Adapting prescriptions

On this page: When adaptation is not appropriate │ Claiming adaptation fees│ Resources

Adapting is defined as any of the following:

• Renewing a prescription
• Changing the dose, formulation or regimen
• Making a therapeutic drug substitution within the same therapeutic class

In October 2022, the period of validity for a prescription was extended to 2 years from the written date, and pharmacists were authorized to adapt prescriptions for a wider range of drugs and conditions.

In order for a pharmacist to renew a prescription, the following must apply:

• The prescription was written less than 2 years ago
• The patient has a stable, ongoing medical condition
• The patient has been stable on the same medication and dosage, usually for 6 months or more, and
• The person who prescribed the medication is still registered with their college and practicing

The College of Pharmacists of BC’s Professional Practice Policy 58 (PDF) details the principles and protocols for all prescription adaptations. The college’s website provides detailed information about, for example, what qualifies as an adaptation, obtaining patient consent, the difference between adapting and providing an emergency supply, how to notify prescribers and how to document adaptations.

If a pharmacist adaptation is out of scope or if the pharmacist is unsure whether adaptation is appropriate, they may access the Provincial Prescription Renewal Support Service (PPRSS).

When adaptation is not appropriate

Pharmacists may not adapt prescriptions:

• Written more than 2 years ago
• For a duration that exceeds the expiry date of the original prescription
• Written by a prescriber whose license is temporarily or permanently inactive
• For cancer chemotherapy treatment
• For narcotics, controlled drugs or targeted substances, except for renewals permitted by the section 56 exemption to the federal Controlled Drugs and Substances Act (which limits renewals to the same duration as originally prescribed). Other adaptations—changing the dose, formulation or regimen, or therapeutic substitution—remain prohibited for these drugs
• On which the prescriber has handwritten “do not renew/adapt” or has initialed an electronically produced “do not renew/adapt” notation

Claiming adaptation fees

Pharmacists can claim a PharmaCare adaptation (“clinical service”) fee for:

• Renewing a prescription ($10)
• Changing the dose, formulation or regimen of a prescription ($10)
• Making a therapeutic drug substitution within the same therapeutic class ($17.20)

A pharmacist can claim a maximum of two clinical services fees per drug, per patient during a six-month period. The PharmaCare limit on clinical services fees of $78 per patient per day per pharmacy is unchanged but is under review.

To claim the clinical services fee, pharmacists enter the following in PharmaNet.

1. PRACT ID Ref field: enter P1 (for College of Pharmacists of BC)
2. PRACT ID field: enter pharmacist’s College ID
3. SIG (directions) field: enter Adapted at the beginning of the field; enter any additional directions after
4. Intervention code: see below – an intervention code is required in order for PharmaCare to pay the fee

Refer to the PharmaCare Policy Manual, Section 8.4 – Clinical Services Fees for additional information about adaptations and claiming fees.

The PharmaCare limit on clinical services fees of $78 per patient per day per pharmacy is unchanged but is under review.