Eligible smoking cessation products
Last updated: October 27, 2022
On this page: Nicotine replacement therapy products | Smoking cessation prescription drugs
Nicotine replacement therapy products
Brand name | Product type | Strength | Pack size | Natural product number (NPN) | Temporary NPN |
---|---|---|---|---|---|
Nicorette® | gum1 | 2 mg | 105 | 80069513 | |
Nicorette® | gum1 | 4 mg | 105 | 80069471 | |
Nicorette® | lozenge2 | 2 mg | 80 | 80110858 | 80053099 (until July 31, 2022) |
Nicorette® | lozenge2 | 4 mg | 80 | 80112095 | 80053100 (until July 31, 2022) |
Nicoderm® Step 1 | patch | 21 mg | 7 | 80044515 | |
Nicoderm® Step 2 | patch | 14 mg | 7 | 80044503 | |
Nicoderm® Step 3 | patch | 7 mg | 7 | 80044518 |
1 Nicorette gum flavour: Ultra Fresh Mint only.
2 Nicorette lozenge flavour: Mint only.
Smoking cessation prescription drugs
Generic name | Brand name | Dosage type | Strength | DIN |
---|---|---|---|---|
bupropion3 | Zyban® | tablet ER | 150 mg | 2238441 |
varenicline | Champix®4 | tablet | 0.5 mg | 2291177 |
varenicline | Champix®4 | tablet | 1 mg | 2291185 |
varenicline | Champix®4 | tablet DS PK | 0.5 mg and 1 mg | 2298309 |
varenicline | Apo-Varenicline | tablet | 0.5 mg | 2419882 |
varenicline | Apo-Varenicline | tablet | 1 mg | 2419890 |
varenicline | Apo-Varenicline | tablet DS PK | 0.5 mg and 1 mg | 2435675 |
varenicline | Teva-Varenicline | tablet DS PK | 0.5 mg and 1 mg | 2426781 |
3 PharmaCare covers only the Zyban® brand of bupropion. Wellbutrin®, Wellbutrin XL®, and generic bupropion are not covered as smoking cessation prescription drugs.
4 PharmaCare fully covers generic versions of varenicline (i.e., Apo-Varenicline, Teva-Varenicline). The brand name Champix® is only covered as a partial benefit.
Physicians: To ensure that PharmaNet correctly adjudicates smoking cessation claims for Zyban®, please use the brand name, include the indication, and note "no substitutions" in the written prescription.
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