Problem/Objective: Blue Cross and Blue Shield of Minnesota (Blue Cross) members are much more likely to fill prescriptions for a tobacco cessation medication than they are to enroll in the free Blue Prints for Health phone counseling program. The goal of the SCRIPS (Smoking Cessation Referral in Pharmacies) project is to implement health plan level system changes to encourage pharmacy referral to phone counseling.

Methods: Pharmacies and health plans exchange information in real-time regarding coverage and co-pays during the prescription filling process. SCRIPS modified centralized health plan systems to include an automatic referral prompt as part of the benefit information returned to pharmacies. This prompt included the offer to reimburse pharmacies $25 per referral. Following pilot testing, SCRIPS was implemented at a state/national level for Blue Cross members

Results: SCRIPS pilot testing occurred in Fall 2003. Twelve-month follow-up of 269 members enrolled in phone counseling via SCRIPS referral demonstrates 7-day abstinence rates of 16.7% by intent-to-treat (equivalent to 13.6% abstinence for self-referred individuals, p=0.19). Since full scale implementation, SCRIPS has provided 15% of the total enrollment in the Blue Prints phone counseling program. In 2006, 1855 members were referred with 698 enrolling in the phone program.

Conclusions: SCRIPS demonstrates that health plan systems change can increase the role of pharmacists in connecting patients to evidence-based services. This approach capitalizes on existing professional resources (i.e. pharmacists and pharmacy technicians) and existing systems (i.e. real-time pharmacy-to-health plan linkages) and can serve as a model for other health plan, state, or national programs.