyone under 18 years of age.

In the submission to the SMC evidence was submitted demonstrating a longer time to first severe exacerbation using this approach compared to alternative reliever therapies. Additionally, it was estimated that using this approach would generate an overall net saving to the NHS although this was only in comparison to alternative combination treatment approaches as used at Step 3 of the British Thoracic Society (BTS) Asthma Guidelines.

Action: Clinicians should be aware of this new approach. It may be of value in some patients who are at BTS Step 3 and have difficulty in understanding or remembering what their different inhalers are for and when they should be used.

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