Eligible Smoking Cessation Products

Nicotine Replacement Therapy Products

 
Brand Name Product Type Strength Pack Size Natural Product Number (NPN)
Nicorette ® gum1 2 mg 105 80069513
Nicorette ® gum1 4 mg 105 80069471
Nicorette ® lozenge 2 mg 88 2247347
Nicorette ® lozenge 4 mg 88 2247348
Nicoderm ® Step 1 patch 21 mg 7 80044515
Nicoderm ® Step 2 patch 14 mg 7 80044503
Nicoderm ® Step 3 patch 7 mg 7 80044518
Nicorette ® inhaler 10 mg2 42 2241742

Nicorette gum flavour: Ultra Fresh Mint only.
4 mg delivered.

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

PharmaCare covers only the Zyban® version as a smoking cessation medication; Wellbutrin®, Wellbutrin XL®, and generic bupropion are not covered as smoking cessation drugs.
PharmaCare only fully covers generic versions of varenicline (i.e., Apo-Varenicline). Brand name Champix® is 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 add the note "no substitutions" in the written prescription.