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Ministry of Health
B.C. Smoking Cessation Program

Page contents last updated on October 6, 2011

Information for Prescribers

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Program overview

The B.C. government’s Smoking Cessation Program is intended to help eligible B.C. residents stop smoking or stop using other tobacco products by assisting them with the cost of smoking cessation aids. The program offers coverage for two treatment options: prescription smoking cessation drugs or non-prescription nicotine replacement therapy (NRT) products.

Patient eligibility criteria

The program is open to eligible B.C. residents who wish to stop using tobacco.

To be eligible for the nicotine replacement therapy program, patients must have valid, active MSP coverage.

To be eligible for PharmaCare coverage of prescription smoking cessation drugs, patients must have valid, active MSP coverage and be either registered for Fair PharmaCare or covered by one of the following PharmaCare plans:

How PharmaCare covers prescription smoking cessation drugs

Each calendar year, eligible B.C. residents may receive one or the other of the following options:

  • coverage for one of the designated prescription smoking cessation drugs for a single continuous course of treatment lasting up to 12 consecutive weeks (84 consecutive days). The amount of coverage patients receive will depend upon the applicable plan rules (see below).
  • 100% coverage for one of the designated nicotine replacement therapy (NTR) products for a single continuous course of treatment lasting up to 12 consecutive weeks (84 consecutive days).

Patients who are beneficiaries of Plan B (Permanent Residents of Licensed Residential Care Facilities), Plan C (Recipients of B.C. Income Assistance) or Plan G (No-Charge Psychiatric Medication plan) receive 100% coverage of the eligible cost of Zyban® (bupropion) or Champix® (varenicline).

Patients may have to partially or fully pay for Zyban® (bupropion) or Champix® (varenicline) if they are registered in the Fair PharmaCare plan. The amount that Fair PharmaCare covers is based on the extent to which the patient has met their annual deductible and family maximum. For further details, refer to “Will I have to pay anything for my medications?”

Medications covered under the Smoking Cessation program

PharmaCare covers only the following products as part of the Smoking Cessation Program:

  1. bupropion (Zyban®, the brand name version for smoking cessation)
  2. varenicline (Champix®)
  3. Thrive™ NRT chewing gum in two strengths
  4. Habitrol® NRT patches in three strengths

Refer to the list of eligible smoking cessation medications (PDF 143K) for details. This list will be updated on an as-needed basis.

Handling requests for prescription drugs – key points

  • You do NOT need to obtain Special Authority for an initial 12-week course of treatment with bupropion (Zyban®) and varenicline (Champix®).
  • Patients do NOT need to register for coverage through HealthLink BC for the prescription drugs.

Handling requests for NRTs – key points

  • You do NOT need to write a prescription for either Habitrol® NRT patches or Thrive™ NRT gum. Patients can have these over-the-counter products fully covered under the B.C. Smoking Cessation program without a prescription.
  • Patients DO have to register for the smoking cessation program by phoning HealthLink BC at 8-1-1 before they can obtain their NRT products.

Important note on Zyban® eligibility for coverage

Of the different versions of bupropion, PharmaCare will cover only the Zyban® version as a smoking cessation medication; Wellbutrin®, Wellbutrin XL® and generic bupropion will not be covered as smoking cessation drugs.

To ensure that PharmaNet correctly adjudicates smoking cessation prescription claims, please use the brand name Zyban®, include the indication “smoking cessation,” and add the note “no substitutions” in the written prescription.

Important note on NRT product eligibility for coverage

Only eligible NRT gum and patches will be covered at the designated price as part of the BC Smoking Cessation Program. Any other brands or product types (e.g. lozenges, inhalers) will not be covered, and should not be dispensed as part of this program.

Coverage limits on medication quantity

As individual patients may not require a full 12-week treatment course, PharmaCare has applied a 28‑day quantity limit per prescription fill. Patients cannot obtain the full 12‑week (84‑day) supply of prescription drug or NRTs with a single prescription fill. Instead, patients will receive only 4 weeks’ (28 days’) worth of medication at a time.

Coverage limits for bupropion or varenicline

Over the total course of a treatment, patients are eligible for coverage of up to 84 days worth of medication. There is a maximum 28-day supply per fill except when products are pre-packaged in a 30-day supply. Claims for these products will be accepted.

