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The Ministry of Health has approved the
that has successfully replaced Champix (varenicline) and Zyntabac (bupropion), withdrawn due to the presence of nitrosamines, following alerts from Aemps, such as those issued in July and September 2021.
is marketed by the pharmaceutical company Aflofarm, it was launched in Spain in November 2021 and since then more than 10,000 patients have already been treated in our country.
Following the financing agreement, active since this Wednesday, it becomes the
only financed prescription drug currently available in Spain
The cost of the
for a single 25-day treatment, but now
the price drops to 116 euros
each patient will have to contribute the percentage that corresponds
to them according to their individual health card (TSI), as explained to This means
, secretary of the Spanish Society of Smoking Experts (Sedet) and owner of a pharmacy in Ferrol (A Coruña).
Rey clarifies that
only one attempt per year is financed
: "And the same requirements must be met as for the other drugs that are financed, Champix and Zyntabac, of which no more batches are being manufactured now, due to nitrosamine contamination in both. They are supposed to return, but we don't know when and, for the moment, they are suspended from commercialization. The laboratories themselves were the ones who withdrew them."
Profile of the patient who is a candidate for smoking cessation medication
The steps to be followed by the patient who wants to quit smoking are:
First: go to the doctor
, since it is a drug that needs a prescription.
Second: meet some requirements.
"The principles with which it is financed are the same as with varenicline: that the patient smoke a minimum of 10 cigarettes a day, that they have a clear desire to quit and have a physical dependence score greater than 7 in the
Fagerström test .
, details Rey, who offers the smoking cessation service at his pharmacy.
Andrés Zamorano Tapia
Andrés Zamorano Tapia
, president of the National Committee for the Prevention of Smoking (CNPT), coordinator of the smoking group of the Spanish Society of General and Family Physicians (SEMG) and family doctor at the health center of Villaluenga de la Sagra (Toledo) , is very satisfied with the news:
"When there is a financed treatment, there is an avalanche of patients who want to quit smoking.
If 70% already say they want to quit, when they find out that there is a financed drug, they go to their doctor and they ask him."
Zamorano indicates that in some regions, such as Castilla-La Mancha, financing has not yet been activated: "As it is linked to protocols, it may still take a few days, but financing is authorized from this Wednesday."
For her part, Rey indicates that in Galicia, where she has a pharmacy, doctors could already prescribe it this morning: "The problem is that this morning we still did not have the drug in the pharmacies. Why?
Now they have to change the packaging and appear with the sealed coupon
; that is, you must change the cartonage. So we believe that, at the latest, at the beginning of next week we will already have it".
Of course, Zamorano Tapia insists that
"all cognitive-behavioral treatments, psychological treatments
, which are what we do with patients, should also be financed. This means that many more help points must be opened to quit smoking. Now the patients can go to their doctor, nurse, pharmacist, psychologist... to any nearby health professional to tell them that they want to quit smoking".
The benefits of 'Todacitan', the new drug to quit smoking
, General Director of Aflofarm Spain, points out that "it is especially important to ensure the health of patients and we consider that smoking is one of the great challenges we have in our society. We have been innovating in this regard for years," he explains.
One of the main advantages of Todacitan is
the short duration of treatment, 25 days, compared to the longer duration
required by other pharmacological treatments with the same indication.
In addition, the product does not contain nicotine, unlike other treatments used to quit smoking.
Zamorano recalls that
cytisine, the active ingredient in Todacitan, has been working in Eastern countries for a long time
: "Champix seems to have been based on the cytisine molecule to extract varenicline. Todacitan works practically the same as Champix and even patients say that it has fewer side effects and is quite effective.
Along the same lines,
Rey states that
is "like a distant cousin of Todacitan
In addition to having demonstrated its efficacy in various clinical studies, there are
data on the use of
in routine clinical practice in Spain
, such as those from the
study , the results of which have recently been published in
Archivos de Bronconeumología
In this regard,
, pulmonologist and coordinator of the Tobacco Group of the Spanish Society of Pneumology and Thoracic Surgery in Spain (Separ), explains that "it is a multicenter study, carried out both in primary care and hospital consultations, in which 105 patients were included.77.1% of the patients were satisfied or very satisfied with the treatment.Adherence to treatment was very high, being good or very good in 82.5% of the patients.In addition, 76 % of patients remained abstinent at the end of treatment".
The only thing, Zamorano comments with a sense of humor on the
dosage of the treatment
: "You have to take a
, because at first you have to take six tablets, then five, four... it decreases.
It is a box of 100 pills that you have to take in a month"
, he details.
Rey agrees with him when explaining that
varenicline had better bioavailability
made it easier to take: one in the morning and one at night"
However, he adds that "with cytisine you have to take six tablets the first three days; five tablets the next nine days, two and a half hours apart... It's a bit more annoying for patients, so I I make them like a
the same laboratory has an application for the mobile, and alarms go off"
Pending subject: a national plan against smoking
Apart from the question strictly related to drugs, Zamorano underlines another issue that he is looking forward to with anxiety: the
publication of the Comprehensive Plan for the Prevention and Control of Tobacco
: "This will advance the entire movement. There are several ministries involved, but we already proposed, in the allegations to the PIT, that there be a single governance. It is a great Plan, but it needs to be led by the Presidency of the Government".
On many occasions they have urged the Government of Spain to go ahead with this Plan, even beyond our borders.
Without going any further, last July Florin Dumitru Mihaltan, a Romanian pulmonologist, took office as president of the
giving Spain a slap on the wrist from Brussels: He sent a letter to the President of the Government, Pedro Sánchez, asking him to resume the
Comprehensive Plan for the Prevention of Smoking 2021-2025
This was the
second letter that the Executive leader received in five days
to show his leadership in the fight against tobacco, after the one sent last Friday by the president of the World Federation of Public Health Associations (WFPHA), Luis Eugenio de Souza, with the same
that the Spanish Executive does not leave in a drawer measures already agreed by Health and scientific societies
, such as the
prohibition of smoking on terraces and inside vehicles
, which had the support and acceptance by a large part of society.
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