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Cost & coverage

More than half of smokers identified the cost of nicotine replacement therapy as a barrier1*

Points to consider

The cost of NRT is comparable, and often lower than cigarettes saving money can be a good motivator for quitting

* 2262 smokers in Ontario recruited from July 2005–June 2007 participated the Ontario Tobacco Survey, a population-representative telephone-based survey and panel study of adult smokers.1, 2

Map of Canada highlighting provinces that provide reimbursement for nicotine replacement products

NRT Feasibility Calculator

A tool to help visualize short-term NRT costs and debunk the myth that the cost of NRT is higher than cigarettes.

A tool by Primary Care Pharmacist Heather Hadden to help patients understand the relative cost of NRT in compairson to the money they are spending on cigarettes.

Download the NRT Feasibility Calculator spreadsheet
Download
Map of Canada highlighting provinces that provide reimbursement for nicotine replacement products

  • AB Drug Benefit reimburses members for NICODERM® Patch, and NICORETTE® Gum, Inhaler, and QuickMist® up to a lifetime maximum of $5001-4

  • AB public drug plans reimburse members for bupropion5

  • AB public drug plans (AB Drug Benefit List, AB Human Services Drug Benefit Supplement or the Palliative

  • Coverage Drug Benefit Supplement) reimburses members for 12 weeks/year of varenicline6

    • An additional 12 weeks of varenicline is available with special authorization from a physician.

Click here for the Drug Benefit List and view more information here.

Click here for samples.

References

1. Government of Alberta. NICODERM 14 mg/day 14 mg/day Transdermal Patch. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=3cc08c67-53bb-4444-bf19-aeaaf638fd3f&id=0000064088&intchg_grp_nbr=1&detailId=8156370.
2. Government of Alberta. NICORETTE 2 mg Oral Gum. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=dcfd7e41-6fbf-4789-9203-450cd44d1425&id=0000050838&intchg_grp_nbr=1&detailId=8156362.
3. Government of Alberta. NICORETTE Inhaler 10 mg Inhalation Cartridge. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=003ea00d-d05a-4a96-8408-7012fafe6415&id=0000064093&intchg_grp_nbr=1&detailId=8156364.
4. Government of Alberta. NICORETTE QuickMist 1 mg/dose Buccal Spray. Available: https://idbl.ab.bluecross.ca/idbl/drugsList;jsessionid=nRa5IZZUbUWwVtHZFj11JcS0Pr1UV7-gDSeQ6BcJecoQl6atvJcE!578169360?searchTerm=nico&category=&genericName=&brandName=NICORETTE+QUICKMIST+1+MG+%2F+DOSE++++BUCCAL+++SPRAY&ptc=&mfgCode=.
5. Government of Alberta. Zyban 150 mg Oral Sustained-Release Tablet. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=e02b5ea1-34c5-45a1-8a3c-0a8d371fe95a&id=0000014817&intchg_grp_nbr=1&detailId=8156358.
6. Government of Alberta. Champix 0.5 mg Oral Tablet. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=e02b5ea1-34c5-45a1-8a3c-0a8d371fe95a&id=0000036017&intchg_grp_nbr=1&detailId=8152507.

Eligible residents can be covered for one of the following1:

  • NRT products

    • 12 weeks/year of cost-free NRT through the BC Smoking Cessation Program with a valid provincial health card for:

      • NICORETTE® Gum (2 mg, 4 mg)

      • NICORETTE® Lozenge (2 mg, 4 mg)

      • NICORETTE® Patch (7 mg, 14 mg, 21 mg)

    • Must be enrolled in the Medical Services Plan

    • No prescription is required

  • Prescription smoking cessation drugs

    • 12 consecutive weeks per 12-month period through BC Pharmacare

    • Must be covered under one of the following PharmaCare plans: Fair Pharmacare, Residential Care (Plan B), B.C. Income Assistance (Plan C), Psychiatric Medications (Plan G), or First Nations Health Benefits (Plan W)

    • Under exceptional circumstances, PharmaCare may cover a course of NRTs in the same calendar year as a prescription drug by a Special Authority request

Click here for the most up-to-date information.

Click here for samples.

References

1. Government of British Columbia. Get help quitting Tobacco. Available: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents/what-we-cover/bc-smoking-cessation-program.

  • SK Public Drug Program reimburses members (>65 or on social assistance) for bupropion and varenicline 1,2

  • Members are limited to 12 weeks/year of treatment with varenicline

Click here for the most up-to-date information.

