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Thursday, October 2, 2014
Smoking and Tobacco
Why Are the Nicotine Products So Costly?
It costs so much to try and quit smoking. Why are some of these products prescription only (for example, Chantix)? Other products are just plain costly... the patch, gum and so on.
Thank you. You've posed an interesting question; one that is well worthwhile discussing. There are currently three medications that, in addition to counseling and a good plan for quitting, are proven to be helpful in staying quit. They are nicotine replacement therapies (NRTs), bupropion (also called Zyban or Wellbutrin), and varenicline (also called Chantix). In general, each medication should be used for six weeks to six months with longer use often leading to greater success in remaining clear of cigarettes.
There are three types of nicotine replacements: gum, the patch (transdermal), and lozenges that are available without a prescription, while two others require a prescription: the inhaler and the nasal spray. Generally they run between $3-5 per day for non-prescription and $5-7 per day for the prescriptions. Medicaid and many insurance companies will often pay most or all of the cost. The challenge for many smokers is that they must buy a week or two weeks of medication at a time; therefore instead of shelling out $5 for a pack of cigarettes, they must come up with $35 for two weeks of patches. The cost of nicotine replacement is, however, often lower on a daily basis.
Bupropion is a prescription antidepressant that was found incidentally to be useful in calming cravings for cigarettes. Just checking online today, it runs about $105 for a month's supply - or about $3.50 per day. Chantix runs about $150 per month or $5 per day. Again, Medicaid and many insurers will pick up most of the cost. These drugs are prescription-only for a reason. The have rare but serious side effects, and a consultation with a physician is truly important.
About costs, here's the kicker. Nowadays, the average pack-a-day smoker spends about $5 per day for cigarettes alone. That's $1825 per year. Of course this doesn't count the extra health care costs, time off work, cleaning expenses or life insurance costs. The average employer spends an extra $4200 per year for each smoking employee in increased health care costs, sick time and reduced productivity. Taking all these costs - oh, and also the risk to your life - makes the use of these quit smoking medicines the bargain of a lifetime.
Rob Crane, MD
Clinical Associate Professor of Family Medicine
College of Medicine
The Ohio State University