Transcript Slide 1

Attempting to increase
the use of smoking
cessation medications
Brendon Baker
Ministry of Health
Most people try to quit without support
Cold Turkey!
Quitting without support
The majority of people who quit this way will
relapse in the first week
Only 2.5%
abstinent
at 1-year
Why do smokers quit without support?
People who smoke
• Don’t believe they need treatment
• Don’t know about treatments
• Can’t access treatments (cost and
availability)
• Don’t believe treatments work
Why do smokers quit without support?
Healthcare professionals
• May lack knowledge / feel unsure about
tobacco dependence and smoking
cessation
• May hold similar beliefs to those of
smokers
• Don’t believe they can help
• Lack resources (time, money) to
help as they might like
Subsidised Pharmacotherapy
•
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•
•
Nicotine replacement therapy
Bupropion (Zyban)
Nortriptyline
Varenicline (Champix) (since 1 November
2010 on ‘special authority’)
Odds ratio (95% CI)
NNT
NRT
1.77 (1.66 -1.88)
17
Bupropion
1.94 (1.72 – 2.19)
13
Nortriptyline
2.34 (1.61 – 3.41)
13
Varenicline
3.22 (2.43 – 4.27)
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Cochrane Library of Systematic Reviews
New Sole Supply NRT agreement in 2011
Pharmaceutical and
formulation Strength Pack size Proposed price
and subsidy
Nicotine lozenge 1 mg 216 $19.94
Nicotine lozenge 2 mg 216 $24.27
Nicotine patch 7 mg 28 $18.13
Nicotine patch 14 mg 28 $18.81
Nicotine patch 21 mg 28 $19.14
• Unlike the currently listed smaller pack sizes,
no rebate would apply to the larger pack sizes
of nicotine lozenges and nicotine patches.
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NRT monthly expenditure
NRT Drug Cost
$1,800,000
$1,600,000
$1,400,000
$1,200,000
$1,000,000
$800,000
$600,000
$400,000
$200,000
$0
Quit Cards
online
1st NY ad campaign &
annual CPI adjustment
Prescribers give On prescription
out Quit Cards
Excise tax
Prescribing of NRT
Prescriptions issued for 21 mg
patches:
• September 09 – 814 (5012 Quit
Cards)
• May 10 – 1802 (8031)
• July 10 – 1847 (5379)
Prescribing of Zyban
Sep 09 – 2168 scripts
July 10 – 3935 scripts
Where to from here?
Māori Affairs Select Committee
recommendations
• Tobacco companies should pay for
meds
• NRT required to be sold everywhere
tobacco is
• Allow Pharmacists to be Quit Card
providers
Conclusions
There has been significant progress
made
More can be done - still 650000
smokers
Potential growth areas:
•
•
•
Prescribers
Champix/Zyban/Nortripyline
Māori Affairs Select Committee Recs