Smoking Cessation Program – Information for Prescribers

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Overview

The Smoking Cessation Program helps eligible B.C. residents to stop smoking or using other tobacco products by helping with the cost of smoking cessation aids. Each calendar year, the program offers coverage for one of two treatment options to eligible B.C. residents:

  • Option 1—Non-prescription nicotine replacement therapy (NRT) products or
  • Option 2—Prescription smoking cessation drugs

Option 1—Nicotine Replacement Therapy

To be eligible for nicotine replacement therapy coverage, patients must have valid, active Medical Services Plan (MSP) coverage.

Each calendar year, PharmaCare will cover 100% of the cost of a single continuous course of treatment lasting up to 12 consecutive weeks (84 days). 

See the recent list of nicotine replacement therapy products eligible for coverage (PDF) under the program.

How does your patient get their NRTs?

  • Patients do not need a prescription for NRTs.
  • As of January 1, 2016, patients should obtain NRTs from their local pharmacy. They do not need to call HealthLink BC at 8-1-1 to register.
  • At the pharmacy, the patient must sign a declaration form before they can receive their NRTs.

Option 2—Prescription Smoking Cessation Drugs

PharmaCare covers prescription smoking cessation drugs for patients who have valid, active MSP coverage and who are covered by Fair PharmaCare or one of the following PharmaCare plans:

Each calendar year, PharmaCare will cover a single continuous course of treatment lasting up to 12 consecutive weeks (84 days) of Zyban® (bupropion) or Champix® (varenicline). Each fill is limited to a 28-day supply.

The actual coverage a patient receives depends on the rules of their PharmaCare plan, as follows:

  • PharmaCare covers 100% of the eligible cost of Zyban® or Champix® for patients covered under Plan B (Permanent Residents of Licensed Residential Care Facilities), Plan C (Recipients of B.C. Income Assistance), Plan G (No-Charge Psychiatric Medication plan) or Plan W (First Nations Health Benefits).
  • For patients covered by the Fair PharmaCare plan, the amount PharmaCare covers depends on whether the patient has met their annual deductible and/or family maximum.

How does your patient get their prescription smoking cessation drug?

  • Physicians do not need to request Special Authority coverage for an initial 12-week course of treatment with Zyban® or Champix®.
  • Patients do not need to register with HealthLinkBC.
  • Patients do need a prescription and the prescription must specify:
    1. "smoking cessation" as the indication
    2. "no substitutions"
    3. "dispense in 28-day supply"
  • At the pharmacy, your patient will need to sign a Declaration and Notification form when filling their prescription.

Important: PharmaCare covers only the Zyban® version of bupropion for smoking cessation (Wellbutrin®, Wellbutrin XL® and generic bupropion are not covered for this indication). To make sure your patient receives coverage, please indicate the brand name Zyban® and "smoking cessation" on the prescription.

What if your patient needs to change or extend their course of treatment?

Although patients can supplement Smoking Cessation Program coverage by paying any additional cost themselves or by claiming the additional cost through their extended health plan, under exceptional and compelling circumstances, PharmaCare may provide additional coverage.

To request exceptional, case-by-case consideration for additional coverage, physicians can submit a General Special Authority Request form (PDF).

To help PharmaCare process the request quickly and reduce the need for us to contact you for clarification—provide as much information as possible, including:

  • patient diagnosis
  • current therapy (e.g., nicotine gum)
  • benefits of extending or changing the current course of treatment (e.g., severe COPD)
  • reasons for the change or extension (e.g., intolerance, co-existing disease, status of quit attempt)
  • length of treatment needed
  • name and dosage of the alternate product, if desired

Important: Special Authority coverage is not retroactive. Special Authority must be in place before the patient fills the prescription.

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