PharmaCare Newsletter
Last updated on May 6, 2025
May 2025 PharmaCare Newsletter
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Q: How does the evidence for tirzepatide subcutaneous (Mounjaro®) compare with semaglutide subcutaneous (Ozempic®) for 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!
RAT kit distribution program winds down
PharmaCare is winding down distribution of COVID-19 rapid-antigen test (RAT) kits.
The last day to order RAT kits that are eligible for the PharmaCare distribution fee is May 31, 2025. Pharmacies have until June 30, 2025 to submit claims for the distribution fee for RAT kits that are:
- ordered by May 31, 2025, and
- opened for public distribution prior to June 30, 2025.
Late claims submitted after June 30 will not be reimbursed.
Distributors will continue to supply tests at no cost to pharmacies while program supplies last, though pharmacies cannot claim the distribution fee on tests ordered after May 31. All provincially supplies tests must be provided to patients free of charge. Pharmacies wishing to provide RAT kits after the provincial distribution program ends can do so through a private-pay model.
Expired kits can be safely disposed of in household garbage.
The BC Centre for Disease Control (BCCDC) currently recommends COVID-19 tests only for symptomatic people when a positive result would impact treatment or care (e.g., the person is at risk of more severe disease, hospitalized, or pregnant). Visit When to get a COVID-19 test for details.
People who do not meet the criteria should monitor their symptoms and limit their activities to avoid spreading any infection, as they did before RAT kits were readily available.
Pharmacists are encouraged to remind people that:
- Provincially supplied kits do not expire until May or June 2026
- Test kits are not needed as they once were because COVID-19 is in decline
- Kits have been distributed for free in B.C. since 2020, with demand on a steep decline
- Kits will be available for private purchase at many pharmacies in the future
Resources
- Rapid antigen test (RAT) kits – PharmaCare information about the fee and PharmaNet instructions
- BCCDC: COVID-19
New interim clinical resource for PA witness requirements
As announced by Health Minister Josie Osborne and described in the February PharmaCare Newsletter (PDF, 448KB), witness requirements for the prescribed alternatives (PA) program have changed. As of February 19, 2025, a health professional must witness the consumption of PA, to ensure that each dose is taken by its intended recipient. The requirement took effect immediately for new clients.
The British Columbia Centre on Substance Use (BCCSU) has published a new Interim Clinical Resource: Transition to Witnessed Dosing for Prescribed Alternatives (PDF, 487KB), which can be found on the BCCSU Prescribed Alternatives web page.
The clinical resource supports prescribers, pharmacists and clients to navigate changes to witness requirements for PA opioid medications only while written policy changes are pending.
Additional clinical resources will be provided as they become available.
Resources
- Government provides update on pharmacy investigations, prescribed alternatives
- February PharmaCare Newsletter (PDF, 448KB)
- Interim Clinical Resource: Transition to Witnessed Dosing for Prescribed Alternatives (PDF, 487KB)
- BCCSU – Prescribed Alternatives
Guidance for pharmacists in the event of a Canada Post strike
When the national Canada Post strike was paused on December 17, 2024, the existing collective agreements were re-instated until May 22, 2025. A labour disruption could occur as early as May 22, but not before.
BC PharmaCare is providing the following guidance for B.C. pharmacists to help ensure patients maintain access to their medications in the event of a Canada Post strike.
- Check with any courier company(ies) you use and consider alternative delivery methods if they rely on Canada Post for any portion of their deliveries. Canada Post provides last-mile delivery in many rural and remote areas, meaning that even when delivery is by courier, Canada Post may be responsible for the final leg of delivery to certain remote locations
- Review patient medication supply levels and encourage early refills when appropriate
- Remind patients to check their medication supply and, when appropriate, provide early refills to prevent gaps in therapy. Consider providing the maximum days' supply when dispensing medication for delivery to clients in rural and remote areas
- When providing an early refill because of a Canada Post strike, use the PharmaNet intervention code UF (“patient gave adequate explanation. Rx filled as written”). This is the code used when there is a legitimate reason for supplying medication early. Use of the UF code must be documented appropriately for audit. Refer to PharmaCare Policy Manual – Section 5.2, Refilling Prescriptions Too Soon for details
- For First Nations Health Authority (FNHA) clients, the FNHA Transitional Payment Request form (PDF, 201KB) can be used to support coverage for an early refill during a Canada Post strike, as needed
- Consider proactively running reports to identify and reach out to patients who rely on cold-chain medications that may require a refill closer to the potential strike date
- Avoid delivering patient cold-chain or temperature-sensitive medications close to a potential strike date, if possible, to prevent spoilage in case of holding/delivery delays
- Note that the Canadian Union of Postal Workers (CUPW) must issue official strike notices for urban, rural and suburban mail carriers at least 72 hours in advance of expected strike action
Resources
- PharmaCare Policy Manual – Section 5.2, Refilling Prescriptions Too Soon
- FNHA Transitional Payment Request form (PDF, 201KB)
Ministry of Health Pharmacy Council update
Thank you to all pharmacy professionals who applied to be members of the newly formed Ministry of Health Pharmacy Council. The Ministry received an overwhelming number of applications from engaged and enthusiastic pharmacy professionals across B.C. in response to the March PharmaCare Newsletter announcement.