Coverage limits for NRT patches

Over the total course of treatment, patients are eligible for coverage of up to 84 NRT patches (supplied as 12 boxes with 7 patches in each box).  This quantity is based on the maximum dosing specified in the product monograph. Patients are covered for 4 boxes of patches (total 28 patches) every 28 days.

Coverage limits for NRT gum

Over the total course of treatment, patients are eligible for up to 972 pieces of NRT gum (supplied as 9 boxes with 108 pieces in each box). This quantity is based on the maximum dosing specified in the product monograph. On average, most patients need 3 boxes of NRT gum (total 324 pieces) every 28 days.

Pharmacists, at their discretion, may provide a larger amount of gum for the first 28-day period to patients with higher nicotine replacement requirements (e.g., 4 boxes for the first 28 days instead of 3). The total supply dispensed over the 12 weeks, however, cannot exceed the allowable 972 pieces of gum.

Prescriber participation in Healthy Families BC strategy

In recognition of the importance of helping smokers develop an individualized smoking cessation strategy, the Ministry of Health supports physicians through the Prescription for Health program, part of the Healthy Families BC strategy.

At present, physicians can do brief interventions for tobacco cessation during a regular office visit (series 0100) but only when the patient is already seeing the physician for an underlying medical condition and the physician feels the patient would benefit. If a patient only comes to see a physician to discuss tobacco cessation or to obtain a prescription under the B.C. Smoking Cessation Program, the physician cannot bill for the office visit.

Under the Prescription for Health program, physicians may bill a Personal Health Risk Assessment visit with at-risk patients to develop an illness prevention health promotion plan tailored to the individual’s medical needs and personal situation. 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 GP Services Committee Prevention Incentives 2011 billing guide.

The smoking cessation strategy may or may not include the use of smoking cessation prescription and/or non-prescription medications aids, and may include 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.

Requesting additional coverage

Patients are eligible for coverage of one single continuous course of treatment, lasting up to 12 consecutive weeks (84 consecutive days) with either one NRT product or one prescription drug per calendar year.

Patients who want to supplement coverage available through the B.C. Smoking Cessation Program are free to do so by covering these costs themselves, or through other extended health plans.

Under exceptional and compelling circumstances, PharmaCare may provide additional coverage.

To request additional coverage, physicians are asked to submit a Special Authority request (using the General Special Authority Request form) (PDF 132K) for exceptional case-by-case consideration.

To help us process your Special Authority in the shortest time, and without having to contact you for more information, please provide as much supplemental information as possible, including the:

  • patient’s diagnosis
  • current therapy (e.g., nicotine gum)
  • benefits that would accrue from 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

As with other Special Authority requests, please note that PharmaCare coverage is not retroactive.

Resources for prescribers

Quit Now has smoking cessation resources for healthcare professionals, including

  • a fax referral service, designed to make it easy for health care professionals to refer their patients/clients to QuitNow By Phone for assistance in quitting smoking
  • no-cost materials (such as posters, brochures, pens and fridge magnets) that you can give out to patients
  • a gallery of videos demonstrating tips and techniques for addressing tobacco-use issues with your patients

Resources for supporting patient efforts

  • Program Patient Information Sheet (PDF 489K) — an easy-to-print downloadable document that provides a high-level overview of the program
  • Patient Information Publications in Farsi, French, Korean, Punjabi, simplified and traditional Chinese and Vietnamese
  • detailed online information for patients — including information on eligibility, coverage and registration procedures for the nicotine replacement therapy gums and patches
  • HealthLink BC (phone 8‑1‑1 and ask for the smoking cessation program)

Resources to help patients plan and manage their stop-smoking activities

The QuitNow.ca website has a wide range of resources for patients on planning and managing their smoking cessation activities, including:

  • QuitNow Services NRT usage guide (PDF 526K), which includes practical tips on using nicotine patches and gum, as well as general information about QuitNow Services
  • information, tips, tools and techniques posted in the QuitNow library
  • access to trained CareCoaches®. A phone consultation can be booked at any time of day or night by phoning 8‑1‑1. More information on CareCoaches® is available online at QuitNow by Phone.
  • the Quit Now Online community of peer-to-peer support groups
  • QuitNow By TXT, a 14-week mobile texting service that provides helpful quit smoking tips and motivational support
  • Demonstration videos on how to use nicotine gum and patches

You can also use Quit Now’s fax referral program to connect patients with counsellors.