{"id":4210,"date":"2026-03-05T11:11:11","date_gmt":"2026-03-05T11:11:11","guid":{"rendered":"https:\/\/nhsdorset.nhs.uk\/medicines\/?page_id=4210"},"modified":"2026-03-06T15:00:55","modified_gmt":"2026-03-06T15:00:55","slug":"fostair-pmdi-switch","status":"publish","type":"page","link":"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/fostair-pmdi-switch\/","title":{"rendered":"Fostair pMDI switch"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p><span class=\"TextRun SCXW60575262 BCX8\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"none\"><span class=\"NormalTextRun SpellingErrorV2Themed SCXW60575262 BCX8\" title=\"\" data-ccp-parastyle=\"Page Title\" data-ccp-parastyle-defn=\"{\" data-ccp-parastyle-linked-defn=\"{\">Proxor<\/span><span class=\"NormalTextRun SCXW60575262 BCX8\" data-ccp-parastyle=\"Page Title\">\u00a0or\u00a0<\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW60575262 BCX8\" data-ccp-parastyle=\"Page Title\">Bibecfo<\/span><span class=\"NormalTextRun SCXW60575262 BCX8\" data-ccp-parastyle=\"Page Title\">: Best\u00a0<\/span><span class=\"NormalTextRun SCXW60575262 BCX8\" data-ccp-parastyle=\"Page Title\">value<\/span><span class=\"NormalTextRun SCXW60575262 BCX8\" data-ccp-parastyle=\"Page Title\">, preferred inhaled corticosteroid (ICS)\/long-acting beta-2 agonist (LABA) combination <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW60575262 BCX8\" data-ccp-parastyle=\"Page Title\">pMDI<\/span><span class=\"NormalTextRun SCXW60575262 BCX8\" data-ccp-parastyle=\"Page Title\"> inhaler for anti-inflammatory reliever (AIR)\/maintenance and reliver therapy (MART) in respiratory conditions.<\/span><\/span><span class=\"EOP SCXW60575262 BCX8\" data-ccp-props=\"\">\u00a0<\/span><\/p>\n<\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-4210-1\"><div class=\"fusion-panel panel-default panel-d680c666fdb23c24f fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_d680c666fdb23c24f\"><a aria-expanded=\"false\" aria-controls=\"d680c666fdb23c24f\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4210-1\" data-target=\"#d680c666fdb23c24f\" href=\"#d680c666fdb23c24f\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What work is required?<\/span><\/a><\/h4><\/div><div id=\"d680c666fdb23c24f\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_d680c666fdb23c24f\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\">In line with the\u00a0<\/span><a href=\"https:\/\/www.dorsetformulary.nhs.uk\/chaptersSubDetails.asp?FormularySectionID=3&amp;SubSectionRef=03.02.03&amp;SubSectionID=A100&amp;drugmatch=6354#6354\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">Dorset Formulary<\/span><\/a><span data-contrast=\"none\">, NHS Dorset recommends\u00a0Bibecfo\u00a0and\u00a0Proxor\u00a0brands as the first line\u00a0Beclometasone\u00a0+ Formoterol (ICS\/LABA) pressurised metered dose inhaler (pMDI) prescribed as part of AIR\/MART (anti-inflammatory reliver\/maintenance and reliever therapy).<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p>NHS Dorset is asking teams to r<span data-contrast=\"none\">eview existing patients on a Fostair pMDI, using the resources provided and where clinically appropriate, switch 80% of patients with asthma to the better value Proxor or Bibecfo brands of Beclometasone + Formoterol pMDI.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><strong>Switching is required by the 30th September 2026.<\/strong><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-da386ee21d6260b4d fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_da386ee21d6260b4d\"><a aria-expanded=\"false\" aria-controls=\"da386ee21d6260b4d\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4210-1\" data-target=\"#da386ee21d6260b4d\" href=\"#da386ee21d6260b4d\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why is this part of the contract?<\/span><\/a><\/h4><\/div><div id=\"da386ee21d6260b4d\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_da386ee21d6260b4d\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"25\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Proxor and Bibecfo brands are better values products and first line choices in Dorset.<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"25\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Switching to\u00a0Proxor\u00a0or\u00a0Bibecfo\u00a0will help PCN teams\u00a0<\/span><span data-contrast=\"none\">care for patients within their NHS England financial envelope and hence release funds to improve unmet needs in prevention.<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"25\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">Ear<\/span><span data-contrast=\"none\">l<\/span><span data-contrast=\"none\">y switching <strong>by the 30th September 2026 is required <\/strong>to maximise cumulative in year cost savings<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"25\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">NICE guideline 245 does not distinguish between the\u00a0different brands\u00a0of ICS\/LABA<\/span><span data-contrast=\"none\">\u00a0pMDI<\/span><span data-contrast=\"none\">\u00a0inhalers.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-95ba1911e1652d8ce fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_95ba1911e1652d8ce\"><a aria-expanded=\"false\" aria-controls=\"95ba1911e1652d8ce\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4210-1\" data-target=\"#95ba1911e1652d8ce\" href=\"#95ba1911e1652d8ce\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"95ba1911e1652d8ce\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_95ba1911e1652d8ce\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"none\">Notify community pharmacy colleagues of the intention to switch to best value ICS\/LABA<\/span><span data-contrast=\"none\">\u00a0pMDI.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Work with community pharmacy colleagues to ensure sufficient stock of\u00a0<\/span><span data-contrast=\"none\">the\u00a0<\/span><span data-contrast=\"none\">preferred branded inhalers <\/span><span data-contrast=\"none\">is available to support the switching programme and minimise disruption to patients,\u00a0GP\u00a0and community pharmacy teams.