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Speaker’s notes:

Please read the Indications on this slide.

References: 1. UTIBRON NEOHALER [prescribing information]. 2019. 2. SEEBRI NEOHALER [prescribing information]. 2018. 3. ARCAPTA NEOHALER [prescribing information]. 2019.

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Speaker’s notes:Choosing an appropriate inhalation device is important in the treatment of chronic obstructive pulmonary disease (COPD)1

• For many patients, coordinated breathing can pose a challenge to therapy administration2

• Patients may unintentionally misuse or be nonadherent to COPD treatment, leading to less successful delivery of medication2-5

• Incorrect inhalation technique, over time, is a major challenge to achieving COPD treatment goals1

According to the 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD)1:• More than two-thirds of patients make at least 1 error using an inhalation device• The selection of inhalation device should depend on the patient’s ability and preference

NEOHALER is for use only with ARCAPTA, SEEBRI, and UTIBRON capsules.

References: 1. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2019:1-139. 2. Taffet GE, Donohue JF, Altman PR. Considerations for managing chronic obstructive pulmonary disease in the elderly. Clin Interv Aging. 2014;9:23-30. 3. Fulvio B, Lavorini F, Blasi F, Baiardini I, Canonica GW. Switching treatments in COPD: implications for costs and treatment adherence. Int J Chron Obstruct Pulmon Dis. 2015;10:2601-2608. 4. Tashkin DP, Fabbri LM. Long-acting beta-agonists in the management of chronic obstructive pulmonary disease: current and future agents. Respir Res. 2010;11(149):1-14. 5. Restrepo RD, Alvarez MT, Wittnebel LD, et al. Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Pulmon Dis. 2008;3(3):371-384.

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Speaker’s notes:Commonly used inhalation devices for COPD medication delivery include metered-dose inhalers (MDIs), slow-mist inhalers (SMIs), dry-powder inhalers (DPIs), jet nebulizers, and vibrating membrane/mesh nebulizers.1-7

Metered-dose inhalers (MDIs)• Aerosolized by compressed HFA• Coordination of breathing and actuation required (coordinated breath)• No drug preparation; device shaking required• Administration in 1-2 breathsSlow-mist inhalers (SMIs)• Aerosolized by spring mechanism• Requires specific breathing technique (coordinated breath)• Multiple steps for setup and maintenance• Administration in 1-2 breathsDry-powder inhalers (DPIs)• Aerosolized by patient inspiratory flow• Breath-actuated• May require loading of capsule• Administration in 1-2 breathsJet nebulizers• Aerosolized by high-velocity air stream• Tidal breathing• Multiple steps for setup and maintenance• Administration time up to 20 minutesVibrating membrane/mesh nebulizers• Aerosolized through vibrating perforated material• Tidal breathing• Multiple steps for setup and maintenance• Administration time less than 5 minutes An appropriate device for the COPD patient is important to achieve treatment goals.1

References: 1. Restrepo RD, Alvarez MT, Wittnebel LD, et al. Medication adherence issues in patients treated for COPD. Int J Chron Obstruct PulmonDis. 2008;3(3):371-384. 2. Tashkin DP. A review of nebulized drug delivery in COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:2585-2596. 3. DolovichMB, Ahrens RC, Hess DR, et al. Device selection and outcomes of aerosol therapy: Evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest. 2005;127(1):335-371. 4. Dhand R, Dolovich M, Chipps B, Myers TR, Restrepo R, Farrar JR. The role of nebulized therapy in the management of COPD: evidence and recommendations. COPD. 2012;9(1):58-72. 5. Lavorini F, Magnan A, Dubus JC, et al. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med. 2008;102(4):593-604. 6. Al-Showair RA, Tarsin WY, Assi KH, Pearson SB, Chrystyn H. Can all patients with COPD use the correct inhalation flow with all inhalers and does training help? Respir Med. 2007;101(11):2395-2401. 7. Virchow JC, Crompton GK, Dal Negro R, et al. Importance of inhaler devices in the management of airway disease. Respir Med. 2008;102(1):10-19.

Speaker’s notes:The NEOHALER device: a delivery option for your COPD patient population

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Speaker’s notes:Consider attributes of the NEOHALER device1-4:• Breath-actuated• Audiovisual feedback mechanisms• Small and portable

ARCAPTA capsules, SEEBRI capsules, and UTIBRON capsules must not be swallowed, as the intended effects on the lungs will not be obtained. ARCAPTA capsules, SEEBRI capsules, and UTIBRON capsules are only for oral inhalation and should only be used with the NEOHALER device.

