PharmaCare Newsletter

Last updated on November 13, 2025

November 2025 PharmaCare Newsletter

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Q: How does the weight loss effect of tirzepatide subcutaneous (Zepbound™) compare to semaglutide subcutaneous (Wegovy®) in people without type 2 diabetes?

A: The answer is in the current edition of PAD Refills. Make sure to subscribe so you don’t miss out on news and updates!

Provincial Prescription Renewal Support Service ends

The Provincial Prescription Renewal Support Service (PPRSS) officially ended on October 31, 2025.

PPRSS supported pharmacists in delivering timely care to patients without a primary care provider. Introduced as a temporary measure, the service enabled prescription renewals in circumstances where pharmacists previously lacked authority. Since launching in 2022, the service managed over 2,000 prescription renewal requests.

With the expanded pharmacist authority introduced in October 2022 and August 2024, allowing pharmacists to adapt and renew prescriptions and order and interpret laboratory tests, the need for PPRSS has significantly decreased.

The Ministry of Health remains committed to future collaboration with pharmacy partners, including frontline pharmacists, to develop services that meet evolving practice needs and improve access and quality of care for B.C. residents.

The Ministry of Health sincerely thanks all pharmacists who used and supported PPRSS.

Resources

Additional private COVID vaccines available

The following two COVID-19 vaccines are available for private purchase during B.C.’s 2025-26 viral respiratory campaign, which began on October 14, 2025.

  • Spikevax, PIN 66128581
  • Comirnaty, PIN 66128582

For more information on vaccines and procedures for entering claims in PharmaNet, visit Publicly funded vaccines. This article is an update to the flu season vaccines announcement made in the October 2025 PharmaCare Newsletter (PDF, 218KB).

Resources

Updates to PPRP formulary review

In June 2025, the Canadian provinces and territories finished a multi-year evaluation of how plasma protein and related products (PPRP) are submitted, reviewed and listed on the national PPRP formulary. The national PPRP formulary is managed by Canadian Blood Services (CBS); except for Quebec, which has its own blood operator. The evaluation was done to better align PPRP processes with how drugs are reviewed for pharmaceutical formularies.

Representatives from provincial and territorial Health Ministries led the evaluation, collaborating with Canada’s Drug Agency (CDA-AMC), CBS and other key partners. Deputy Ministers of Health approved a set of recommendations, which included revised eligibility criteria for PPRPs and an aligned PPRP review process for the national formulary. On September 25, 2025, CDA-AMC formally announced the end of the review.

Revised eligibility criteria for PPRPs

A key objective of the evaluation was revising eligibility criteria for PPRPs to be listed on the national formulary. The revised eligibility criteria:

  • Address challenges arising from novel therapies that treat conditions which have historically been treated with plasma-derived products
  • Provide clearer direction for how novel therapies (e.g., monoclonal antibodies) will be reviewed for listing on public drug plans
  • Reduce uncertainty for manufacturers, patient groups, and payors

Products that do not meet the criteria may be reviewed through CDA-AMC’s Reimbursement Review process to determine if they will be listed on provincial or territorial drug plans. Manufacturers can complete the CDA-AMC eligibility inquiry form (DOCX, 166KB) to find out if their product is eligible for review.

Aligned PPRP review process

Under the new aligned PPRP review process, the Canadian Expert Drug Committee (CDEC) is responsible for reviewing PPRPs and providing listing recommendations. Clinical specialists advise the review teams and participate in expert committee deliberations. Based off CDA-AMC and CBS’ prior Interim PPRP Review process, the new review process has CDEC taking on the role of the Canadian Plasma Protein Product Expert Committee (CPEC).

For more details on the evaluation findings and the new PPRP eligibility criteria and review process, refer to Pharmaceutical Reviews Update – Issue 59.

Resources

New direction for pharmacies using PPM version 70 software to claim special services fees

PharmaCare has posted new directions for pharmacies using software updated to support Provincial Prescription Management (PPM) to claim special services fees for refusing to fill a prescription.

