Generic Breo Ellipta: Price, coverage, and alternatives

In this article:

• Is there a generic for Breo Ellipta?
• Differences between brand and generic
• How much is generic Breo Ellipta?
• Is Breo Ellipta covered by insurance?
• Generic alternatives to Breo Ellipta

In this article

• Is there a generic for Breo Ellipta?
• Differences between brand and generic
• How much is generic Breo Ellipta?
• Is Breo Ellipta covered by insurance?
• Generic alternatives to Breo Ellipta

Breo Ellipta is a prescription inhaler that combines two different medications—the corticosteroid fluticasone and the long-acting beta-2 adrenergic agonist (LABA) vilanterol. It’s approved for the long-term maintenance of asthma or chronic obstructive pulmonary diseases (COPD) like chronic bronchitis and emphysema. Anyone looking to save money on their Breo Ellipta prescription may wonder if a generic version is available. Read on for all the details. 

Is there a generic for Breo Ellipta?

Yes, the first generic version of Breo Ellipta was released in 2022. It’s called fluticasone furoate/vilanterol and is distributed by the company Prasco. 

What are the differences between brand name and generic Breo Ellipta?

To earn FDA approval, generic drugs have to be essentially identical to their brand-name reference products. This means they must have the same active ingredient, strength, dosage form, and route of administration—but they can have different inactive ingredients like fillers and dyes. 

The authorized generic and brand-name Breo Ellipta, however, also have identical inactive ingredients, so they’re virtually the same medication. Additionally, a study on fluticasone-salmeterol inhalers found that both generic and brand-name formulations yielded similar outcomes in patients with COPD. 

The only potential difference between versions of Breo Ellipta is the design of the device itself. And while this might seem like a minor variation, it can significantly impact the inhaler’s effectiveness. “It is not wise to look at an inhaler/device switch as a simple lightbulb change. The formulation may be equivalent, but the performance does not always correlate,” says Elizabeth Moffett, registered respiratory therapist, certified asthma educator, and respiratory wellness advocate at Omhale. 

“The angle of the device in the mouth can make a difference,” she continues. “Generic versions of Breo may have slight changes in airflow resistance, dosing feedback, which sounds trivial until it’s you wheezing your way through a treatment.” This might not be the case with every generic, but the design of the device can have a significant influence on its effectiveness. 

How much is generic Breo Ellipta?

In many cases, generic drugs are much cheaper than brand-name ones—but that’s not always the case with Breo Ellipta. 

Is Breo Ellipta covered by insurance?

Many private insurance and Medicare Part D plans cover Breo Ellipta, although coverage ultimately depends on the specific plan and a few variables that may influence it. 

For example, some insurance plans may require prior authorization, which determines whether a particular drug is medically necessary. In some cases, it’s as simple as requesting additional documentation from the healthcare provider. But in other cases, it might require step therapy—trying other (typically cheaper) drugs first, then moving to Breo Ellipta if they don’t work or cause side effects. 

Even with coverage, your copays and co-insurance may depend on how the insurance plan classifies Breo Ellipta. Every plan has a formulary that categorizes drugs into tiers, providing different levels of coverage for each tier. Typically, generic drugs receive the best coverage, followed by “preferred” brands, then “non-preferred” brands, and specialty drugs. If your plan lists Breo Ellipta as a non-preferred brand, you may be subject to higher copays or additional prior authorization requirements. 

Generic alternatives to Breo Ellipta

Generic fluticasone furoate-vilanterol is the most comparable alternative to Breo Ellipta, since they’re essentially the same drug. However, there are other generics available that may be viable options. 

“Breo is a combination of an inhaled steroid and long-acting beta agonists (ICS/LABA). There are many different types of inhalers with these medications, so luckily there are many alternatives,” says Dr. Purvi Parikh, MD, allergist and immunologist at the Allergy & Asthma Network. “I would first recommend the generic Breo, as the device is the same, and it’s a once-per-day dosing. But, if the insurance doesn’t cover that, some of the other ICS/LABA inhalers are just as good, but you just need to take them more frequently.” 

Some options include:

• Combination inhalers: Fluticasone-Salmeterol (brand names: Advair, AirDuo, Seretide), budesonide-formoterol (Symbicort, Breyna)
• Corticosteroids: Fluticasone furoate (Arnuity Ellipta), mometasone furoate (Asmanex), fluticasone propionate (Flovent)
• Long-acting anticholinergic (LAMAs): Tiotropium bromide (Spiriva Respimat)
• Long-acting beta agonists (LABAs): Arformoterol (Brovana), salmeterol (Serevent Diskus)

Generics are usually the more financially attractive alternatives, but there are some other brand-name options too. Common ones include triple-combination inhalers like Βrеztri Aerosphere or Trelegy Ellipta and biologics like Dupixent, Fasenra, or Nucala. 

The best option for you depends on your medical condition—ideal choices for COPD might be different from the drugs that work best for asthma. When choosing the best inhaler for a patient, Dr. Parikh says she considers pulmonary function tests, compliance, and the patient’s preferences. “There’s shared decision making to choose which inhaler is best for a patient, and dosing depends on breathing test and asthma control,” she says. “Unfortunately, many times we are forced to choose whatever the insurance will cover, as even generics can be costly to a patient without insurance coverage.”

It’s also worth noting that some states allow pharmacists to substitute a generic version of a drug, even if a brand name is on the prescription. Since they’re bioequivalent, it usually isn’t a significant issue, but if your healthcare provider prefers you to have the brand name, they can include a “dispense as written” statement on the prescription. 

If you and your healthcare provider decide that a different medication might work better for you and/or your budget, don’t stop taking Breo Ellipta until you have your new medication ready to go. This will help prevent a lapse in treatment, which can worsen lung symptoms. But if the new inhaler contains a LABA medication, avoid overlapping them, since it increases the risk of overdose. Always follow the healthcare provider’s directions and dosage exactly.