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September 18, 2013
Subsidizing smoking cessation would reduce health costs, group says

More Canadians would likely quit smoking if they had group insurance coverage for smoking cessation products, a report by the Cancer Advocacy Coalition of Canada (CACC) says.

In its review of the economic impact of smoking in Canada, the advocacy group urged the adoption of smoking cessation coverage by employers as a low-cost and effective way to reduce incidence rates of cancer.

According to the CACC, Canada has a “postal code lottery of cancer prevention” where the availability of smoking cessation modalities varies widely by province and by employers.  The group was particularly critical of Newfoundland & Labrador and New Brunswick, neither of which has directed public funding toward nicotine replacement products or smoking cessation drugs.  Coverage for these products is available in the other provinces and territories.  However, coverage maximums and treatment durations vary considerably by jurisdiction.  

“An estimated 53 per cent of Canadians have prescription drug coverage through publicly funded plans,” according to a CACC report entitled Discrepancies in public and private funding for smoking cessation products.  “Persons who are not eligible for provincial drug plans may rely on group benefits offered by their employer or a family member’s employer, if such a benefit exists and the employee is eligible.”

However, the group adds, restrictions by insurers, such as plan deductibles, co-payments, annual or lifetime caps or exclusions prevent many individuals from taking full advantage of drug benefit plans to help them quit smoking.

However, in areas such as Atlantic Canada, where fewer employers offer group drug coverage, the opportunity to take advantage of smoking cessation products or medications is especially limited.

“The majority of the uninsured reside in Atlantic Canada, where an estimated 24 to 30 per cent of the population does not have public or private drug insurance,” the CACC report notes. “What remains clear is that access to smoking cessation products through private insurance is inconsistent and depends greatly upon where you live and your employer’s choice of plans.”

The CACC report also focuses on the anomalies within the public health care system.  For example, Ontario spends $10-15 million per year on the smoking cessation medications bupropion (commonly marketed as Zyban®) and varenicline (Champix®), yet spends $1.6 billion annually on tobacco-related illnesses.  Directing more money to products and medications that help current smokers to stop smoking could result in large savings for the public health system, it says.

“The expenditure needed for coverage of smoking cessation pharmacotherapy is very small compared to the billions of dollars’ worth of prescription drugs covered by private insurers for the treatment of smoking-related illnesses,” the CACC reports concludes.

The costs of smoking

Following are some of the costs of smoking, according to the Cancer Advocacy Coalition of Canada:

  • 21 per cent of deaths in Canada are related to smoking.
  • Costs incurred by Canadian employers due to increased absenteeism, higher life and health insurance premiums and decreased productivity:  $4 billion annually.
  • Lost income resulting from premature deaths from smoking:  $6.4 billion.
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