PharmaCare Newsletter

Last updated on August 6, 2025

August 2025 PharmaCare Newsletter

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The current edition of PAD Refills is titled Split, open, sprinkle: navigating ADHD medication formulations.

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2025 B.C. Prescription Drug Atlas

The 2025 edition of the B.C. Prescription Drug Atlas (PDF, 3.2MB) is now available online.

This document provides an overview of prescribing patterns in B.C. for opioids and benzodiazepine receptor agonists (BZRAs; benzodiazepines and the z-drugs: zopiclone, zolpidem, eszopiclone, and zaleplon) during the period 2016-2024. It is an update of the 2024 edition.

The 2025 Atlas also includes sections focused on the regulatory colleges whose registrants have legal authority to prescribe opioids and/or BZRAs.

Read previous editions of the Prescription Drug Atlas on the PharmaCare publications web page.

Resources

Pharmacy services claims 2024/25

PharmaCare pays pharmacies enrolled as PharmaCare providers set fees for providing pharmacy services associated with prescription adaptation, medication reviews, and vaccine administration for residents of B.C.

Below are the numbers of prescription adaptation and renewal services, and immunization administrations claimed by B.C. pharmacies in the fiscal year 2024/25.

For more pharmacy service statistics, refer to our pharmacist scope of practice data web pages:

Resources

Staying in touch is getting easier – thanks to you!

In the July 2025 PharmaCare Newsletter (PDF, 605KB), we asked PharmaCare providers to provide a permanent email address that is checked daily. Since then, your PharmaCare Provider Change forms have been flooding in.  

Thank you so much for making our work more efficient – and effective! Having the right email on file means you get important information without delay.

If you haven’t yet registered a permanent, regularly monitored email address, please submit the PharmaCare Provider Change form (PDF, 1.3MB) by August 31, 2025. Complete the cover page, update the email section in Part A, and check if Parts C or D apply.

Resources

TI Letters: Antidepressant withdrawal

Therapeutics Initiative recently published two Therapeutics Letters about antidepressant withdrawal.

The first letter, Antidepressant withdrawal syndrome – Update, reviews the risks, symptoms and prevalence of antidepressant withdrawal, emphasizing the importance of informed consent and careful prescribing.

The second letter, How to stop antidepressants, looks at the problems people may have when they stop taking antidepressants. It talks about how to stop safely and avoid withdrawal problems.

Resources

Beyond the Patch: QuitNow BC online webinar

QuitNow BC is offering beyond the Patch: Supporting Youth Through Evidence-Based Nicotine Cessation, an online training webinar for healthcare professionals, educators and other people working with youth.

Nicotine use among young people is a public health concern, particularly with the rising prevalence of vaping. The webinar will explore the clinical rationale, ethical considerations and practical strategies for supporting young people in their efforts to quit.

Participants will gain evidence-based guidance on the safe and effective use of nicotine replacement therapy (NRT) for youth, along with approaches for motivational engagement and meaningful family involvement to improve treatment outcomes.

The webinar will be held on August 11, 2025, from 11 am – 12 pm PST, and will be presented by Dr. Kevin M. Simon, MD, MPH, Boston’s first Chief Behavioural Health Officer.

Refer to Dr. Simon’s website for information about his professional background and experience. Visit the QuitNow BC website for registration details. There is no cost to attend.

Resources

Guidance for pharmacists in the event of a Canada Post strike

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 clients 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

RAT kit payment update

Since the last newsletter, PharmaCare has paid pharmacies for COVID-19 rapid antigen test (RAT) kit distribution as follows:

Payment month Payment date
May 2025 August 5, 2025

RAT kit distribution fee program ends

As announced in the May 2025 and June 2025 PharmaCare Newsletters, PharmaCare has ended the RAT kit distribution fee program. The last day to submit claims for the PharmaCare RAT kit distribution fee was June 30, 2025.

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). 

Resources

Resource: 5 Ws of Patient Discharge

With the support of Canadian Society of Healthcare-Systems Pharmacy (CHSP) Foundation, Dr. Karen Dahri has created education resources to help patients learn about their medications and support their transition home from the hospital.

The resources describe the 5 Ws of patient discharge:

  • What are the medication changes?
  • Why are there changes to my medications?
  • Where do I go to get my medications after discharge?
  • When is my follow-up appointment?
  • Who should I connect with after discharge?

The resources are available in multiple languages (English, French, Punjabi, Mandarin, Simplified and Traditional Chinese) and formats (video, infographic, pamphlet and form). You can access them by visiting 5 Ws of Patient Discharge.

Resources

Web page spotlight: Correct quantities for PharmaCare claims

When entering a claim in PharmaNet, make sure the unit of measure (e.g., volume in milliliters, number of syringes, number of vials, package, doses per inhaler) for the dispensed quantity matches the one in PharmaNet.  This ensures claims are adjudicated correctly in PharmaNet. Refer to the units of measure on the Correct quantities for PharmaCare claims web page.   Use CTRL+F (Win) or Cmd+F (Mac) to search by item or DIN.

