The real benefit of trelegy is that it’s three medications in one. It’s steroid, laba (Long-acting beta-agonist), and lama (Long-acting muscarinic antagonists ). Out of those three the one that is costing you the big bucks is the Lama, it’s also the one that symbicort is missing, so it’s probably the one that is making the difference for you.

Luckily I believe there is a generic option for a Lama inhaler (tiotropium bromide) that is less than a hundred bucks out of pocket with a coupon.

You would probably have much better coverage for something like a generic symbicort and a generic Spiriva (tiotropium). A lot of manufacturers basically keep doing different combinations to keep their drugs from being moved over to generics. So a combo is probably going to be the most effective cheap option for ya.

Good luck! I wish more providers took more time to consider their patients financial health as well, but unfortunately a lot of prescribers are just as lost as a lot of patients when it comes to understanding health coverage. The insurance and pharma companies like to make it as difficult as possible and offload all the blame on the healthcare providers.