Here you will find the recommendations we have made about the use of individual medicines in Lancashire.


Brand: Daxas®
NICE TA: 461
Indication: Treating chronic obstructive pulmonary disease (NICE TA461)
Disease category: Respiratory system
Commissioning responsibility: CCG
PbR excluded: No


Roflumilast, as an add-on to bronchodilator therapy, is recommended as an option for treating severe chronic obstructive pulmonary disease in adults with chronic bronchitis, only if:

•the disease is severe, defined as a forced expiratory volume in 1 second (FEV1) after a bronchodilator of less than 50% of predicted normal, and
•the person has had 2 or more exacerbations in the previous 12 months despite triple inhaled therapy with a long-acting muscarinic antagonist, a long-acting beta‑2 agonist and an inhaled corticosteroid.

Treatment with roflumilast should be started by a specialist in respiratory medicine.


LMMG recommendation: Amber0
Click here to find the definitions for the colour classifications

Reason for decision:  Suitable for GP prescribing following recommendation/initiation by specialist

Supporting documents:

NICE TA461 - Roflumilast for treating chronic obstructive pulmonary disease

Decisions of Lancashire local decision making groups:

NHS Blackburn With Darwen CCG and NHS East Lancashire CCG NHS Blackpool CCG NHS Chorley and South Ribble CCG and NHS Greater Preston CCG NHS Fylde and Wyre CCG NHS Morecambe Bay CCG NHS West Lancashire CCG