Smoking Cessation Program – for prescribers

Overview

The Smoking Cessation Program helps eligible B.C. residents pay for smoking cessation aids. Each calendar year, the program offers coverage for one of two treatment options:

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

Nicotine replacement therapy

To be eligible for NRT coverage, patients must have active Medical Services Plan (MSP) coverage.

Each calendar year (January 1 to December 31), PharmaCare will cover 100% of the cost of a single continuous course of treatment lasting up to 12 consecutive weeks (84 days). 

See the current list of NRT products eligible for full coverage.

How do patients get their NRTs?

Prescription smoking cessation drugs

PharmaCare covers prescription smoking cessation drugs for patients who have active MSP coverage.

Each calendar year, PharmaCare will cover a single continuous course of treatment lasting up to 12 consecutive weeks (84 days) of bupropion (Zyban®) or varenicline generics*. 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:

*Champix® (brand name varenicline) is only a partial benefit under PharmaCare. See Eligible Smoking Cessation Products for low-cost alternatives.

How does my patient get their prescription smoking cessation drug?

  • Physicians don't need to request Special Authority coverage for the initial 12-week course of treatment with Zyban® or varenicline generics
  • Patients don't need to register with QuitNow BC
  • 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"
  • When your patient fills their prescription at a pharmacy for the first time, they will be given a 28-day supply. They can return to the pharmacy near the end of their 28-day supply for a refill

Important: When prescribing Zyban®, indicate both the brand name and "smoking cessation" to ensure your patient receives coverage. PharmaCare covers only the Zyban® version of bupropion for smoking cessation (Wellbutrin®, Wellbutrin XL® and generic bupropion are not covered for this indication).

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

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 circumstances, PharmaCare may permit a change in the currently covered course of treatment (e.g., switching from an NRT to a prescription smoking cessation drug or vice versa).

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 changing the current course of treatment (e.g., severe COPD)
  • Reasons for the change (e.g., intolerance, co-existing disease)
  • Length of treatment needed
  • Name and dosage of the alternate product, if applicable

Important: Special Authority coverage is not retroactive.

Resources

For health professionals

The Ministry of Health supports physicians through the Prescription for Health Program, part of the Healthy Families BC strategy.

Under current MSP billing rules, physicians can conduct brief interventions for tobacco cessation during a regular office visit (series 0100) only if the patient is already seeing the physician for an underlying medical condition. Physicians cannot bill for an office visit if the sole purpose of that visit is to discuss tobacco cessation or to write a prescription under the B.C. Smoking Cessation Program.

However, under the Prescription for Health Program, physicians may bill a Personal Health Risk Assessment visit when developing a health promotion and illness prevention plan tailored to the medical and personal needs of an at-risk patient. Patients who smoke or use other forms of tobacco are considered to be at risk.

Physicians may provide Personal Health Risk Assessments for up to 100 patients per year. For further details on patient eligibility, refer to the billing guide on the General Practice Services Committee website.

The smoking cessation plan may or may not include the use of smoking cessation prescription and/or non-prescription medication aids or other strategies, at the discretion of the prescriber and patient.

For information on program objectives, activities and funding, refer to the Personal Health Risk Assessment Incentive on the General Practice Services Committee website.

For patients