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References

1. Government of Saskatchewan. Zyban | Bupropion HCL. Available: https://formulary.drugplan.ehealthsask.ca/SearchFormulary/BG/814645.
2. Government of Saskatchewan. Drug Details Varenicline Tartrate. Available: https://formulary.drugplan.ehealthsask.ca/SearchFormulary/BG/812512.

  • The Tobacco Quit Card and Counselling Program has recently expanded to provide province-wide access to NRT for low-income Manitobans who have no other coverage options1

    • The quit card can be used to redeem up to $300 in NRT support at any pharmacy of choice, as well as counselling sessions with a healthcare professional

  • MB Pharmacare reimburses members for bupropion and varenicline2

Click here for the most up-to-date information.

Click here for samples.

References

1. Government of Manitoba. Manitoba Government Expands Program to Help Manitobans Quit Smoking Provincewide. Available: https://news.gov.mb.ca/news/index.html?item=57157.
2. Government of Manitoba. Manitoba Drug Benefits Formulary. Available: https://residents.gov.mb.ca/forms.html?d=details&pub_id=10541&filter_keyword=drug%20benefits.

  • In Ontario, patients with a Family Health Team (FTF), Community Health Centre, Nurse Practitioner Led Clinic, or Addictions Agency are eligible for the CAMH Smoking Treatment for Ontario Patients (STOP) program, which provides free NRT as either monotherapy or combination therapy1

  • The STOP Program is a province-wide initiative delivering smoking cessation treatment for up to 26 weeks of free NRT and counselling support2
    The STOP on the NET Program provides free NRT for 10 weeks of treatment that can be mailed to patients’ homes within 2 weeks of enrollment3

  • Eligible patients can register themselves online, without assistance from a healthcare practitioner1

  • Find more information about the STOP and STOP on the NET Programs here

  • The Ontario Drug Benefit program provides reimbursement for bupropion and varenicline for smoking-cessation treatment, in conjunction with smoking-cessation counselling4,5
    Treatment with each agent is limited to 12 weeks/year/patient (168 tablets) of reimbursement

Click here for samples.

References

1. The Centre for Addiction and Mental Health. Welcome to STOP. Available: https://www.nicotinedependenceclinic.com/en/stop/home.
2. The Centre for Addiction and Mental Health. About the STOP Program. Available: https://www.nicotinedependenceclinic.com/en/stop/about-the-stop-program.
3. The Centre for Addiction and Mental Health. Join STOP on the Net. Available: https://www.nicotinedependenceclinic.com/en/stop/stop-on-the-net.
4. Government of Ontario. Limited Use Note(s) Bupropion HCL. Available: https://www.formulary.health.gov.on.ca/formulary/limitedUseNotes.xhtml?pcg9Id=920000632.
5. Government of Ontario. Limited Use Note(s) Varenicline Tartrate. Available: https://www.formulary.health.gov.on.ca/formulary/limitedUseNotes.xhtml?pcg9Id=920000630.

  • In Quebec, if two NRT formats (e.g. patch + gum) are included on the same prescription, RAMQ will reimburse for the combination1

    • NRT patch, gum, and lozenge

    • Bupropion

    • Varenicline

  • If obtained by prescription, Régie de l’assurance maladie du Québec (RAMQ) reimburses members for1,2:

  • Members can receive NRT reimbursement for a maximum of 12 consecutive weeks per year (max. 840 lozenges or pieces of gum)1

    • During the same 12 weeks, both patch and gum/lozenges may be reimbursed together if written on the same prescription

  • Bupropion and varenicline are also covered for 12 consecutive weeks per year2

    • For varenicline, coverage may be extended by 12 weeks, provided that one has stopped smoking

  • All employer sponsored drug plans are required to provide comparable reimbursement for stop smoking medications as the government plan3

Click here for the most up-to-date information.

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References

1. Régie de l’assurance maladie. Stop-smoking products: Conditions for coverage. Available: https://www.ramq.gouv.qc.ca/en/citizens/prescription-drug-insurance/know-conditions-coverage.
2. Régie de l’assurance maladie. List of Medications. Available: https://www.ramq.gouv.qc.ca/sites/default/files/documents/liste-med-2022-11-09_en.pdf.
3. Régie de l’assurance maladie. Minimal conditions of coverage. Available: https://www.ramq.gouv.qc.ca/en/citizens/prescription-drug-insurance/information-private-plans.

