Patients rarely remain on varenicline in effort to quit smoking

Few patients who are prescribed varenicline to assist in smoking cessation remain on the therapy, according to retrospective data presented during the 45th midyear meeting of the American Society of Health-Systems Pharmacists.

A retrospective review of the pharmacy database of Blue Cross and Blue Shield (BCBS) of Vermont was conducted for members who were prescribed varenicline, yielding 3,758 members who filled 7,911 prescriptions. The mean duration of therapy was approximately 2 months (59.2 days).

About half (47.7%) of members received only 1 prescription for varenicline, and 24.6% received 2 prescriptions.

The recommended initial treatment duration for varenicline is 12 weeks, and for patients who successfully quit smoking, an additional 12 weeks of therapy is recommended to increase the likelihood of long-term abstinence. Allowing for a 7-day grace period, only 8.1% of members completed the recommended continuous 84-day treatment, reported John Grossomanides, PharmD, director of pharmacy at BCBS of Vermont, Montpelier.

Some 39.1% completed 28 days or fewer of therapy. Only 3% completed 2 full 84-day courses.

The proportion of days covered, defined as the number of days with drug divided by the number of days in the specific time interval (maximum of 84 days), was greater than 80% for only 13% of the varenicline courses, indicating low adherence.

The reason for the low duration of treatment and low adherence needs to be explored, said Grossomanides.