PERFOROMIST Coverage

"Am I covered?" That’s one of the first questions people ask when considering medications.

Good news! Most insurance companies include PERFOROMIST® (formoterol fumarate) in their coverage. And, as a nebulized medication, PERFOROMIST® is also eligible for Medicare reimbursement.

  • PERFOROMIST is covered under Medicare Part B and most Part D plans.

  • Medicare Part B may reimburse much of the cost of your PERFOROMIST Inhalation Solution prescription if you are 65 or over. Remind your doctor that PERFOROMIST is reimbursed under J-Code 7606.

  • PERFOROMIST is covered by more than 84% of commercial plans, as of 5/21/15.

  • The PERFOROMIST Savings Card helps reduce out-of-pocket costs for eligible patients with commercial insurance. Eligibility restrictions apply. See full Terms and Conditions.

If you are unable to afford the cost of your medication, Medicaid may also reimburse much of the cost. You may qualify for Medicaid if you have a limited income; this program covers certain adults, those with disabilities and people 65 and older.

Unsure of your health insurance coverage? Contact your insurance provider for an explanation of your benefits or consult BreathAssist®.

Home Healthcare

You may be able to have PERFOROMIST delivered to your home as part of the Medicare Part B home healthcare benefit. If you meet the eligibility criteria, Medicare will pay for you to have certain healthcare services in your home, or supplies delivered to your home.

Your doctor can help you find a medical equipment supplier pharmacy, which will provide the services you need, including devices and medications. You can also consult BreathAssist®, to help you find a pharmacy. If you use other COPD medications and devices, check to see if the medical equipment supplier pharmacy can provide those as well.

Call 1.800.MEDICARE (1.800.633.4227) or visit http://www.medicare.gov for more information or for the phone number of your local state survey agency (the agency that inspects and certifies home healthcare agencies).

Other resources include your local long-term ombudsman on home healthcare agencies in your area (www.ltcombudsman.org) or the Eldercare Locator (www.eldercare.gov; 1.800.677.1116).

Save on PERFOROMIST® (formoterol fumarate) with the savings card

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Important Safety Information

People with asthma who take long-acting beta2 adrenergic agonist (LABA) medicines such as PERFOROMIST have an increased risk of death from asthma problems. It is not known whether LABA medicines, such as PERFOROMIST, increase the risk of death in people with COPD. Get emergency medical care if breathing problems worsen quickly, or you use your rescue inhaler medicine but it does not relieve your breathing problems

Indication

PERFOROMIST Inhalation Solution is used long term, twice a day (morning and evening), in controlling symptoms of chronic obstructive pulmonary disease (COPD) in adults with COPD. PERFOROMIST is for inhalation use only through a standard jet nebulizer connected to an air compressor and should not be swallowed or injected.

Important Safety Information

PERFOROMIST should not be used in children.

PERFOROMIST is not for use to treat sudden symptoms of COPD and should not be used more than twice a day. Always have a short-acting beta2-agonist with you to treat sudden symptoms.

Tell your healthcare professional about all of your health conditions, including if you:

  • have heart problems
  • have high blood pressure
  • have diabetes
  • have seizures
  • have thyroid problems
  • have liver problems
  • are pregnant or planning to become pregnant. It is not known if PERFOROMIST Inhalation Solution can harm an unborn baby.
  • are breastfeeding. It is not known if PERFOROMIST Inhalation Solution passes into breast milk and if it can harm your baby.

Tell your healthcare professional about all medicines you take including prescription and non-prescription medications, vitamins, and herbal supplements. PERFOROMIST and certain medicines may interact with each other and cause serious side effects.

PERFOROMIST can cause serious side effects including:

  • Increased risk of death from asthma problems (See Boxed Warning above)
  • Sudden shortness of breath immediately after use of PERFOROMIST
  • Serious allergic reactions including rash, hives, swelling of the face, mouth, and tongue, and breathing problems. Call your healthcare professional or get emergency medical care if you get any symptoms of a serious allergic reaction.
  • Chest pain
  • Increased or decreased blood pressure
  • A fast and irregular heartbeat
  • Low blood potassium
  • High blood sugar
  • High blood acid

The most common side effects of PERFOROMIST include:

  • Headache
  • Tremor
  • Nervousness
  • Dry mouth
  • Muscle cramps
  • Nausea, vomiting
  • Diarrhea
  • Dizziness
  • Trouble sleeping
  • If your COPD symptoms worsen over time do not increase your dose of PERFOROMIST, instead call your healthcare professional.

Click here for full Prescribing Information, including Boxed Warning and Medication Guide.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Prescribing Information Show More

Important Safety Information

People with asthma who take long-acting beta2 adrenergic agonist (LABA) medicines such as PERFOROMIST have an increased risk of death from asthma problems. It is not known whether LABA medicines, such as PERFOROMIST, increase the risk of death in people with COPD. Get emergency medical care if breathing problems worsen quickly, or you use your rescue inhaler medicine but it does not relieve your breathing problems

Indication

PERFOROMIST Inhalation Solution is used long term, twice a day (morning and evening), in controlling symptoms of chronic obstructive pulmonary disease (COPD) in adults with COPD. PERFOROMIST is for inhalation use only through a standard jet nebulizer connected to an air compressor and should not be swallowed or injected.

Important Safety Information

PERFOROMIST should not be used in children.

PERFOROMIST is not for use to treat sudden symptoms of COPD and should not be used more than twice a day. Always have a short-acting beta2-agonist with you to treat sudden symptoms.

Tell your healthcare professional about all of your health conditions, including if you:

  • have heart problems
  • have high blood pressure
  • have diabetes
  • have seizures
  • have thyroid problems
  • have liver problems
  • are pregnant or planning to become pregnant. It is not known if PERFOROMIST Inhalation Solution can harm an unborn baby.
  • are breastfeeding. It is not known if PERFOROMIST Inhalation Solution passes into breast milk and if it can harm your baby.

Tell your healthcare professional about all medicines you take including prescription and non-prescription medications, vitamins, and herbal supplements. PERFOROMIST and certain medicines may interact with each other and cause serious side effects.

PERFOROMIST can cause serious side effects including:

  • Increased risk of death from asthma problems (See Boxed Warning above)
  • Sudden shortness of breath immediately after use of PERFOROMIST
  • Serious allergic reactions including rash, hives, swelling of the face, mouth, and tongue, and breathing problems. Call your healthcare professional or get emergency medical care if you get any symptoms of a serious allergic reaction.
  • Chest pain
  • Increased or decreased blood pressure
  • A fast and irregular heartbeat
  • Low blood potassium
  • High blood sugar
  • High blood acid

The most common side effects of PERFOROMIST include:

  • Headache
  • Tremor
  • Nervousness
  • Dry mouth
  • Muscle cramps
  • Nausea, vomiting
  • Diarrhea
  • Dizziness
  • Trouble sleeping
  • If your COPD symptoms worsen over time do not increase your dose of PERFOROMIST, instead call your healthcare professional.

Click here for full Prescribing Information, including Boxed Warning and Medication Guide.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

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