  • Combination therapy coverage may be considered under the special authorization process for beneficiaries at least 18 years old1

  • Special authorization process form can be found here

  • A provincial smoking cessation program is available for adults who are registered under the Newfoundland and Labrador Prescription Drug Program Access, Foundation (Income Support), or 65+ plans2

  • An individual can receive up to 12 continuous weeks of one nicotine replacement product (patch, gum, lozenge, or inhaler) or one prescription drug (varenicline or bupropion) within a 365 period2

Click here for the most up-to-date information.

Click here for samples.

References

1. Government of Newfoundland and Labrador. Drug Information Nicoderm Patch 14 mg. Available: https://www.health.gov.nl.ca/health/prescription/class_search_nl.asp?din=80044503&GReturn=GenericName&Subtitle1=Generic%20or%20Brand%20Name%20:%20%20%20&Subtitle2=nicotine.
2. Government of Newfoundland and Labrador. Newfound and Labrador Smoking Cessation Program (under NLPDP). Available: https://www.gov.nl.ca/hcs/files/healthyliving-pdf-pscp-health-care-provider-brochure.pdf.

  • Drug Plans ADEFG and V annually reimburse members for the patch, lozenge, or gum1

  • Special authorization is required for additional reimbursement of bupropion or nicotine patches1

  • NB Pharmacare reimburses members for bupropion and varenicline2

  • For varenicline, members are limited to 12 weeks of reimbursement annually2

  • For bupropion, coverage may be extended by 12 weeks by special authorization if some success has been achieved2

  • Those who have already completed a full bupropion course are not eligible for varenicline in the same fiscal year2

Click here for the most up-to-date information.

Click here for samples.

References

1. Government of New Brunswick. Smoking Cessation Therapies. Available: https://www2.gnb.ca/content/gnb/en/departments/health/MedicarePrescriptionDrugPlan/NBDrugPlan/ForHealthCareProfessionals/SmokingCessationTherapies.html.
2. Government of New Brunswick. New Brunswick Drug Plans Formulary. Available: https://www.gnb.ca/0212/pdf/NBPDP_Formulary-e.pdf.

  • A Quit Smoking program is available for eligible PEI Medicare plan members (>65 or on social assistance); it covers 100% of the cost of NRT, varenicline, or bupropion1

Click here for the most up-to-date information.

Click here for samples.

References

1. Government of Prince Edward Island. Quit Smoking. Available: https://www.princeedwardisland.ca/en/information/health-and-wellness/quit-smoking.

  • NS Pharmacare reimburses members for bupropion and varenicline for 12 weeks1

Click here for the most up-to-date information.

Click here for samples.

References

1. Pharmacy Association of Nova Scotia. Quit Smoking Programs. Available: https://pans.ns.ca/quit-smoking-programs.

Non-Insured Health Benefit Plan (NHIB):

  • The NIHB reimburses plan members (eligible registered First Nations and recognized Inuit) for NRT (gum, inhaler, lozenge, patch), bupropion, and varenicline on an annual basis28

    • Nicotine gum and lozenges are covered for 945 pieces per year30,31

    • The NICORETTE® Inhaler is limited to 945 doses per year32

    • Up to 252 nicotine patches of any listed brand33

    • NICORETTE® QuickMist® is limited to 3450 sprays per year34

    • Varenicline is limited to 330 tablets/year35

    • Bupropion is limited to 360 tablets/year35,29

  • Recipients are eligible to receive up to three treatment courses of NRT/year with quantity limits, which include two courses of NRT patches and one course of NRT products used PRN (i.e. gums, lozenges, inhalers)29

Coupons are available to help defray the cost.In all provinces, members of the Funding for Smoking Cessation Aids on the Public Service Health Care Plans are eligible for reimbursement for all smoking cessation aids to a maximum lifetime limit of $1000.36 In other provinces where one format is covered, consider advising your patients to purchase the second format themselves.

The Smokers’ Helpline NICODERM® / NICORETTE® Combination Therapy Trial Offer37,38

Smokers’ Helpline provides counselling and support services in PEI, Ontario, Manitoba, Saskatchewan, and Yukon. If you reside outside of those provinces, you may still receive the Trial Pack offer.†

† Trial packs offered from December 2024 to the end of December 2025, or while supplies last.

