Pharmacists Manitoba

Smoking Cessation Expression of Interest

All Manitoba Pharmacies and Pharmacists

We are pleased to announce the launch of the Manitoba Smoking Cessation Social Impact Bond, a partnership between the Government of Manitoba, Shoppers Drug Mart and Pharmacists Manitoba. Starting April 1, 2022, participating pharmacies will be compensated for providing smoking cessation assessment, counseling, follow up and smoking cessation implementation strategies to help more Manitobans quit smoking thereby reducing health care costs.

We encourage all eligible pharmacies in Manitoba to express interest to participate in the first phase of the program.

About the Program
The Manitoba Smoking Cessation Social Impact Bond Program will allow pharmacies to be compensated for an initial one-hour assessment ($100) and up to nine (9) follow up counseling sessions ($20 per session up to maximum $180). Patients will also be able to access up to $100 in product subsidy for prescribed first-line smoking cessation pharmacotherapy including unscheduled NRT products. Each patient will have up to a maximum of $380 in smoking cessation support provided by the pharmacist through this program. Patients are eligible for product subsidy and pharmacies are eligible for compensation on an annual basis. The annual date will be based on the date of the patient’s initial assessment, to support those who need multiple attempts to quit.

It is expected that 4,500 smokers will be accepted into the program over a three (3) year period upon a pharmacist’s evaluation of their eligibility and readiness to quit. Patients eligible for this program must be 18 years of age or older, be a Manitoba resident with a valid Manitoba Health card, and consent to participate in the program and have their smoking cessation documentation utilized for program evaluation.

Pharmacists Manitoba is looking for pharmacies with one or more pharmacists authorized by the College of Pharmacists of Manitoba to assess and prescribe medications for smoking cessation to participate in this innovative smoking cessation program. This program is funded by a Social Impact Bond (SIB) and all community pharmacies in the province of Manitoba will be eligible to participate. We encourage all eligible pharmacies to participate in the program over the next three (3) years to improve our success in reducing the number of Manitobans who smoke while establishing pharmacists’ role in health care prevention services.

As you know, community pharmacists are the most accessible health care provider in our health system. Community pharmacists play a key role in preventative health care and connect with patients who may not otherwise be reached. As a key member of the healthcare team, with reach into remote, rural, northern and other underserviced communities, Manitoba pharmacists are well-suited to provide smoking cessation services to citizens in all areas of the province.

Manitoba has allowed authorized pharmacists to prescribe smoking cessation products since 2014, yet cost barriers exist to access these services. Manitoba pharmacists are an underutilized health care resource for those who want to access smoking cessation counseling, medication options, and follow up. Research shows that individuals who received smoking cessation support from authorized pharmacists valued the intervention, found it helpful, and considered the pharmacist-delivered service appropriate.

Program Support
Internet-based Orientation Sessions will be held for all eligible pharmacies and pharmacists prior to program launch in April 2022 to ensure consistency in program implementation and full understanding of program participation requirements by pharmacists and pharmacies.

We will also be offering pharmacy managers/owners an opportunity to participate in optional training to facilitate implementation of professional services into workflow prior to the January implementation date.

Additional support will be provided throughout the three (3) year program to ensure compliance with program objectives, deliverables, and funding. In addition, supports and resources will be made available as needed and as identified by those participating in the program.

Phases of Program Implementation
The program is set to launch on April 1st, 2022.
Application Requirements
To be eligible to participate in this program, pharmacies must:

Have a valid Pharmacy Agreement with The Government of Manitoba, have the ability to submit claims via DPIN and operate within Manitoba. Initial program launch will include those pharmacies operating within the Interlake-Eastern, Northern Health and Prairie Mountain Health RHAs. Following the initial program launch we will be monitoring the achievement of objectives and process Expression of Interest Applications for pharmacies operating in Southern Health-Santé Sud and Winnipeg RHAs as early as possible.
Employ or contract one or more pharmacists with authorization by CPhM to assess and prescribe for smoking cessation:

Participating pharmacists agree to collect smoking cessation data utilizing prescribed program forms and to submit these forms to an evaluation team in a timely manner
Participating pharmacists agree to actively participate in all stages of the smoking cessation program, including evaluation.
Participating pharmacists are up to date with Manitoba’s Personal Health Information Act (PHIA), available at https://web2.gov.mb.ca/laws/statutes/ccsm/p033-5e.php

Both the pharmacies and pharmacists must agree to participate in a mandatory Orientation Session, complete all mandated forms and documentation in full, and commit time and effort to the Readiness to Quit, Initial Assessment, and Follow Up phases of the program. Follow up with patients requires follow up communication and documentation with each enrolled patient.

