Chris Monteith - General Motors of Canada LimitedJim Beaudry - CAWSal Cimino - Green Shield Canada

A SMOKING CESSATION PROGRAM

PERSPECTIVE

1) Plan Sponsor

2) Labour

3) Plan Administrator

PERSPECTIVE

1) Plan Sponsor2) Labour

3) Plan Administrator

Plan Sponsor’s Perspective

GMCL/CAW Health and Wellness Program known today as ‘Motoring to Wellness’ launched new smoking cessation program September 2006

Designed for GMCL employees, retirees and their family members

In partnership with Durham Region Health Department and Green Shield Canada

Plan Sponsor’s Perspective

Theme of Fall 2006 campaign Program very timely as the Smoke Free Ontario

Act came into effect May 31, 2006 Key Campaign Messages

– Increase awareness of health effects of tobacco use– Increase awareness of health effects of 2nd hand

smoke– Provide supports to those who wish to quit smoking

Plan Sponsor’s Perspective

Health & Wellness Employee Survey conducted Spring 2006 revealed:– 18.4% GMCL employees were current smokers– 50.5% were considering quitting in the next 6 months

(contemplation) or committed to quitting in next 30 days (preparation)

– 38.3% were not considering quitting

Plan Sponsor’s Perspective

Unique program design included combination of motivation, education and support– Intervention support through pharmacists trained in

clinical tobacco intervention (CTI)– Participants accessing pharmacists support provided

benefit coverage for all NRT– Support material including

• Self-help resources (e.g. websites, phone lines)• CTI trained pharmacist listing

Plan Sponsor’s Perspective

Combination of pharmacotherapy and professional support considered to be program’s key to improve quit rate– GMCL committed to helping participants be

successful – GMCL covered related pharmacist cognitive fees in

addition to NRT costs

Plan Sponsor’s Perspective

180 individuals registered Approximately 50% of those registered took

advantage of the CTI trained pharmacist/NRT coverage offering

Outcomes of that 50% signified success of Program

Health Canada has approved funding support for 2008 Program

PERSPECTIVE

1) Plan Sponsor

2) Labour3) Plan Administrator

Labour’sPerspective

CAW behind initiative 100%– Program excellent example for other sectors of our

Union– Demonstrates value of working closely with benefit

providers to achieve Wellness Program success– Improved quality of life for our members

PERSPECTIVE

1) Plan Sponsor

2) Labour

3) Plan Administrator

Plan Administrator’s Perspective

1) Eligible vs Ineligible benefits

2) Trained Pharmacists

3) Electronic Adjudication

4) Communication

5) Data Mining

Plan Administrator’s Perspective

Eligible vs Ineligible Benefits Oral smoking cessation products (e.g., Champix,

Zyban®) full benefit of the drug plan Nicotine replacement therapy (NRTe.g. patches,

gum) removed from the plan in 2001 due to “unscheduled” status

Programming to “include” the NRT

Plan Administrator’s Perspective

Trained Pharmacists “The intervention was associated with increased

and more highly rated counselling, and a trend toward higher smoking cessation rates, indicating that community pharmacy personnel have the potential to make a significant contribution to national smoking cessation targets.”

Sinclair HK et al. Training pharmacists and pharmacy assistants in the state-of-change model of smoking cessation: a randomised controlled trial in Scotland. Tob Control 1998 Autumn;7(3):253-61

Plan Administrator’s Perspective

Trained Pharmacists About 1,000 CTI trained pharmacists in Ontario

(CTI = clinical tobacco intervention) CTI uses “state-of-change model” for smoking

cessation Engaged chains & banners Over 250 pharmacists committed initially

Plan Administrator’s Perspective

Electronic Adjudication Using the existing claims form CPhA v.3 Tie the “consultative” claim to payment

AND

Allow for ineligible benefits to be eligible on individual basis i.e. pay for patches, gum, etc.

Plan Administrator’s Perspective

Electronic Adjudication Need for pharmacists to understand Presentation was prepared and delivered in

specific areas of concern (e.g. Oshawa, Windsor)

Green Shield website used to inform pharmacists of process; two Green Shield pharmacists dedicated for FAQ & troubleshooting

Plan Administrator’s Perspective

Communication Plan members - basically through GMCL

and CAW with help from Durham Health Pharmacists via mailings, presentations,

faxes, chains, banners

Plan Administrator’s Perspective

Data Mining “How many succeeded?” Also important to note the “persistence”

 Number of Patients

Number Relapsed/ Withdrawn

Number Quit % Quit

By Gender a

Male 47 25 22 46.8%

Female 33 25 8 24.2%

By Employee/Dependent b

Employees 53 28 25 47.2%

Dependents 27 22 5 18.5%

Total 80 50 30 37.5% a p= 0.034, Fisher exact test

b p= 0.011, Fisher exact test

Plan Administrator’s Perspective

Persistence Pierce and Gilpin (2002)1:

– Median duration of OTC NRT use: 14.0 days– Mean duration of OTC NRT use: 28.2 days

Uncontrolled Rx2: 39-45 days (mean)

GMCL intervention group2: 61.2 days (mean)