The demand for nicotine replacement therapies (NRT) is directly related to the level of third-party coverage for NRT products, and inversely related to out-of-pocket costs.

Individuals who face decreased out-of-pocket costs for obtaining NRT products from either insurers or employers are more likely to use NRT, use NRT for longer periods of time, and subsequently use more units of NRT than individuals who face higher out-of-pocket costs. Over-the-counter (OTC) availability of nicotine gum and nicotine patches increased the proportion of smokers using the patch and gum in the period immediately following approval of OTC sale in California; there was also a significantly higher proportion of smokers reporting abstinence through gum and patch use in that period. Making smokers aware of insurance coverage for a pharmacotherapy benefit (such as NRT, bupropion or varenicline) and making it very easy to obtain the medication increases use of the medication and quit rates, even in the absence of insurance coverage for behavioral counseling. However, simply providing coverage for pharmacotherapy, without extraordinary efforts to make smokers aware of the covered benefit and making it easy to obtain, was not shown to increase the use of medication and quit rates.

1. Cox JL, McKenna JP. Nicotine gum: Does providing it free in a smoking cessation program alter success rates. J Fam Pract 1990; 31: 278-280. http://www.findarticles.com/p/articles/mi_m0689/is_n3_v31/ai_8955494
2. Curry SJ, Grothaus LC, McAfee T, Pabiniak C. Use and cost effectiveness of smoking-cessation services under four insurance plans in a health maintenance organization. N Engl J Med 1998; 339 : 673-679. http://content.nejm.org/cgi/content/full/339/10/673
3. Hughes JR, Wadland WC, Fenwick JW, Lewis J, Bickel WK. Effects of cost on the self administration and efficacy of nicotine gum: a preliminary study. Preventive Medicine 1991; 20: 486-496. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1908080&dopt=Abstract
4. Johnson RE, Hollis JF, Stevens VJ, Woodson GT. Patterns of nicotine gum use in a health maintenance organization. Ann Pharmacother 1991; 25: 730-735. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1949928&dopt=Abstract
5. Solberg LI. Impact of insurance coverage on the use and effects of smoking cessation medications. Dis Manage Health Outcomes 2005; 3 (13); 151-158.