We encourage all eligible pharmacies in Manitoba to express interest to participate in the first phase of the program. While the initial program will be implemented first in Interlake-Eastern RHA, Northern Health RHA, and Prairie Mountain Health RHA we encourage all eligible pharmacies across Manitoba to express interest at this time.

We will communicate with all pharmacies that respond to this Expression of Interest with confirmation of program start dates regardless of the RHA in which they provide service. The Expression of Interest application and forms are available directly from the Pharmacists Manitoba website www.pharmacistsmb.ca or by contacting our office directly at info@pharmacistsmb.ca.

Please complete Sections A and B of the following application. Section C should be completed by each of your participating and authorized pharmacists. All completed sections must be submitted at the same time.

For additional information, please see the attached Frequently Asked Questions (FAQ) document included with this package.

Expression of Interest Form – PHARMACY Sections A & B

Section A – Contact Information

Section A – Contact Information

Name(s) of Pharmacy Owner(s)/Manager(s) *

Phone Number of Pharmacy Owner(s)/Manager(s) *

Ext. *

Phone Type *
Choose 1

Email *

Pharmacy Name *

Legal Name *

Pharmacy Address *

City *

Province *

Postal Code *

Country *

Where did you first become aware of the Submission process for the QUIT SMOKING with your Manitoba Pharmacist Expression of Interest? *
Choose 1

Section B – Pharmacist Experience and Pharmacy Capacity

B1. Participating pharmacies must employ or contract pharmacists authorized through the College of Pharmacists of Manitoba to prescribe smoking cessation drugs included in Schedule 3 of the Pharmaceutical Regulation.

Please provide the names of the authorized pharmacists working at or contracted at your pharmacy:

Pharmacist 1

First Name

Last Name *

Pharmacist 2 First Name

Last Name

Pharmacist 3 First Name

Last Name

Pharmacy Manager to fill out the questions below

B2. How many smoking cessation clients do you think your pharmacy will be able to see on an average monthly basis? *

B3. Do you have the capacity to incorporate virtual smoking cessation services to the population that you serve? *

Yes

B4. Please identify any resources that Pharmacists Manitoba can provide to support your pharmacy in being successful in this initiative:

Expression of Interest – PHARMACIST Section C
Each Participating Pharmacist to Fill Out
C1. Pharmacist 1 Name: *

Pharmacy Name *

Email Address *

In what year did you successfully complete the CPhM authorization to prescribe for smoking cessation services? *

C2.
We recommend all participating pharmacists complete the Tobacco Interventions for First Nations, Inuit, and Métis Populations course offered through TEACH (register here: https://www.nicotinedependenceclinic.com/en/teach/Pages/Upcoming-Courses---Registration.aspx) or an equivalent course.

Have you taken this course or an equivalent? *

Yes

Would you be willing to take this course or an equivalent prior to April 1, 2022? *
Choose 1

C1. Pharmacist 2 Name:

Pharmacy Name

Email Address

In what year did you successfully complete the CPhM authorization to prescribe for smoking cessation services?

We recommend all participating pharmacists complete the Tobacco Interventions for First Nations, Inuit, and Métis Populations course offered through TEACH (register here: https://www.nicotinedependenceclinic.com/en/teach/Pages/Upcoming-Courses---Registration.aspx) or an equivalent course.

Have you taken this course or an equivalent? *

Yes

Would you be willing to take this course or an equivalent prior to April 1, 2022?
Choose 1

C1 Pharmacist 3 Name:

Pharmacy Name

Email Address

In what year did you successfully complete the CPhM authorization to prescribe for smoking cessation services?

C2. We recommend all participating pharmacists complete the Tobacco Interventions for First Nations, Inuit, and Métis Populations course offered through TEACH (register here: https://www.nicotinedependenceclinic.com/en/teach/Pages/Upcoming-Courses---Registration.aspx) or an equivalent course.

Have you taken this course or an equivalent? *

Yes

Would you be willing to take this course or an equivalent prior to April 1, 2022?
Choose 1

Smoking Cessation Social Impact Bond Signature Page
This page must be signed by the pharmacy owner/manager and all pharmacists participating in the program. The form must be attached to the online application form in order for the Expression of Interest Form to be submitted. Please download, complete and attach in the designated field below. Please ensure the file name is less than 37 characters in order to be received when submitted.

Upload the signed Smoking Cessation Social Impact Bond Signature Page here *