  1. If the prescription authorization has not been uploaded to PharmaNet (i.e., for paper or faxed prescriptions received at the pharmacy), upload the prescription with the details as written by the prescriber. Do not perform a dispense/claim adjudication.
  2. Update the prescription authorization status to ‘O – Obsolete’ by submitting a TRX-X2 transaction.
  • Ensure the following are entered as this information is used by PharmaCare to provide payment to pharmacies
    • Reason Code = RF (Refusal to Fill)*
    • Medication Management Intervention (MMI) code = RTF (Refusal to Fill)*
    • Clinical Service (CS) code = as appropriate, refer to table below
Clinical Services (CS) codes
CS Code Description
ATPR ALLERGY TO PRODUCT IS ON RECORD
CGDS CONSULTED PRESCRIBER – CHANGED DOSAGE
CGIN CONSULTED PRESCRIBER – CHANGED INSTRUCTIONS FOR USE
DNGR DANGEROUSLY HIGH DOSE
DUPL THERAPEUTIC DUPLICATION
FALS FALSIFIED/ALTERED PRESCRIPTION
MULT MULTI-DOCTORING / MULTI-PHARMACY
PADR PRIOR ADVERSE REACTION
PINE PRODUCT IS NOT EFFECTIVE
PTOA POTENTIAL OVERUSE/ABUSE
QPNR QUANTITY PRESCRIBED IS NOT RATIONAL
SDTD SIGNIFICANT DRUG INTERACTION (DRUG-TO-DRUG)
SUBD SUB-THERAPEUTIC DOSE
TFLR TREATMENT FAILURE

*Note: Some software may automatically populate the Reason and MMI codes based on workflow prompts and selections by the user.

Performing this action will prevent the prescription authorization from being filled in the future. It is important the pharmacist only takes this action for prescriptions that are true refusals to fill and not a situation where the client is requesting an early fill of a medication. For additional questions about entry procedures, pharmacies are encouraged to contact their software vendor.

New PharmaCare benefit: Ethnocare Overlay™

Effective November 3, 2025, PharmaCare will cover Ethnocare Overlay™, an air expansion sleeve designed to adjust the fit of prosthetic leg sockets and accommodate limb volume fluctuation.

Clients who use a liner with no other socks are eligible for coverage of one sleeve per year under Fair PharmaCare (subject to the client’s annual deductible and family maximum), PharmaCare Plan B (Long-term Care), and PharmaCare Plan C (Recipients of B.C. Income Assistance).

Pre-approval is required. Trans-femoral and trans-tibial versions of these devices are both covered up to the lowest available price; claims can be submitted by using the appropriate TF or TT socket PIN, or the PIN for supplies requiring pre-approval.

Resources

Effect of free contraceptives on contraceptive use in B.C.

Throughout the past year, the Ministry of Health partnered with researchers at the University of British Columbia (UBC) to review contraceptive prescribing by pharmacists to examine the impact of PharmaCare’s free contraception initiative.

Results of the research are in the published study: Effect of universal no-cost coverage on use of long-acting reversible contraception and all prescription contraception: population based, controlled, interrupted time series analysis.

For an overview of the key findings, refer to UBC’s infographic: BC’s universal, no-cost contraception coverage significantly increased use of the most effective contraception methods (PDF, 327KB).

Resources

Pharmacist survey: Building community knowledge about PharmaCare

Pharmacists know their community well—and we want to learn from you. The PharmaCare Community Outreach Survey is open from November 13 to 27, to solicit pharmacist experience and ideas for improving public knowledge about PharmaCare.

The BC PharmaCare communications team is launching a project to help community organizations, from libraries to refugee settlement agencies, share information about PharmaCare with the people they serve.

By completing our short survey, pharmacists can help us understand what pharmacy clients don’t know about PharmaCare and what they should know. The survey also invites ideas for ways for us to share information.

We want to create more opportunities for people to learn about PharmaCare coverage. We hope the project will mean fewer questions for pharmacists about BC PharmaCare.

Visit PharmaCare Community Outreach Survey to take part. The survey has seven questions and will be open from November 13 to 27, 2025.

You can email us at pharmacareinfo@gov.bc.ca if you'd rather share your thoughts by email or to set up a call. If you are not a pharmacist, you are also welcome to reach out.