Resources

Drug shortages

Disopyramide capsules – imported supply added as temporary benefit

Effective July 16, 2025, PharmaCare has added US-labelled disopyramide capsules as a temporary regular benefit. Health Canada has permitted the exceptional, temporary sale of US-labelled disopyramide capsules imported by Dr. Reddy’s Laboratories during the shortage of Canadian-marketed disopyramide capsules.

The US products have the same active ingredient, strengths, and dosage form. US products differ from the Canadian-market versions in their labelling (English-only), physical appearance (opaque orange capsules imprinted with m on one side and 095 on the other), and non-medicinal ingredients. Refer to Dr. Reddy’s Laboratories disopyramide capsules risk communication (PDF, 495KB) for more details.

To dispense US-labelled disopyramide 100mg capsules use PIN 09858365.

Ipratropium nebules

There is an active shortage of all ipratropium nebules. The hydrofluoroalkane products Ipratropium HFA (Atrovent DIN: 02247686 and Jamp-Ipratropium HFA DIN: 02542587) are available. The shortage is expected to resolve by September 2025.

Consult the Ipratropium-Bromide-Shortage-EN (PDF, 307KB) clinical resource document, released by MedSask and the Canadian Pharmacists Association to learn more.

Olanzapine for injection

Effective July 10, 2025, olanzapine for injection (DIN 02416522) is in shortage. The shortage is expected to resolve in November of 2025.

As a mitigation measure, use SteriMax’s US-authorized olanzapine for injection. Use PIN 66128561 for dispensing. Olanzapine for injection is not a PharmaCare benefit.

For more information on the US-authorized product, consult the SteriMax advisory (PDF, 389 KB)

Pain medications: oxycodone/acetaminophen 5/35 mg, Teva-Emtec-30 and Teva-Lenoltec No. 2, No. 3, No. 4

Effective July 10, 2025, multiple DINs of oxycodone/acetaminophen 5/35 mg, Teva-Emtec-30 (DIN 00608882) and Teva-lenoltec No. 2 (DIN 00653241), No. 3 (DIN 00653276) and No. 4 (DIN 00621463) are in shortage. Until the expected resolution in September 2025, PharmaCare encourages prescribers to consider other opioid therapies.

The Canadian Pharmacists Association has an opioid conversion table in their resource Shortages of Acetaminophen with Oxycodone or Codeine (PDF, 114KB) to support recommendations on equivalent doses.

For more information, refer to Health Canada’s notice Acetaminophen with codeine or oxycodone in short supply.

Resources

Formulary and listing updates

Limited coverage benefits: tofacitinib (generics), bimekizumab (Bimzelx®), methylphenidate controlled release (CR) (Foquest®)

PharmaCare has added the following limited coverage items to the PharmaCare drug list. Special Authority approval is required for coverage.

Drug name tofacitinib (generics)
Date effective     July 16, 2025
Indication For the treatment of active ankylosing spondylitis and active psoriatic arthritis.
DINs Refer to the Low Cost Alternative (LCA) and Reference Drug Program (RDP) Data Files for eligible DINs. Strength & form 5 mg tablet
Special notes PharmaCare is also transitioning tofacitinib coverage from the brand name product Xeljanz® to generic tofacitinib products. Refer to Tofacitinib coverage transition below for more details.
Drug name bimekizumab (Bimzelx®)
Date effective     July 16, 2025
Indication 160 mg/mL: ankylosing spondylitispsoriatic arthritis and active.
320 mg/2 mL: plaque psoriasis.
DINs 02525267
02525275
02553619
02553627
Strength & form 160 mg/mL pre-filled syringe
160 mg/mL autoinjector
320 mg/2 mL pre-filled syringe
320 mg/2 mL autoinjector
Drug name methylphenidate controlled release (CR) (Foquest®)
Date effective     July 23, 2025
Indication For the treatment of attention deficit hyperactivity disorder (ADHD) in patients 6 years of age or older.
DINs 02470292
02470306
02470314
02470322
02470330
02470349
02470357
Strength & form 25 mg CR capsule
35 mg CR capsule
45 mg CR capsule
55 mg CR capsule
70 mg CR capsule
85 mg CR capsule
100 mg CR capsule

Non-benefits: upadacitinib (Rinvoq®)

PharmaCare has decided not to cover the following drug for the noted indication.

Drug name upadacitinib (Rinvoq®)
Date effective     July 16, 2025
Indication For the treatment of active ankylosing spondylitis.
DIN 02495155 Strength & form 15 mg tablet

Tofacitinib coverage transition

PharmaCare is transitioning tofacitinib coverage from the brand name product Xeljanz® to generic tofacitinib products. According to Health Canada, generic drugs are pharmaceutically equivalent to brand name drugs; they contain the identical medicinal ingredients, in the same amounts and in a similar dosage form.

To maintain coverage, patients currently covered for the brand name product Xeljanz for rheumatoid arthritis or ulcerative colitis must transition to a generic tofacitinib product. PharmaCare is providing six-month transitional coverage ending January 15, 2026, to allow time for patients to switch. For patients with existing Xeljanz Special Authority (SA) approval, the generic tofacitinib products will automatically be covered; prescribers do not need to submit a new SA request until the next scheduled renewal date.