Privately sponsored drug plans

While 73% of privately (i.e. employer) sponsored drug plans provide coverage for prescription smoking medicines, only 25–40% cover NRT patches, gums, lozenges, mouth sprays or inhalers.39

  • Of the 73%, approximately 16% have annual maximums and 48% have lifetime maximums on the amounts which can be claimed

  • Of those plans covering NRT products, an estimated 31% have annual maximums and 38% have lifetime maximums on amounts reimbursed

Percentage of plan subscribers with smoking cessation product coverage under The Great-West Life Assurance Company and Sun Life Financial drug plans40


Province

Nicotine Patches %

Nicotine Gum %

Varenicline %

Bupropion %

BC

23

23

56

54

AB

17

17

62

60

SK

14

14

74

73

MB

27

27

66

52

ON

18

20

60

59

QC

100

100

100

100

NB

40

40

65

62

PE

28

28

76

75

NS

37

37

66

64

NF

29

30

61

58

Canada

34

35

68

66

Adapted from McDonald J et al., 2013-2014.

References

1. Bondy SJ, Diemer LM, Victor JC, et al. Assessing the Reach of Nicotine Replacement Therapy as a Preventive Public Health Measure. Chronic Dis Injur Can 2012;33(1):19-28.
2. The Ontario Tobacco Research Unit. OTS Technical Documentation. Available: https://www.otru.org/topics/cessation/ots-technical-documentation/.
3. Government of British Columbia. Get help quitting Tobacco. Available: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents/what-we-cover/bc-smoking-cessation-program.
4. Government of Alberta. NICODERM 14 mg/day 14 mg/day Transdermal Patch. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=3cc08c67-53bb-4444-bf19-aeaaf638fd3f&id=0000064088&intchg_grp_nbr=1&detailId=8156370.
5. Government of Alberta. NICORETTE 2 mg Oral Gum. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=dcfd7e41-6fbf-4789-9203-450cd44d1425&id=0000050838&intchg_grp_nbr=1&detailId=8156362.
6. Government of Alberta. NICORETTE Inhaler 10 mg Inhalation Cartridge. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=003ea00d-d05a-4a96-8408-7012fafe6415&id=0000064093&intchg_grp_nbr=1&detailId=8156364.
7. Government of Alberta. NICORETTE QuickMist 1 mg/dose Buccal Spray. Available: https://idbl.ab.bluecross.ca/idbl/drugsList;jsessionid=nRa5IZZUbUWwVtHZFj11JcS0Pr1UV7-gDSeQ6BcJecoQl6atvJcE!578169360?searchTerm=nico&category=&genericName=&brandName=NICORETTE+QUICKMIST+1+MG+%2F+DOSE++++BUCCAL+++SPRAY&ptc=&mfgCode=.
8. Government of Alberta. Zyban 150 mg Oral Sustained-Release Tablet. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=e02b5ea1-34c5-45a1-8a3c-0a8d371fe95a&id=0000014817&intchg_grp_nbr=1&detailId=8156358.
9. Government of Alberta. Champix 0.5 mg Oral Tablet. Available: https://idbl.ab.bluecross.ca/idbl/drugDetails?_cid=e02b5ea1-34c5-45a1-8a3c-0a8d371fe95a&id=0000036017&intchg_grp_nbr=1&detailId=8152507.↩
10. Government of Saskatchewan. Zyban | Bupropion HCL. Available: https://formulary.drugplan.ehealthsask.ca/SearchFormulary/BG/814645.
11. Government of Saskatchewan. Drug Details Varenicline Tartrate. Available: https://formulary.drugplan.ehealthsask.ca/SearchFormulary/BG/812512.
12. Government of Manitoba. Manitoba Government Expands Program to Help Manitobans Quit Smoking Provincewide. Available: https://news.gov.mb.ca/news/index.html?item=57157.
13. Government of Manitoba. Manitoba Drug Benefits Formulary. Available: https://residents.gov.mb.ca/forms.html?d=details&pub_id=10541&filter_keyword=drug%20benefits.
14. The Centre for Addiction and Mental Health. Welcome to STOP. Available: https://www.nicotinedependenceclinic.com/en/stop/home.
15. The Centre for Addiction and Mental Health. About the STOP Program. Available: https://www.nicotinedependenceclinic.com/en/stop/about-the-stop-program.
16. The Centre for Addiction and Mental Health. Join STOP on the Net. Available: https://www.nicotinedependenceclinic.com/en/stop/stop-on-the-net.