Pharmacist survey questions

  1. Do your clients express difficulty understanding PharmaCare coverage or policies?
  2. What do you wish your clients knew about PharmaCare?
  3. Which community organizations do you interact with most?
  4. What do you wish students or new graduates in health care knew about PharmaCare before starting work?
  5. What types of communication materials are helpful for sharing PharmaCare information with staff?
  6. What types of communication materials are helpful for sharing PharmaCare information with clients?
  7. Is there anything else you would like to add?

Non-pharmacists can email us with thoughts, ideas or questions at pharmacareinfo@gov.bc.ca.

Resources

TI Letter: Understanding insomnia treatment

The Therapeutics Initiative has recently published a Therapeutics Letter about the evidence-informed use of zopiclone and trazadone for insomnia treatment.

Visit Improving how we prescribe zopiclone and trazadone for insomnia to read the Letter.

Resources

Pharmacist interviews: Nicotine cessation support in B.C.

The Ministry of Health Research Seed Grant Program continues to seek input from community pharmacists providing non-pharmacologic nicotine cessation support to patients in B.C.

Community pharmacists who complete a 30-minute one-on-one interview with the research team will receive a $50 honorarium for their participation. To take part in the study, contact Dr. Karen Dahri at karen.dahri@vch.ca.

Smoking cessation is part of the Minor Ailments and Contraception Services (MACS) provided by B.C. community pharmacists. The goal of the interviews is to determine how community pharmacists in B.C. deliver non-pharmacologic nicotine cessation support to individuals who smoke and/or vape and related barriers and facilitators to providing this service.

Resources

Study reminder: Pharmacists providing OUD care

If you provide care for individuals with opioid use disorder (OUD) or have ideas about pharmacists providing care, the Centre for Advancing Health Outcomes wants to hear from you!

A group of researchers from the Centre for Advancing Health Outcomes at St. Paul’s Hospital in Vancouver is conducting a study titled Exploring pharmacists’ perspectives to inform recommendations on barriers and facilitators for engaging people with opioid use disorder in care. The project is funded by the Ministry of Health Research Seed Grant Program.

The researchers’ goal is to identify the barriers and facilitators to pharmacists providing OUD care. The information gathered will be used to develop ideas to help pharmacists and address the barriers to providing OUD care.

Participation in the study involves a one-hour interview over Zoom. Participants will be compensated $30 for their time.

If you are interested in participating, visit Exploring pharmacists’ perspectives to inform recommendations on barriers and facilitators for engaging people with opioid use disorder in care to complete an eligibility survey. Eligible participants will be contacted with study details, procedures, and a consent form.

Please contact pharmacistoudcare@advancinghealth.ubc.ca with any questions about the study.

Resources

RAT kits available free of charge until supplies run out

Pharmacies are encouraged to order RAT kits from distributors, available free of charge until supplies run out. Pharmacy distributors have stockpiled kits to be available to pharmacies and stores until the supply is exhausted or expired (i.e., late 2026).

Resource: PharmaCare Help Desk self-serve options

The PharmaCare Help Desk provides support for pharmacists. You can use the automated self-service support option if you are looking for:

  • Practitioner ID number – press 1 and enter prescriber’s MSP billing #
  • Special Authority details (e.g., max days’ supply, expiry date if applicable) – press 2 and enter client’s PHN
  • Which plans cover a particular drug – press 3 and enter drug DIN or PIN
  • Client’s blood glucose test training status – press 4 and enter client PHN
  • Client’s coverage plans – press 5 and enter client PHN
  • Name of pharmacy that previously dispensed a prescription – press 6 and enter client PHN

When calling the Help Desk, you will need to enter your College of Pharmacists of BC practitioner ID number (not employee number).

The Help Desk is open 24/7, closed only on December 25.

To access the PharmaCare Help Desk, call 604-682-7120 (Lower Mainland) or 1-800-554-0225 (toll-free).

Resources

Policy Reminder: Protective words

Policy reminder: Protective words. A clients can attach a protective word to their PharmaNet record. The protective word acts as a lock. Only a practitioner with the protective word can view or update a client's records. Protective words may be overridden by authorized health care practitioners in an emergency situation where the client is unable to provide it. Protective words are not required but all clients must be informed of the option. Learn more in the PharmaCare Policy Manual, Section 9.6: Protective Words.

