Community Pharmacy NRT Fulfillment Program

ASHLine NRT Starter Kits Will Now Be Supplied by Community Pharmacies

Starting July 1, 2020, per changes directed by the Arizona Department of Health Services, ALL eligible clients enrolled with ASHLine will be referred to their community pharmacy for a 2-week NRT starter kit from their preferred pharmacy. Please read this information carefully to avoid workflow disruptions and delays in getting the NRT to ASHLine clients who are ready to quit.

Pharmacy FAQ's

  • What is ASHLine?
    • Housed in the Mel & Enid Zuckerman College of Public Health at the Arizona Center for Tobacco Cessation it has been Arizona’s tobacco Quitline for over 20 years.
    • This program is funded by state tobacco tax dollars allocated by the Arizona Department of Health Services, Centers for Disease Control and Prevention grants, contracts with public and private partners, and research grants.

 

  • What does the ASHLine Tobacco Cessation Program consist of?
    • Provision of OTC nicotine replacement therapy (nicotine gum, patch, lozenge)
    • 3 telephone-based counseling sessions, with 3 weekly check-in calls
    • Client quit materials, Quit Book o Text message support
    • Program completion certificate

 

  • Is the fax from ASHLine considered a prescription?
    • No: The OTC product is being requested by the client and this is an OTC product that is NOT being processed by an insurance company and will NOT be labeled as a prescription. This process was set up for accounting and billing purposes only. Prior to this new program the ASHLine mailed the product out directly to the client. The pharmacist in this case is helping the ASHLine client to select the proper OTC product just as they do now for those patients that have NRT questions in their pharmacy.

 

  • What products are covered?
    • OTC Generic NRT 
Cover (Yes or No) GPI Number Drug Name and Strength Strength UOM Dosage Form Route of Admin Max Qty Limit
YES-OTC, Generics Only 62100005008520 NICOTINE TD DIS 7MG/24HR 7 MG/24HR PT24 TRANSDERMAL 14
YES-OTC, Generics Only 62100005008530 NICOTINE TD DIS 14MG/24HR 14 MG/24HR PT24 TRANSDERMAL 14
YES-OTC, Generics Only 62100005008540 NICOTINE TD DIS 21MG/24HR 21 MG/24HR PT24 TRANSDERMAL 14
YES-OTC, Generics Only 62100010002810 NICOTINE POL GUM 2MG 2 MG GUM MOUTH 100
YES-OTC, Generics Only 62100010002820 NICOTINE POL GUM 4MG 4 MG GUM MOUTH 100
YES-OTC, Generics Only 62100010004710 NICOTINE POL LOZ 2MG 2 MG LOZG MOUTH 81
YES-OTC, Generics Only 62100010004720 NICOTINE POL LOZ 4MG 4 MG LOZG MOUTH 81
  • Are there any limitations?
    • Yes: Each client is eligible for one 2-week supply of NRT in a 12month period.
    • Exception: Pregnant and postpartum clients can receive 2-weeks of NRT up to 4 times per year

 

  • How do I enter this OTC product in my system?
    • OptumRx: BIN: 001553 | PCN: ASHLINE
    • Member ID: ASHLine Number on form
    • Prescriber: Pharmacist name and NPI
    • Qty: 14 patches, 100 pieces of gum, or 81 lozenges
    • Directions: Take as directed by quit coach
    • Note: Use the fax from ASHLine to account for the prescription number if necessary, based on your computer system and company SOP's.

 

  • What is the reimbursement rate for these products?
    • Reimbursement for these products will be at the pharmacy contracted rate with OptumRx.

 

  • What if the ASHLine client has a medical contraindication marked on the form?
    • The pharmacist should use their professional judgement to determine if it is a true contraindication before dispensing which may include contacting the client’s PCP just as you would for another person wanting to quit and use an OTC product. For your
      convenience, the PCP contact information and a fax cover sheet will be included in the fax bundle you will receive from ASHLine.
    • Pregnancy: The U.S. Clinical Practice Guideline states that pregnant smokers should be encouraged to quit without medication based on insufficient evidence of effectiveness and theoretical concerns with safety. Pregnant smokers should be offered behavioral counseling interventions that exceed minimal advice to quit. According to multiple national practice guidelines pregnant smokers should be encouraged to quit without medication based on insufficient evidence of effectiveness and hypothetical concerns with safety. For this reason, the recommended first-line treatment approach for pregnant women who use tobacco is behavioral interventions that exceed minimal advice to quit (Fiore et al., 2008; Siu et al, 2015; ACOG Committee Opinion, 2017).
    • Heart disease: Nicotine activates the sympathetic nervous system leading to an increase in heart rate, blood pressure, and myocardial contractility. Nicotine may also cause coronary artery vasoconstriction. These known hemodynamic effects of nicotine have led to concerns about the safety of NRT use in patients with established cardiovascular disease, particularly those with serious arrhythmias, serious or worsening angina, or those patients in the immediate post-myocardial infarction period (within past 2 weeks). NRT use in patients with cardiovascular disease has been the subject of numerous reviews, and it is widely believed by experts in the field that the risks of NRT in this patient population are small in relation to the risks of continued tobacco use (Benowitz, 2003; Joseph & Fu, 2003; McRobbie & Hajek, 2001; Stead et al., 2012; Mills et al., 2014). The 2008 updated Clinical Practice Guideline concludes that there is no evidence of increased cardiovascular risk with these medications (Fiore et al., 2008)

 

  • I am concerned about privacy-What if an ASHLine client is not a current patient at my pharmacy and I need to leave a message/text that the order is ready? Since I don’t have a signed consent can I still make this call?
    • ASHLine asks each client for verbal consent in their process and will indicate on the fax form that they have received verbal consent for voicemail and/or SMS.
    • Always consult your company policies and options in this case, but keep in mind these clients are expecting to receive a call from the pharmacy

 

  • I thought pharmacists can prescribe NRT due to ARS 32-1979.03?
    • Yes, this is true for pharmacists that have completed the proper training program and are offering a tobacco cessation service in their pharmacy however AHCCCS has not made the necessary changes to their state plan amendment to allow this at this time.
    • AzPA is working with AHCCCS to make this process easier and will also be rolling out a certification program that satisfies the requirements of the statute.
  • What if the client needs more than a 2-week supply?
    • Some eligible AHCCCS members will qualify for an additional 12-week supply of NRT and in this case you will need a prescription to process a claim through AHCCCS.
    • You can use the PCP fax form that comes with your fax bundle to request this prescription from their PCP. It would also be helpful to include the original fax form as documentation of what they are currently taking.
  • Who can I contact if I have additional questions?
    • ASHLine: 1-800-556-6222, Ext. 230 or ecoach@ashline.org
    • OptumRx Pharmacy Help Desk: 1-(855)-577-6310 (24 hours a day, 7 days a week)

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