Applicants from a variety of practice settings were eager to share knowledge gained from navigating challenges that they regularly faced in their practices. They also expressed excitement about the opportunity to contribute to the evolution of pharmacy practise and quality patient care in B.C.
The council selection committee has reviewed each application and decided on a final group of highly qualified applicants.
The council is made up of 20 pharmacists who practice in community, 10 hospital or health authority pharmacists, and four pharmacy technicians. 17 council members have 3-10 years of pharmacy experience, 10 members have between 11-20 years' experience, and seven members have over 20 years of pharmacy experience.
Council members represent five geographic regions in B.C. based on the health authority catchment areas. 11 council members practice in Fraser Health area, seven in Vancouver Coastal, two work in Northern Health, six members practice in Island Health, and eight council members work in Interior Health area.
The Ministry looks forward to bringing the council together to discuss practice issues important to front line pharmacists and the Ministry of Health.
Resources
TI Letter: Triple therapy for COPD
The Therapeutics Initiative (TI) recently published a Therapeutics Letter that reviewed guideline recommendations and critically appraised the evidence of triple therapy for chronic obstructive pulmonary disease (COPD).
Visit Triple therapy for COPD: Understanding the evidence is complicated to read the Letter.
Resources
Policy spotlight: MDPO
Resources
Limited coverage benefits: maribavir (Livtencity™), riociguat (Sandoz® riociguat)
PharmaCare has added the following limited coverage items to the PharmaCare drug list. Special Authority approval is required for coverage.
| Drug name | maribavir (Livtencity™) | ||
|---|---|---|---|
| Date effective | April 3, 2025 | ||
| Indication | Treatment of adults with post-hematopoietic cell transplant (HSCT) cytomegalovirus (CMV) infection/disease who are refractory (with or without genotypic resistance) to one or more prior antiviral therapies. | ||
| DIN | 02530740 | Strength & form | 200 mg tablet |
BC Transplant will be providing coverage for Livtencity for adult patients with post-solid organ transplant (SOT) CMV infection or disease who are refactory (with or without genotypic resistance) to one or more prior antiviral therapies.
| Drug name | riociguat (Sandoz® riociguat) | ||
|---|---|---|---|
| Date effective | April 1, 2025 | ||
| Indication | For the treatment of inoperable chronic thromboembolic pulmonary hypertension (CTEPH, WHO Group 4) or persistent or recurrent CTEPH after surgical treatment in adult patients with WHO Functional Class II or III pulmonary hypertension. | ||
| DIN | 02533545 02533561 02533588 02533596 02533618 |
Strength & form | 0.5 mg tablet 1 mg tablet 1.5 mg tablet 2 mg tablet 2.5 mg tablet |
| Note | For more information about ordering Sandoz riociguat, pharmacies can call Specialty Health Network at 1-888-360-6929. | ||
Regular benefit: micronized progesterone (generics)
PharmaCare has added the following oral micronized progesterone capsules as a regular coverage item under Plan B (long-term care), Plan C (income assistance), Plan F (Children in the At Home Program), Plan W (First Nations Health Benefits) and Fair PharmaCare.
PharmaCare covers the full cost of micronized progesterone under Plans B,C, F and W. Coverage under the Fair PharmaCare plan will be subject to a patient's PharmaCare deductible and family maximum.
PharmaCare has listed the following generic brands of micronized progesterone as regular benefits, which will reduce their cost by about 75% compared to other generic micronized progesterone. These savings will benefit everyone in B.C., regardless of their PharmaCare plan.
| Drug name | micronized progesterone (pms-progesterone) | ||
|---|---|---|---|
| Date effective | April 3, 2025 | ||
| Indication | Adjunct to postmenopausal estrogen replacement therapy. | ||
| DINs | 02476576 | Strength & form | 100 mg capsule |
| Drug name | micronized progesterone (auro-progesterone, reddy-progesterone, sanis progesterone) | ||
|---|---|---|---|
| Date effective | May 1, 2025 | ||
| Indication | Adjunct to postmenopausal estrogen replacement therapy. | ||
| DINs | 02493578 02463113 02516187 |
Strength & form | 100 mg capsule |
Non-benefit: deferiprone modified release (Ferriprox MR)
| Drug name | deferiprone modified release | ||
|---|---|---|---|
| Date effective | April 24, 2025 | ||
| Indication | Treatment of transfusion-dependent iron overload due to thalassemia syndromes, where iron chelation therapy is required. | ||
| DINs | 02536579 | Strength & form | 1000 mg tablet |
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 | |
| cipaglucosidase alfa with miglustat (Pombiliti® with Opfolda®) | Late-onset Pompe disease in adults | April 30 to May 27 at 11:59 pm | |
| fecal microbiota (Rebyota®) | Prevention of recurrence of Clostridioides difficile infection (CDI) in adults | April 30 to May 27 at 11:59 pm | |
| daridorexant (Quviviq™) | Insomnia in adults | April 30 to May 27 at 11:59 pm | |
| dupilumab (Dupixent®) PN | Moderate-to-severe prurigo nodularis (PN) in adults | April 30 to May 27 at 11:59 pm | |
| dupilumab (Dupixent®) COPD | Chronic obstructive pulmonary disease (COPD) associated with type 2 inflammation in adults | April 30 to May 27 at 11:59 pm | |
| dupilumab (Dupixent®) CRSwNP | Severe chronic rhinosinusitis with nasal polyposis (CRSwNP) in adults | April 30 to May 27 at 11:59 pm | |
| nemolizumab (TBC) | Moderate-to-severe prurigo nodularis (PN) | April 30 to May 27 at 11:59 pm | |
April 22, 2025 mid-month update
Changes to COVID-19 vaccine administration fee
Effective May 1, 2025, the fee for COVID-19 vaccine administrations will be $12.10, the standard fee paid to pharmacists for administering publicly funded vaccines.