17. Government of Ontario. Limited Use Note(s) Bupropion HCL. Available: https://www.formulary.health.gov.on.ca/formulary/limitedUseNotes.xhtml?pcg9Id=920000632.
18. Government of Ontario. Limited Use Note(s) Varenicline Tartrate. Available: https://www.formulary.health.gov.on.ca/formulary/limitedUseNotes.xhtml?pcg9Id=920000630.
19. Régie de l’assurance maladie. Stop-smoking products: Conditions for coverage. Available: https://www.ramq.gouv.qc.ca/en/citizens/prescription-drug-insurance/know-conditions-coverage.
20. Régie de l’assurance maladie. List of Medications. Available: https://www.ramq.gouv.qc.ca/sites/default/files/documents/liste-med-2022-11-09_en.pdf.
21. Régie de l’assurance maladie. Minimal conditions of coverage. Available: https://www.ramq.gouv.qc.ca/en/citizens/prescription-drug-insurance/information-private-plans.
22. Government of New Brunswick. Smoking Cessation Therapies. Available: https://www2.gnb.ca/content/gnb/en/departments/health/MedicarePrescriptionDrugPlan/NBDrugPlan/ForHealthCareProfessionals/SmokingCessationTherapies.html.
23. Government of New Brunswick. New Brunswick Drug Plans Formulary. Available: https://www.gnb.ca/0212/pdf/NBPDP_Formulary-e.pdf.
24. Government of Prince Edward Island. Quit Smoking. Available: https://www.princeedwardisland.ca/en/information/health-and-wellness/quit-smoking.
25. Pharmacy Association of Nova Scotia. Quit Smoking Programs. Available: https://pans.ns.ca/quit-smoking-programs.
26. Government of Newfoundland and Labrador. Drug Information Nicoderm Patch 14 mg. Available: https://www.health.gov.nl.ca/health/prescription/class_search_nl.asp?din=80044503&GReturn=GenericName&Subtitle1=Generic%20or%20Brand%20Name%20:%20%20%20&Subtitle2=nicotine.
27. Government of Newfoundland and Labrador. Newfound and Labrador Smoking Cessation Program (under NLPDP). Available: https://www.gov.nl.ca/hcs/files/healthyliving-pdf-pscp-health-care-provider-brochure.pdf.
28. Government of Canada. Who is eligible for the Non-Insured Health Benefits program. Available: https://www.sac-isc.gc.ca/eng/1574187596083/1576511384063.
29. Government of Canada. Non-Insured Health Benefits: Drug benefit list. Available: https://www.sac-isc.gc.ca/eng/1572888328565/1572888420703.
30. Express Scripts. Online Drug Benefit Details Nicorette 2mg Gum. Available: https://nihb-ssna.express-scripts.ca/en/0205140506092019/16/160407.
31. Express Scripts. Online Drug Benefit Details Nicorette 2mg Lozenge. Available: https://nihb-ssna.express-scripts.ca/en/0205140506092019/16/160407.
32. Express Scripts. Online Drug Benefit Details Nicorette 10mg/Cartridge Inh. Available: https://nihb-ssna.express-scripts.ca/en/0205140506092019/16/160407.
33. Express Scripts. Online Drug Benefit Details Nicoderm 14 mg/24 hr Patch. Available: https://nihb-ssna.express-scripts.ca/en/0205140506092019/16/160407
34. Express Scripts. Online Drug Benefit Details Nicorette QuickMist Oral Spr. Available: https://nihb-ssna.express-scripts.ca/en/0205140506092019/16/160407.
35. Government of Canada. Non-Insured Health Benefits program updates. Available: https://www.sac-isc.gc.ca/eng/1578079214611/1578079236012#s23-01-a2.
36. Government of Canada. Public Service Health Care Plan summary. Available: https://www.canada.ca/en/treasury-board-secretariat/services/benefit-plans/health-care-plan/public-service-health-care-plan-glance.html.
37. Smokers’ Helpline. NICODERM®/NICORETTE® Combination Therapy Trial Offer. Available: https://smokershelpline.ca/trial-pack/trial-offer.
38. Smokers’ Helpline. NICODERM®/NICORETTE® Combination Therapy Trial Offer FAQ. Available: https://smokershelpline.ca/trial-pack/faq.
39. PDCI Market Access. Nicotine Replacement Therapy: The Case & Roadmap for Comprehensive Private Coverage. 2018.
40. McDonald J, Coady K, Saltman D. The postal code lottery of cancer prevention in Canada: Discrepancies in Public and Private Funding for Smoking Cessation Products. Cancer Advocacy: Report Card on Cancer in Canada 2012-13, 2013.