Government

Quick access to information based on government's structure

Ministry of Health
B.C. Smoking Cessation Program
Page contents last updated on February 22, 2012

Information for Pharmacists

On this page…

Summary of latest updates to the Guide

The Smoking Cessation Program Policies and Procedures for Pharmacists (PDF 429K) document is the detailed and authoritative resource for B.C. Smoking Cessation Program policy and procedures and should be the primary source of information for pharmacists. It will be updated as needed.

LATEST UPDATE: Version 1.4, updated on February 15, 2012. Updates include

  • Removal of reference to different PINs for NRTs obtained from the government’s Product Distribution Centre; PDC PINs are now the same as those used by pharmacies
  • Additional guidelines about coverage options and processing claims for patients covered under certain federal insurance plans

You may also want to download the Quick Reference Sheet (PDF 106K) for pharmacists.

Program Overview

The B.C. government’s Smoking Cessation Program is intended to help B.C residents stop smoking or using other tobacco products by helping 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 B.C. residents who wish to stop using tobacco.

To be eligible for the nicotine replacement therapy products, patients must have valid, active Medical Services Plan coverage.

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

PharmaCare may or may not cover smoking cessation products for patients with federal coverage. See Smoking Cessation Coverage for federally covered patients for details.

When patients choose to pick up their NRTs at a pharmacy, HealthLink BC issues them a reference number that they must present before the pharmacy can dispense the product. This number must be recorded on the patient’s PharmaNet record.

Coverage Details

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 products for a single continuous course of treatment lasting up to 12 consecutive weeks (84 consecutive days).

Applicable plan rules for prescription smoking cessation drugs

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 per cent coverage of the eligible cost of a designated prescription smoking cessation drug.

Coverage for Fair PharmaCare patients is subject to annual income-based deductibles and family maximums. For further details, refer to “Will I have to pay anything for my medications?”

Medications covered under the B.C. Smoking Cessation Program

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

  1. Zyban®, the brand name version of bupropion used for smoking cessation
  2. Champix® (varenicline)
  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, including product DINs and PINs. This list will be updated on an as-needed basis.

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.

Important note on NRT product eligibility for coverage

Only eligible NRT gum and patches (PDF 143K) 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 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 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.

Allowable dispensing fees

Refer to the Smoking Cessation Program Policies and Procedures for Pharmacists for details on dispensing fees for prescription smoking cessation drugs and NRTs.

Program policies and procedures

The B.C. Smoking Cessation Program policies and procedures are set forth in the Smoking Cessation Program Policies and Procedures for Pharmacists (PDF 429K). This document will be updated on an as-needed basis.

Pharmacist activities

For detailed instructions on submitting smoking cessation claims, refer to “Submitting claims” section in the Smoking Cessation Program Policies and Procedures for Pharmacists.

Advising patients before they have registered for the program

Patients do not have to call HealthLink BC to get coverage of prescription smoking cessation drugs. They do have to get a prescription from a physician.

Patients do have to call HealthLink BC at 8-1-1 to get coverage of nicotine replacement therapy products.

When patients choose to pick up their NRTs at a pharmacy, HealthLink BC issues them a reference number. They must bring that number with them to the pharmacy before the order can be filled.

Resources for your patients

More information about the B.C. Smoking Cessation Program

If patients want to learn more about the program, refer them to the:

Information about smoking cessation strategies

For more information on smoking cessation strategies, refer your patients to QuitNow Services (www.quitnow.ca). QuitNow’s services include:

  • 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.
  • 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

Getting NRTs

Patients who are ready to begin using NRTs can call HealthLink BC at 8-1-1 at any time.

When patients fill their prescription smoking cessation drug for the first time

When patients fill their first dispense of the prescription, please remind them that the Coverage of Early Fills of Medication policy applies, and they should therefore not order their refills until they have less than 14 days’ worth of drugs left.

When patients fill their NRT product for the first time

Patients who request nicotine replacement therapy products may or may not have determined which nicotine replacement therapy medication is best for them. Patients may require pharmacist assistance in

  • ensuring that nicotine replacement therapy is the best smoking cessation aid for them, and
  • selecting the best product and strength for their circumstances

Patients are to receive the nicotine replacement therapy product in 3 dispenses of 28 days each. Refer to the “Maximum Days’ Supply Per Fill” policy in the Smoking Cessation Program Policies and Procedures for Pharmacists (PDF 429K) for details.

When patients pick up their first fill of nicotine gum or patches, please remind them that they will need to contact HealthLink BC at 8-1-1 to obtain a new reference number for each subsequent fill. Because the Coverage of Early Fills of Medication policy applies, patients should not order their second or third fill until 14 days after they picked up their previous fill.

For details on entering NRT claims, refer to the section on processing claims for NRT products in the Smoking Cessation Program Policies and Procedures for Pharmacists (PDF 429K).

When patients fill their NRT product for the second and third times

Each fill of an NRT product must be entered into PharmaNet as a separate dispense and must include the HealthLink BC-provided reference number in the SIG field as part of the record.

For details on entering claims for subsequent NRT fills, refer to the sections on subsequent fill policies and processing claims for NRT products in the Smoking Cessation Program Policies and Procedures for Pharmacists (PDF 429K).

When patients report adverse reactions

When patients report adverse reactions during the course of a bupropion, varenicline, or NRT treatment, please advise them as you would for any other adverse reaction and update the information in their PharmaNet medication history. Please also report the adverse reaction to Health Canada through the Health Canada Drug and Health Products’ Adverse Reaction Reporting Program.

If patients have questions about why their prescription smoking cessation medication is not fully covered

Prescription drugs

Patients who are covered under Fair PharmaCare may have to pay for part or all of their prescription costs depending on the degree to which they have met their annual deductible and family maximum. If patients ask you why they have to pay, you can refer them to

NRT products

Patients who present duplicate or age-dated reference numbers for NRTs will not have their claims covered.

Patients who undertook a course of smoking cessation prescription drug treatment for which PharmaCare paid any part of the cost will not be able to obtain free NRTs in the same calendar year.

Those patients should be referred to Health Insurance BC to determine when they will next be able to receive a free supply of NRTs.

Resources for pharmacists

Program Information

Clinical

Information for your Patients