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    NDC 00173-0859-14 Breo Ellipta 100; 25 ug/1; ug/1 Details

    Breo Ellipta 100; 25 ug/1; ug/1

    Breo Ellipta is a RESPIRATORY (INHALATION) POWDER in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by GlaxoSmithKline LLC. The primary component is FLUTICASONE FUROATE; VILANTEROL TRIFENATATE.

    Product Information

    NDC 00173-0859
    Product ID 0173-0859_58e62ebe-a977-4ab7-b932-a2e985360dfb
    Associated GPIs 44209902758020
    GCN Sequence Number 070972
    GCN Sequence Number Description fluticasone/vilanterol BLST W/DEV 100-25MCG INHALATION
    HIC3 B63
    HIC3 Description BETA-ADRENERGIC AND GLUCOCORTICOID COMBO, INHALED
    GCN 34647
    HICL Sequence Number 040319
    HICL Sequence Number Description FLUTICASONE FUROATE/VILANTEROL TRIFENATATE
    Brand/Generic Brand
    Proprietary Name Breo Ellipta
    Proprietary Name Suffix n/a
    Non-Proprietary Name fluticasone furoate and vilanterol trifenatate
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form POWDER
    Route RESPIRATORY (INHALATION)
    Active Ingredient Strength 100; 25
    Active Ingredient Units ug/1; ug/1
    Substance Name FLUTICASONE FUROATE; VILANTEROL TRIFENATATE
    Labeler Name GlaxoSmithKline LLC
    Pharmaceutical Class Adrenergic beta2-Agonists [MoA], Corticosteroid Hormone Receptor Agonists [MoA], Corticosteroid [EPC], beta2-Adrenergic Agonist [EPC]
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA204275
    Listing Certified Through 2024-12-31

    Package

    NDC 00173-0859-14 (00173085914)

    NDC Package Code 0173-0859-14
    Billing NDC 00173085914
    Package 1 TRAY in 1 CARTON (0173-0859-14) / 1 INHALER in 1 TRAY / 14 POWDER in 1 INHALER
    Marketing Start Date 2013-08-26
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 5.3987
    Pricing Unit EA
    Effective Date 2024-01-01
    NDC Description BREO ELLIPTA 100-25 MCG INHALR
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 4, 5
    Classification for Rate Setting B
    As of Date 2024-02-21
    This pricing file, entitled the NADAC (National Average Drug Acquisition Cost) files, provide state Medicaid agencies with covered outpatient drug prices by averaging survey invoice prices from retail community pharmacies across the United States. These pharmacies include independent retail community pharmacies and chain pharmacies. The prices are updated on a weekly and monthly basis