Coverage transition timeline
July 16, 2025 July 16, 2025, to January 15, 2026 January 16, 2026
All new SA requests, including renewals, for tofacitinib will only be approved for the generic brand products. The brand product Xeljanz will not be approved for new SA requests, including renewals. To maintain coverage, patients with existing Xeljanz SA approval must transition to the generic brand of tofacitinib within the six-month transition period. Xeljanz is no longer a PharmaCare benefit and only the generic tofacitinib products are covered. 

SA requests for patients who are unable to transition to any formulation of generic tofacitinib will be considered on a case-by-case basis.

Prescribers can submit HLTH 5861 – Tofacitinib patient list request (PDF, 968KB) form to request a list of their patients who are receiving PharmaCare coverage for Xeljanz so they can contact them to start the switch. PharmaCare will not be offering patient support fees for the transition.

Patients with rheumatoid arthritis

Some patients with rheumatoid arthritis may take Xeljanz 11 mg XR formulation. To maintain PharmaCare coverage, these patients must, in consultation with their prescriber, switch to the equivalent dose of a generic tofacitinib product (5 mg twice daily). Prescribers do not need to submit a new SA request until the next scheduled renewal date (if applicable).

Patient support programs

For patients transitioning to a generic tofacitinib product, a different patient support program is available. Note that PharmaCare coverage is not tied to participation in a patient support program.

Generic manufacturer Patient support program
Taro (taro-tofacitinib) Sun360
Tel: 1-800-268-1975
Fax: 1-866-712-0001
Email: info@sun360psp.ca
Website: https://www.sun360psp.ca/for-patients/taro-tofacitinib
PharmaScience (PMS-tofacitinib) Tel: 1-888-255-9777
Fax: 1-833-350-3886
Email: tofacitinib@allypsp.ca
Website: 
JAMP (JAMP-tofacitinib) JAMP Care
Tel: 1-855-517-0710 (Monday to Friday, 9 am to 6 pm EST)
Fax: 1-855-437-1490
Email: immunology@jampcarepsp.ca 
Website: https://jampcare-support.ca/
Auro (Auro-tofacitinib) Auro generics are available; please follow up with them for PSP information.

Tel: 1-905-856-8063 Ext: 242
Fax: 1-905 856-8094
Email: cs@auropharma.ca
Website: https://auropharma.ca

For questions or concerns, please contact the Formulary Management team by email at FM.GenericMailbox@gov.bc.ca

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
Bulevirtide (Hepcludex®) The treatment of chronic hepatitis delta virus (HDV) infection in adults with compensated liver disease July 30 to August 26 at 11:59 pm
pegunigalsidase alfa (TBC) Long-term enzyme replacement therapy in adult patients with a confirmed diagnosis of Fabry disease (deficiency of alpha-galactosidase) July 30 to August 26 at 11:59 pm
Risankizumab (Skyrizi®) The treatment of adult patients with moderately to severely active ulcerative colitis (UC) who have had an inadequate response, loss of response, or were intolerant to conventional therapy or advanced therapy July 30 to August 26 at 11:59 pm
Risperidone (Okedi®) The treatment of schizophrenia in adults July 30 to August 26 at 11:59 pm
Lemborexant (Dayvigo®) The treatment of insomnia in adults diagnosed according to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) referring to chronic insomnia disorder (CID) July 30 to August 26 at 11:59 pm

BC PharmaCare covered 264 new generic drugs in 2023/2024. Read PharmaCare Trends 2023-24 (PDF, 1MB) for more PharmaCare facts.

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July 17 update: Regulatory change keeps tirzepatide and dulaglutide for B.C. residents, Canadian citizens and permanent residents

The Minister of Health approved Ministerial Order 226 to keep B.C. supplies of tirzepatide (Mounjaro®) and dulaglutide (Trulicity®) in the province. The Ministerial order adds tirzepatide and dulaglutide to the Drug Schedules (Limits on Sale) Regulation.

Tirzepatide and dulaglutide sold by a B.C. pharmacy must be:

  • Sold to a citizen or permanent resident of Canada, and/or
  • Sold directly to the person, while the person is on the premises of the pharmacy

In April 2023, the provincial government added a “limits on sale” regulation to the Pharmacy Operations and Drug Scheduling Act to prevent sales of semaglutide (Ozempic®, Wegovy®, Rybelsus®) to non-Canadian residents, to limit the impact of a supply shortage.

Resources

[End of July 17 update]

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About the PharmaCare Newsletter

The PharmaCareNewsletter is published on the first Wednesday of each month, 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.

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 

teva-emtec-30; ipratropium nebules; disopyramide capsules; olanzapine for injection; praziquantel (Biltricide); fluorouracil 5% cream (Efudex®); peginterferon alfa-2a (Pegasys®​) injection; calcitrol injection.

Visit Drug shortages for full list and details.