Resources

Formulary and listing updates

Biosimilars Initiative: tocilizumab transition coverage ending

As announced in the June 2025 PharmaCare Newsletter (PDF, 699KB), the Biosimilars Initiative is switching PharmaCare coverage from the originator tocilizumab product Actemra® to the biosimilar tocilizumab product Tyenne®. Transitional coverage for Actemra will end on November 27, 2025.

Effective November 28, 2025, PharmaCare no longer covers Actemra. To obtain PharmaCare coverage for tocilizumab, patients must obtain a prescription for the biosimilar product Tyenne.

Biosimilars are limited coverage benefits. Eligible patients must meet Special Authority criteria. For more information on the Biosimilars Initiative, visit Biosimilars Initiative for health professionals.

New SA form: botulinumtoxinA

The PharmaCare Special Authority (SA) team has launched the new SA request form for botulinumtoxinA, HLTH 5865 – BotulinumtoxinA (PDF, 1.3MB). All SA requests for Botox, Xeomin and Dysport brands of botulinumtoxinA must be submitted using the new form (or eForm) as of November 12, 2025.

Non-benefits: insulin icodec (Awiqli®), ravulizumab (Ultomiris®)

PharmaCare has decided not to cover the following drugs for the noted indications.

Drug name insulin icodec (Awiqli®)
Date September 10, 2025
Indication For the once-weekly treatment of adults (≥ 18 years of age) with type 2 diabetes mellitus (T2DM) to improve glycemic control
DINs 02546213
02546221		 Strength & form 700 U/mL in a 1.5 mL pre-filled pen
700 U/mL in a 3 mL pre-filled pen
Drug name ravulizumab (Ultomiris®)
Date September 16, 2025
Indication Anti-aquaporin 4 (AQP4) antibody-positive neuromyelitis optica spectrum disorder (NMOSD)
DINs 02491559
02533448
02533456		 Strength & form

10 mg/mL
100 mg/mL
1100 mg/mL

EDRD coverage: evinacumab (Evkeeza®), metreleptin (Myalepta™)

The Ministry has initiated funding for the following drugs through PharmaCare’s Exceptional funding of EDRDs (expensive drugs for rare diseases) process.

Drug name evinacumab (Evkeeza®)
Date October 7, 2025
Indication As an adjunct to diet and other low-density lipoprotein cholesterol (LDL-C) lowering therapies for the treatment of adult and pediatric patients aged 5 years and older with homozygous familial hypercholesterolemia (HoFH)
DIN 02541769 Strength & form

345 mg/2.3 mL and 1,200 mg/8 mL (150 mg/mL) single-use vials
Notes Evinacumab will be distributed through Innomar Strategies. Initial applications for coverage will be approved for up to six months. The prescribing physician is responsible for requesting continued Ministry funding every 12 months thereafter.
Drug name metreleptin (Myalepta™)
Date October 21, 2025
Indication

As an adjunct to diet as a replacement therapy to treat the complications of leptin deficiency in lipodystrophy (LD) patients:

  • With confirmed congenital generalized LD (Berardinelli-Seip syndrome) or acquired generalized LD (Lawrence syndrome) in adults and children two years of age and above
  • With confirmed familial partial LD (PL) or acquired PL (Barraquer-Simons syndrome), in adults and children 12 years of age and above for whom standard treatments have failed to achieve adequate metabolic control
DINs 02544555
02544563
02544571		 Strength & form

3 mg powder for solution for injection
5.8 mg powder for solution for injection
11.3 mg powder for solution for injection
Notes Metreleptin will be distributed through Bioscript Logistics Inc. The prescribing physician is responsible for requesting continued Ministry funding every 12 months.

Discontinuations: insulin products

Drug name insulin regular human/isophane (NPH) insulin human 30/70 (Novolin®ge 30/70 Penfill®)
Anticipated discontinuation date December 31, 2025
Expiry of last lot 2027
Drug class Premixed (prandial/basal) insulin
DIN 02025248 Strength & form 100 U/mL, solution for subcutaneous injection in a 3 mL cartridge
Drug name insulin regular human (Novolin®ge Toronto Penfill®)
Anticipated discontinuation date December 31, 2025
Expiry of last lot 2027
Drug class Prandial insulin
DIN 02024284 Strength & form 100 U/mL, solution for subcutaneous injection in a 3 mL cartridge
Drug name isophane (NPH) insulin human (Novolin®ge NPH Penfill®)
Anticipated discontinuation date December 31, 2025
Expiry of last lot 2027
Drug class Basal insulin
DIN 02024268 Strength & form 100 U/mL, solution for subcutaneous injection in a 3 mL cartridge
Drug name insulin detemir (Levemir® Penfill®)
Anticipated discontinuation date December 31, 2025
Expiry of last lot 2027
Drug class Basal insulin
DIN 02271842 Strength & form 100 U/mL, solution for subcutaneous injection in a 3 mL cartridge

