Insurers often deny Breztri as 'non-formulary' or push step therapy first—here's how to fight back.

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If dual-therapy inhalers aren't controlling your COPD, triple therapy may be medically necessary.

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Understanding Your Breztri Aerosphere (budesonide/glycopyrrolate/formoterol fumarate) Denial

Breztri Aerosphere is a triple-therapy inhaler that combines an inhaled corticosteroid (budesonide), a long-acting muscarinic antagonist (glycopyrrolate), and a long-acting beta agonist (formoterol). Insurers frequently deny it for COPD patients—demanding step therapy with cheaper dual-therapy inhalers, questioning medical necessity, or labeling it non-formulary. A focused appeal that documents your COPD history, prior medications, and exacerbations can overturn these denials.

Common Reasons for Denial

  • ! Non-formulary or requires step therapy with cheaper inhalers first
  • ! Not medically necessary / dual therapy considered adequate
  • ! Insufficient documentation of COPD severity or exacerbation history
  • ! Prior authorization not approved
  • ! Quantity limits or coverage restrictions

How We Help

We help you and your clinician summarize your COPD history—prior inhalers, exacerbations, hospitalizations, ER visits, and lung function (FEV1)—to demonstrate why triple therapy and Breztri specifically are medically appropriate for you.

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Some Types of Evidence We Can Use For Supporting Your Appeal

✓ Breztri Aerosphere is FDA-approved for the maintenance treatment of chronic obstructive pulmonary disease (COPD).

✓ In clinical trials, triple therapy with budesonide/glycopyrrolate/formoterol reduced the rate of moderate-to-severe COPD exacerbations compared with dual therapy.

✓ Triple ICS/LAMA/LABA therapy improves lung function and symptom control in patients with COPD who remain symptomatic on dual therapy.

✓ GOLD guidelines support escalation to triple therapy for COPD patients with continued exacerbations despite LAMA/LABA treatment.

Patient Assistance & Copay Programs

These programs may help reduce your costs while you appeal:

Breztri Savings Program ↗

Eligible commercially insured patients may pay as little as $0 per fill for Breztri. Restrictions apply; not valid for government insurance.

AZ&Me Prescription Savings Program ↗

AstraZeneca's patient assistance program offering Breztri at no cost to eligible uninsured patients and those on Medicare who meet income requirements.

Eligibility requirements and program terms may change. Please verify current details directly with each organization.

Patient Advocacy & Support Organizations

These organizations provide education, support, and advocacy for patients:

COPD Foundation ↗

Leading patient advocacy and education organization for people living with COPD.

American Lung Association ↗

Nonprofit providing COPD education, support, and patient advocacy resources.

Frequently Asked Questions

Triple-therapy inhalers are more expensive than single- or dual-therapy options, so insurers commonly require step therapy—asking you to try and fail cheaper inhalers first. Your appeal can explain why you specifically need triple therapy now.

Document prior COPD medications and how you responded, the frequency and severity of exacerbations, hospitalizations and ER visits, oral steroid or antibiotic courses, lung function tests (FEV1, FEV1/FVC), and how symptoms limit your daily life.

Yes. If you're already stable on Breztri and your insurer wants you to switch or removes it from formulary, you may have continuity of care rights and can request a medical exception explaining that switching may destabilize your COPD. See our continuity of care page for more information.

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Disclaimer: Fight Health Insurance is not affiliated with, endorsed by, or partnered with any pharmaceutical manufacturer, healthcare provider, medical device company, or patient assistance program, including AstraZeneca. All information provided is for educational and informational purposes only and does not constitute medical or legal advice. Please consult with your healthcare provider regarding treatment options and with your insurance company regarding coverage decisions.