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↩
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
Reimbursement coverage
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 basis28,29
- 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
- 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
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 2022 to the end of December 2023, 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.