Impact Evaluation of theBC Smoking Cessation Program

2016 CADTH SymposiumElaine Chong, Anne Nguyen, Shelley Canitz, HealthLink BC, Product Distribution Centre,Kelly Uyeno, Eric Lun

Speaker Disclosure

I have no actual or potential conflict of interest in relation to this topic or presentation.

2

Agenda Background

Program Evaluation

Operational Improvement

BC Stats Survey

2016 Program Refresh

Discussion and Questions

3

Background Program launch September 2011

No-cost nicotine replacement therapy products (NRTs) Phone registration through HealthLink BC at 8-1-1 Choice of pharmacy pick-up or free mail delivery

PharmaCare coverage of bupropion or varenicline By prescription only, and dispensed at pharmacy

Annual coverage up to 12 consecutive weeks

4

Background

Broad reach> 25% of BC smokers = 187,000 patients

Substantial investmentTotal expenditure for NRTs and prescription drug

coverage (to March 2015): $38.2 million

 

5

Program EvaluationHow well was the Program working?

How can processes be improved?

Operational review Focus was to characterize and determine registration

preferences, accessibility, and interest in behavioural support

No operational changes for prescription drugs

6

Update – NRT Registration Goals of registration component:

Accessible (24/7/365) method Clinical interface for the Program (“safety net”) Behavioural therapy support (QuitNow Services)

Results: success in meeting intended goals Clinical interface and behaviour therapy support

not used/needed as Program matured Ongoing staffing constraints

7

Update – NRT Distribution Goals of distribution component:

Choice of two timely and flexible mechanisms Results: success in meeting intended goals Majority choose pharmacy distribution

Consistent across all health authorities Pharmacy-only distribution model acceptable as per

previous conversations NRT supply and pharmacy distribution are

stable

8

9

Your Doctor

Your Pharmacist

Shipping

Get your prescription

Fill the prescription at your pharmacy

QuitNowServices

You decide to try bupropion (Zyban®)

or varenicline (Champix®)

You decide to try an NRT gum or patch

Your Pharmacist

You ask to pick up the nicotine gum or patches at your pharmacy

Fill the order at your pharmacy

You ask for the nicotine gum or patches to be

mailed directly to you

Your nicotine gum or patch is mailed to you

Nicotine gum or patchPrescription

Rx

YOU

2. You want more information

Call 8-1-1

Visit your doctor

1. You want to try bupropion (Zyban®) or varenicline (Champix®)

or get advice from your doctor

Your doctor and you will discuss what

medications are best for you.

Your pharmacist and you will discuss tips on

how best to take the prescription drug.

3. You want to try a nicotine replacement

therapy (NRT) gum or patch

Call 8-1-1 to register

QuitNow Services will answer your questions and help you with your

stop-smoking plans.

Your pharmacist and you will discuss which nicotine gum or patch will work best

for you.

HealthLink BC will help you register for the Smoking

Cessation Program.

HealthLink BC will place your order for the nicotine gum or

patch or give you a Reference Number for use at a pharmacy.

Getting your smoking cessation aids

HealthLink BC

HealthLink BC

HealthLink BC will answer your questions about the B.C.

Smoking Cessation program.

You need more information and/or support

Operational Improvements Streamline operations – simplify registration process and

maintain pharmacy distribution model only

10

11

Operational Improvements

Operational Improvements New: Declaration Form (required for each dispense)

Purpose: Self-declaration as a smoker Affirmation of pharmacist obligations

NRTs dispensed Update patient address and phone number Update PharmaNet record Records subject to PharmaCare audit

Future program evaluation

12

Operational Improvements New: Request-for-Proposals for NRT Products Last RFP from summer 2011 (Habitrol®, Thrive®) Current contract will expire RFP launched and completed in Fall 2015

Nicoderm® patch Nicorette® gum, lozenge, inhaler

Transition phase provided

13

Program Evaluation

Did the Program help British Columbians quit smoking?

BC Stats Survey Focus was to characterize and determine the impact

of the Program (NRT component) Future evaluation to include prescription drugs

14

BC Stats Survey Central statistical agency of BC

Inform decision making and policy development British Columbia Statistics Act, R.S.B.C. 1996, C. 439

Survey conducted in early 2015 Assess Program impact on 3,000 NRT recipients Results posted on the PharmaCare website: http://

www2.gov.bc.ca/assets/gov/health/health-drug-coverage/pharmacare/smokingcessationevaluationreport.pdf

15

16

17

18

BC Stats Survey The Program is effective

27% quit smoking 76% were smoking less than before 71% made at least one quit attempt 52% remained smoke free for more than 30 days 65% strongly agreed or agreed that the Program

helped them quit smoking

19

2016 Program Simplified registration process

Registration through HealthLink BC discontinued Pharmacy distribution only (self-declaration)

New products Nicoderm® patch Nicorette® gum, lozenge, inhaler

Collaboration with tobacco control programs in BC health authorities

20

Discussion and Questions

21