attempting to increase the use of smoking cessation medications brendon baker ministry of health
TRANSCRIPT
![Page 1: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/1.jpg)
Attempting to increase the use
of smoking cessation
medications
Brendon Baker
Ministry of Health
![Page 2: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/2.jpg)
Most people try to quit without support
Cold Turkey!
![Page 3: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/3.jpg)
Quitting without support
The majority of people who quit this way will relapse in the first week
Only 2.5%
abstinent at 1-year
![Page 4: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/4.jpg)
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
![Page 5: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/5.jpg)
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
![Page 6: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/6.jpg)
Subsidised Pharmacotherapy
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) 7
Cochrane Library of Systematic Reviews
• Nicotine replacement therapy• Bupropion (Zyban)• Nortriptyline• Varenicline (Champix) (since 1 November
2010 on ‘special authority’)
![Page 7: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/7.jpg)
![Page 8: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/8.jpg)
New Sole Supply NRT agreement in 2011
Pharmaceutical andformulation Strength Pack size Proposed priceand subsidyNicotine lozenge 1 mg 216 $19.94Nicotine lozenge 2 mg 216 $24.27Nicotine patch 7 mg 28 $18.13Nicotine patch 14 mg 28 $18.81Nicotine 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.
![Page 9: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/9.jpg)
NRT monthly expenditureNRT Drug Cost
$0
$200,000
$400,000
$600,000
$800,000
$1,000,000
$1,200,000
$1,400,000
$1,600,000
$1,800,000
Jul-
06
Au
g-0
6S
ep
-06
Oct
-06
No
v-0
6D
ec-
06
Jan
-07
Fe
b-0
7M
ar-
07
Ap
r-0
7M
ay-
07
Jun
-07
Jul-
07
Au
g-0
7S
ep
-07
Oct
-07
No
v-0
7D
ec-
07
Jan
-08
Fe
b-0
8M
ar-
08
Ap
r-0
8M
ay-
08
Jun
-08
Jul-
08
Au
g-0
8S
ep
-08
Oct
-08
No
v-0
8D
ec-
08
Jan
-09
Fe
b-0
9M
ar-
09
Ap
r-0
9M
ay-
09
Jun
-09
Jul-
09
Au
g-0
9S
ep
-09
Oct
-09
No
v-0
9D
ec-
09
Jan
-10
Fe
b-1
0M
ar-
10
Ap
r-1
0M
ay-
10
Jun
-10
Jul-
10
1st NY ad campaign & annual CPI adjustment
Quit Cards online
Prescribers giveout Quit Cards
On prescription
Excise tax
![Page 10: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/10.jpg)
Prescribing of NRT
Prescriptions issued for 21 mg patches:
• September 09 – 814 (5012 Quit Cards)
• May 10 – 1802 (8031)• July 10 – 1847 (5379)
![Page 11: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/11.jpg)
Prescribing of Zyban
Sep 09 – 2168 scripts
July 10 – 3935 scripts
![Page 12: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/12.jpg)
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
![Page 13: Attempting to increase the use of smoking cessation medications Brendon Baker Ministry of Health](https://reader035.vdocuments.mx/reader035/viewer/2022062423/5697bfcf1a28abf838ca9e41/html5/thumbnails/13.jpg)
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