\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><strong>Run the\u00a0SystmOne\u00a0search provided to\u00a0identify\u00a0existing patients prescribed a\u00a0Fostair\u00a0pMDI:\u00a0<\/strong><\/p>\n<p><span data-contrast=\"none\">Dorset SystmOne GPs> PINH 26 27> F2 Fostair pMDI> 2c Work to do: Fostair pMDI RPT (>11 years) switch to Proxor or Bibecfo pMDI<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">A risk management approach should be taken<\/span><span data-contrast=\"none\">\u00a0to any batch-switching arrangement, which includes safeguards which enable patients to have a review, should they have any queries or changes to their condition.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><strong>Exclusion criteria:\u00a0<\/strong><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"26\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">Patients < 12 years of age<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"26\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">Patients for whom a\u00a0pMDI\u00a0is not suitable<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"26\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">Allergy\/sensitivity to excipients in the Proxor\/Bibecfo\u00a0products<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"26\" data-list-defn-props=\"{\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"none\">Patients who have trialled and failed on a\u00a0Proxor\u00a0and\u00a0Bibecfo\u00a0device<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/li>\n<\/ul>\n<p><strong>Special considerations:\u00a0<\/strong><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"27\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">A face-to-face medication review may be considered for patients with poorly controlled asthma, severe asthma, frequent exacerbations or those under secondary respiratory care<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"27\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">For those patients clinically suitable to switch to a dry powder inhaler please discuss suitable options at the patient's next face-to-face review<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"none\">Where clinically\u00a0appropriate, switch patient to\u00a0Proxor\u00a0or\u00a0Bibecfo\u00a0pMDI.<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-73b017ffacad45d7c fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_73b017ffacad45d7c\"><a aria-expanded=\"false\" aria-controls=\"73b017ffacad45d7c\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4210-1\" data-target=\"#73b017ffacad45d7c\" href=\"#73b017ffacad45d7c\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"73b017ffacad45d7c\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_73b017ffacad45d7c\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><strong>How to communicate this to patients:\u00a0\u00a0<\/strong><\/p>\n<p><span data-contrast=\"none\">Use the template patient text message and letter in\u00a0SystmOne\u00a0to notify patients of the change.<\/span><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><strong>Text message:\u00a0<\/strong><\/p>\n<p>\"NHS Dorset has asked GP teams to review use of Fostair brand inhaler and switch to Proxor or Bibecfo brands. These brands contain the same medicines in the same quantity as Fostair but are 1st choice in Dorset. Bibecfo, Proxor and Fostair pMDI use the same inhaler technique, you should not experience any change in clinical effect. Please finish your Fostair supply first, then read the label and patient information leaflet before starting this new inhaler. If you have any questions, please ask your Community Pharmacist for a New Medicines Service Review. If you feel that your respiratory condition requires a medical review, please make an appointment to discuss.\"<\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-content\/uploads\/sites\/3\/2026\/02\/Fostair-template-patient-letter.pdf\">Fostair template patient letter<\/a><\/p>\n<p><strong>References:\u00a0<\/strong><\/p>\n<p><a href=\"https:\/\/www.dorsetformulary.nhs.uk\/chaptersSubDetails.asp?FormularySectionID=3&SubSectionRef=03.02.03&SubSectionID=A100&drugmatch=6354#6354\"><span data-contrast=\"none\">Dorset\u202fFormulary<\/span><\/a><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/Downloads\/aboutus\/medicines-management\/Other%20Guidelines\/Dorset%20Asthma%20Prescribing%20Guide%20for%20CYP%20March%202025%20v3.pdf?boxtype=pdf&g=false&s=true&s2=false&r=wide&UNLID=795900729202617122433\"><span data-contrast=\"none\">CYP Asthma Guideline<\/span><\/a><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng245?UNLID=795900729202617122433\"><span data-contrast=\"none\">Overview | Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) | Guidance | NICE<\/span><\/a><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.rightbreathe.com\/?UNLID=795900729202617122433\"><span data-contrast=\"none\">RightBreathe<\/span><\/a><span data-ccp-props=\"\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-24ccdc355eccef005 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_24ccdc355eccef005\"><a aria-expanded=\"false\" aria-controls=\"24ccdc355eccef005\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-4210-1\" data-target=\"#24ccdc355eccef005\" href=\"#24ccdc355eccef005\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-capsules fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I calculate my progress against the target for this metric<\/span><\/a><\/h4><\/div><div id=\"24ccdc355eccef005\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_24ccdc355eccef005\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p>Tracking achievement:<\/p>\n<p>Numerator divided by Denominator from SystmOne searches x 100 for %<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":3067,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-4210","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4210","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/comments?post=4210"}],"version-history":[{"count":14,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4210\/revisions"}],"predecessor-version":[{"id":4477,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/4210\/revisions\/4477"}],"up":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/3067"}],"wp:attachment":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/media?parent=4210"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}