Drug shortages

PharmaCare has announced, updated, or indicated the resolution of the following drug shortages. Subscribe to the Drug shortages web page to be notified of drug shortage advisories and resolutions.

Shortage updates: Expected resolution date extended for spironolactone tablets, oxycodone/acetaminophen 5/325 mg, Teva-lenoltec No. 2, No. 3, No. 4

Shortage Spironolactone 25 mg and 100 mg tablets (multiple brands)
Mitigation Refer to Spironolactone shortage (PDF, 285KB) for guidance on using alternative therapies. Consider alternative anti-hypertensives for management of simple hypertension
Reason Teva and Mint are reporting shortages because of manufacturing disruptions. Pfizer is reporting a shortage because of increased demand
Expected resolution Continued resupplies are expected in fall and supply should stabilize in December 2025
Resources
Shortage  Oxycodone/acetaminophen 5/325 mg, multiple DINs
Mitigation Consider other opioids
Expected resolution Product is on allocation. Supply expected to stabilize in December 2025
Note Use the opioid conversion table in the Canadian Pharmacists Association resource below to make recommendations on equivalent doses
Resources
Shortage

Teva-lenoltec No. 2, No. 3, No. 4
Mitigation Consider other opioids
Expected resolution Product is on allocation. Supply expected to stabilize in January 2026
Note Other combination analgesics are available
Resources

Your Voice: Input needed for drug decisions

The knowledge and experience of patients, caregivers and patient groups is integral to B.C.'s drug review process. If you know someone who is taking one of the drugs below or who has a condition any of the drugs treat, please encourage them to visit www.gov.bc.ca/BCyourvoice.

Your Voice is now accepting input on the following drugs:

Drug Indication Input window
efgartigimod alfa (Vyvgart®) Chronic inflammatory demyelinating polyneuropathy (CIDP) in adults October 28 to November 25 at 11:59 pm
roflumilast cream (Zoryve®) Mild to moderate atopic dermatitis (AD) in patients 6 years of age and older October 28 to November 25 at 11:59 pm
upadacitinib (Rinvoq®) Giant cell arteritis (GCA) in adults October 28 to November 25 at 11:59 pm

Did you know? In 2023/24, PharmaCare added 264 new generic drugs to its formulary. Read PharmaCare Trends 2023-24 (PDF, 1MB) for more PharmaCare facts.

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About the PharmaCare Newsletter

The PharmaCareNewsletter is published on the first Wednesday of each month, with occasional mid-month releases. The PharmaCare Newsletter communicates drug listings, PharmaCare policy, PharmaNet procedures, and other pertinent information for PharmaCare providers and health care partners. 

Information in previous newsletters is accurate as of the date it was published. Newsletters are not retroactively updated when policy, procedures or other information changes. Refer to the most recent mention of a topic for up-to-date information.

Search past newsletters on the Newsletter search page.

Welcome

The PharmaCare Newsletter team works from the territory of the Lekwungen People, including the Songhees and Esquimalt Nations. Our gratitude extends to them, and all the Indigenous Peoples on whose territories and lands we build relationships.

Cultural safety and humility

BC PharmaCare counts on pharmacy and device providers to practise cultural safety and humility.

To learn more, read Coming Together for Wellness, a series of articles by First Nations Health Authority (FNHA) and PharmaCare, and consider taking the online San’yas Indigenous Cultural Safety course.  

Drug shortages

Active advisories 

spironolactone tablets; ipratropium nebules; disopyramide capsules; olanzapine for injection; oxycodone/acetaminophen 5/325 mg; teva-lenoltec No. 2, No. 3, No. 4, praziquantel (Biltricide); peginterferon alfa-2a (Pegasys®​) injection

Visit Drug shortages for full list and details.