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 August 2024, the college updated PPP 58 to authorize pharmacists to:

• Adapt prescriptions that have previously been adapted
• Adapt a prescription from a former practitioner (i.e. a practitioner who is no longer practising), if the prescription at the time of adaptation is otherwise valid
• Renew prescriptions for a narcotic, controlled drug, or targeted substance for a duration that may be longer than prescribed, for continuity of care
• Change the dose, formulation or regimen for a prescription for a narcotic, controlled drug, or targeted substance, if the quantity dispensed does not exceed the stated amount authorized in the prescription

For a pharmacist to renew a prescription, the following must apply:

• The prescription was written less than 2 years ago
• The condition being treated is stable
• There has been no clinically significant changes to the prescription for a minimum of 3-6 months per accepted clinical practice for the condition being treated

The College of Pharmacists of BC’s Professional Practice Policy 58 (PDF, 148KB) 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 two years ago
• For a duration that exceeds the expiry date of the original prescription
• For cancer chemotherapy treatment
• Written by a veterinarian
• On which the prescriber has handwritten “do not renew/adapt” or has initialed an electronically produced “do not renew/adapt” notation
• For any other reason outlined in Professional Practice Policy 58 (PDF, 148KB)

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.

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 (unless leveraging PharmaNet PPM version 70 software, which automatically marks the record as an adaptation), and additional directions after

Intervention code: see below – an intervention code is required 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.

NOTE: For users leveraging PharmaNet PPM these intervention codes should be entered on the first dispense associated with an Adaptation record. PharmaCare does not pay a service fee for adapting a record with no associated dispense. Prescription authorizations should not be adapted unless the pharmacist intends to dispense a product at that time.