When the vaccine was launched in 2021, PharmaCare temporarily added a $5.90 supplement to the usual vaccine administration fee of $12.10, bringing the fee for COVID-19 vaccinations to $18.00.
As described then in the May 4 2021 PharmaCare Newsletter, the supplement was intended to “offset additional activities associated with COVID-19 vaccines, such as managing high public demand for information and appointments, in-depth patient screening, verifying a patient’s COVID-19 vaccination information in the provincial immunization record, and daily reporting of vaccinations and inventory received, transferred or wasted, to support provincial data collection and tracking.”
The supplement was made possible through the province’s Pandemic Recovery Contingencies fund, which ended in 2024. In July 2024, Dr. Bonnie Henry, the provincial health officer (PHO), issued an order to end the public-health emergency for COVID-19 and rescinded all related orders.
At this stage of pandemic recovery, the health care system is shifting to steady state programming.
Fee for publicly funded vaccine administrations
The $12.10 vaccine administration fee is intended to support costs for patient assessment, vaccination supplies, administering the vaccine, monitoring for adverse events post-immunization, and record-keeping.
The number of pharmacist administrations of publicly funded vaccines is anticipated to continue to rise, as B.C.’s population grows, and as more vaccines and injectables are made available in pharmacies.
PharmaCare thanks B.C. pharmacists for their participation in the COVID-19 vaccination campaign during the public health emergency, and for continuing to support B.C.’s vaccination campaigns.
Resources
Drug shortages: Peginterferon alfa-2a (Pegasys®) & sulfamethoxazole/trimethoprim
Peginterferon alfa-2a (Pegasys®)
Due to an increase in demand and change in the manufacturing site, there is a shortage of peginterferon alfa-2a (Pegasys®) 180 mcg/0.5 mL pre-filled syringes (DIN 02248077).
To mitigate the shortage, Health Canada permitted the temporary use of US-labelled ropeginterferon alfa-2b (BESREMi®), manufactured by Forus Therapeutics Inc.
Dispense BESREMi using PIN 09858357.
BESREMi is not an eligible PharmaCare benefit. Pharmacies should direct eligible cancer patients who have been prescribed BESREMi to a BC Cancer centre or a Community Oncology Network site.
To order BESREMi from Forus Therapeutics Inc., send an email to FORUS-CSR@innomar-strategies.com or call 1-866-542-7500.
The Pegasys shortage is expected to resolve in early 2026.
Resources
- Importation of US-Authorized BESREMi (Ropeginterferon alfa-2b-njft) Injection Due to the Current Shortage of Canadian-Authorized PEGASYS (Peginterferon alfa-2a) Injection – Government of Canada
- Centres & Clinics – BC Cancer
- Community Oncology Network – BC Cancer
Sulfamethoxazole/trimethoprim tablets
Due to manufacturing disruptions, there is a shortage of sulfamethoxazole/trimethoprim (SMX/TMP) 400 mg/80 mg (DIN 00445274) and 800 mg/160 mg (DIN 00445282) tablets. Pediatric 100 mg/20 mg (DIN 00445266) tablets are not in shortage; however, stock is not stable at wholesale.
To mitigate the shortage, PharmaCare is temporarily covering compounded SMX/TMP capsules. Pharmacies can compound this alternative if commercial therapeutic options are not available and/or appropriate (consult the prescriber). All PharmaCare compounded prescriptions policies must be followed.
Use the following PINs to claim compounded capsules as regular benefits:
- 400/80mg compounded SMX/TMP capsules—PIN 22123402
- 100/20mg compounded SMX/TMP capsules—PIN 22123403
The expected shortage resolution is mid-May 2025.
Refer to Bugs & Drugs for infection-specific treatment alternatives.
Resources
About the PharmaCare Newsletter
The PharmaCareNewsletter is published on the first Tuesday of each month (or Wednesday, if following a long weekend), with occasional mid-month special 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.
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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.
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.
Active advisories:
Fluorouracil 5% cream (Efudex®); sulfamethoxazole/trimethoprim tablets; peginterferon alfa-2a (Pegasys®) injection; Nicorette 4 mg mint prescription lozenges; oxybutynin oral syrup; calcitrol injection; carbamazepine CR tablets.
Visit Drug shortages for full list and details.