References: 1. Tashkin DP. A review of nebulized drug delivery in COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:2585-2596. 2. UTIBRON NEOHALER [prescribing information]. 2019. 3. SEEBRI NEOHALER [prescribing information]. 2018. 4. ARCAPTA NEOHALER [prescribing information]. 2019.

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Speaker’s notes:The NEOHALER device allows patients to visualize whether there is powder left in the capsule, giving them the flexibility to inhale any remaining dose1-3

Audiovisual feedback mechanisms1-3:• On inhalation, the capsule spins around in the chamber, producing a whirring noise• Patients are advised to open the NEOHALER device to ensure the capsule is empty. If any powder

remains in the capsule, the patient should inhale the remaining powder. Most people are able to empty the capsule with 1 or 2 inhalations

IMPORTANT SAFETY INFORMATION ARCAPTA NEOHALER is contraindicated in patients with a history of hypersensitivity to indacaterol or to any of the ingredients, and UTIBRON NEOHALER is contraindicated in patients with a history of hypersensitivity to indacaterol, glycopyrrolate, or to any of the ingredients. SEEBRI NEOHALER is contraindicated in patients with a hypersensitivity to glycopyrrolate or to any of the ingredients.

References: 1. UTIBRON NEOHALER [prescribing information]. 2019. 2. SEEBRI NEOHALER [prescribing information]. 2018. 3. ARCAPTA NEOHALER [prescribing information]. 2019.

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Speaker’s notes:

An easy way for patients to remember the 13-step detailed instructions is to think of the 3 I's.• Insert:

- 1 UTIBRON or SEEBRI capsule twice daily for 24-hour bronchodilation- 1 ARCAPTA capsule once daily for 24-hour bronchodilation- Close the inhaler fully. You should hear a "click" as it fully closes

Step 1. Pull off capStep 2. Open the inhalerStep 3. Prepare the capsuleStep 4. Remove 1 capsuleStep 5. Insert capsuleStep 6. Close the inhaler

• Inhale: - Close the NEOHALER and press both piercing buttons together firmly to pierce the capsule, then fully release the buttons- Distinct whirring sound during inhalation confirms the capsule is placed within the chamber correctly- UTIBRON, SEEBRI, and ARCAPTA capsules are for oral inhalation only and should not be swallowed

Step 7. Pierce the capsuleStep 8. Release the piercing buttons fullyStep 9. Breathe outStep 10. Inhale the medicineStep 11. On inhalation, the capsule spins around in the chamber and you should hear a whirring noiseStep 12. Hold your breath for 5-10 seconds

• Inspect: - Clear capsule design enables the patient to visualize whether there is any powder left in the capsule, giving them the flexibility to

inhale any remaining doseStep 13. Remove capsule

IMPORTANT SAFETY INFORMATION Immediate hypersensitivity reactions have been reported with ARCAPTA NEOHALER, SEEBRI NEOHALER, and UTIBRON NEOHALER. If signs occur, discontinue immediately and institute alternative therapy. ARCAPTA NEOHALER, SEEBRI NEOHALER, and UTIBRON NEOHALER should be used with caution in patients with severe hypersensitivity to milk proteins.References: 1. UTIBRON NEOHALER [prescribing information]. 2019. 2. SEEBRI NEOHALER [prescribing information]. 2018. 3. ARCAPTA NEOHALER [prescribing information]. 2019.

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Speaker’s notes:Summary• Patient's ability to correctly take their COPD medication is important for selection of an

appropriate device1

• Choosing an appropriate inhalation device is important for COPD treatment goals1

• The NEOHALER device was designed with patients’ needs in mind2-5

– Breath actuated– Provides audiovisual feedback mechanisms– An easy way to remember the detailed instructions is to think of the 3 I's:

• Insert• Inhale• Inspect

– Small and portable

IMPORTANT SAFETY INFORMATION ARCAPTA capsules, SEEBRI capsules, and UTIBRON capsules must not be swallowed as the intended effects on the lungs will not be obtained. ARCAPTA capsules, SEEBRI capsules, and UTIBRON capsules are only for oral inhalation and should only be used with the NEOHALER device.

References: 1. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2019:1-139. 2. TashkinDP. A review of nebulized drug delivery in COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:2585-2596. 3. UTIBRON NEOHALER [prescribing information]. 2019. 4. SEEBRI NEOHALER [prescribing information]. 2018. 5. ARCAPTA NEOHALER [prescribing information]. 2019.

Speaker’s notes:Read the full Indication and Important Safety Information on this slide.

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Speaker’s notes:Read the full Important Safety Information on this slide.

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Speaker’s notes:Read the full Important Safety Information on this slide.

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Speaker’s notes:Read the full Important Safety Information on this slide.

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Speaker’s notes:Thank you!

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