COVID-19 Information for Pharmacies

Due to the COVID-19 crisis, the Provincial Health Officer has asked that pharmacists use their judgement and the options available to them to reduce non-essential physician visits, including those for prescription renewals. This may require pharmacists to act with broader latitude than they do normally. For more details on specific procedures, see below.

Please note that PharmaCare will be taking direction from the Provincial Health Officer and may develop other policies or processes to further assist pharmacies in providing first-line patient care during this emergency. These will be communicated in PharmaCare newsletters.

For more information on the COVID-19 situation in B.C., please visit the BC Centre for Disease Control’s COVID-19 page for health professionals.

The BC Centre for Disease Control (BCCDC) will test all individuals showing symptoms for COVID-19, however mild. Use the BCCDC Self-Assessment Tool to determine whether you require testing. 

Health care workers, including pharmacy professionals are eligible for priority testing if they exhibit symptoms consistent with COVID-19 infection. Individuals should follow the COVID-19 testing process developed for all British Columbia health care workers and find a collection centre (location for assessing and testing for COVID-19) near them:

Chrome: COVID-19 Collection Centre Search Tool

Internet Explorer: COVID-19 Collection Centre Search Tool

Please note testing is not done for asymptomatic individuals. 

Pharmacists may have received conflicting information regarding the days supply permitted for any dispense. Pharmacies may also have encountered local, demand-driven shortages that require them to dispense smaller amounts than they would normally.

PharmaCare policy is that fills should be up to the maximum days’ supply wherever possible. If this policy conflicts with what is feasible given the pharmacy’s on-hand supply, the pharmacy may fill an amount less than the maximum days’ supply indicated in PharmaNet or on the written prescription. If smaller dispenses are required for supply management, additional dispensing fees may be claimed for subsequent dispenses to complete the fill.

To prevent unnecessary personal interactions, a temporary exemption to the federal Controlled Drugs and Substances Act has been issued to allow pharmacy staff to deliver controlled substances.

The College of Pharmacists of British Columbia has amended PPP-71 on March 17, 2020 (see below), allowing pharmacists to authorize/initiate delivery of Opioid Agonist Therapy (OAT) medications when appropriate, rather than requiring prescriber pre-approval. For OAT medications, prescribers must be notified as soon as is practical that delivery has commenced, and delivery must cease if the prescriber indicates it is not permitted.

When delivering to a patient in self-isolation, please ensure to follow safe procedures that allow you to deliver the medications, identify the patient, confirm receipt of the medications, and maintain a 2m distance.

Documentation Requirements

Pharmacies receiving verbal orders for controlled drugs and substances from a prescriber must record the prescription details in the patient’s file (either paper or electronic). Please see the College of Pharmacists of BC’s website for detailed documentation instructions.

A pharmacist’s decision to deliver OAT must also be stored in the patient’s file. These records must indicate the individual who performed the delivery, the address delivered to, time of delivery, and the patient’s acceptance of the drug.

PPP-71 Amendments

Effective March 17, 2020, Professional Practice Policy 71 (PPP-71) – Delivery of Methadone for Maintenance became PPP-71 – Delivery of Opioid Agonist Treatment (OAT). This update to the policy name reflects several amendments to the policy itself, effective on the same day. Notable changes include, but are not limited to:

  • Pharmacists being able to use their own discretion when deciding whether to deliver OAT, without the need for prescriber authorization, if there is appropriate communication to the prescriber;
  • Temporary ability for pharmacists to authorize a regulated health professional (or a pharmacy employee under exceptional circumstances only) to deliver OAT to a patient;
  • Lifting the restriction that a patient’s home must be the delivery location;
  • Allowing delivery criteria to be based on more than only immobility and extraordinary circumstances;
  • The addition of new safety provisions concerning the safety of the pharmacist, the patient, and the public; and
  • The phasing-out of current Controlled Prescription Program (CPP) forms in light of a redesigned and harmonized CPP form, to come later.

See the College of Pharmacists of BC’s News section of their website for more information on the amendments to PPP-71.

Due to the need to minimize in-person interactions during the COVID-19 crisis, the requirement for patient signatures on the below forms are temporarily suspended:

Frequent Dispensing Authorization form

Effective April 17, 2020, the requirement for a patient signature on the Frequent Dispensing Authorization (HLTH 5378) (PDF, 543KB) form is temporarily suspended. Pharmacists may indicate patients’ verbal assent on the form by writing “COVID” in the patient signature block.

If blister packs are dispensed, pharmacists are urged to consider providing longer supplies (e.g., four weeks as opposed to one) for patients to minimize interactions.

Forms must be retained, and when feasible, patients must be asked to sign them. Alternately, pharmacists may contact the prescriber and request a new prescription with weekly or daily dispense indicated on the prescription.

Smoking Cessation Program Declaration and Notification form

Effective April 17, 2020, a patient signature in the Patient Declaration section of the Smoking Cessation Program Declaration and Notification form (HLTH 5464) (PDF, 563KB) is temporarily suspended. Provided that there is verbal assent from a patient, pharmacists may indicate “COVID” in the patient signature block. Pharmacists should ensure that patients are aware of the contents of the declaration to which they are verbally assenting.

First Nations Health Authority (FNHA) aims to support continuity of treatment and immediate coverage for eligible benefit items. The Transitional Coverage Request (TCR) is a manual claim process that reimburses pharmacists for a one-time fill, allowing additional time for providers to address the coverage issue. The updated form has a checkbox to indicate whether the coverage issue is COVID-19 related and can support timely coverage to reduce gaps in care.

FNHA will reimburse pharmacists a $10 service fee in addition to the drug cost and dispensing fee (up to the PharmaCare maximum). This pharmacist’s fee also extends transitional coverage for medical supply and equipment items that are urgent and eligible for coverage. The following PIN will show on your payment statement from our partner Pacific Blue Cross: 3642005 – TCR payment.

Plan W provides the most comprehensive drug coverage for FNHA clients.  If an FNHA client does not have Plan W as their primary drug plan, then the pharmacist can submit a TCR with the client’s PHN, status number, date of birth and address, indicating that the client requires Plan W enrolment. In this scenario, FNHA will reimburse pharmacists a $10 service fee. The following PIN will show on your payment statement from Pacific Blue Cross: 3642006 – MSP enrolment payment.

For any questions about Transitional Coverage Requests, please contact FNHA at 1-855-550-5454.

Due to concerns related to COVID-19, drug wholesalers have implemented allocation percent strategies for the distribution of drugs across Canada. Every level of the drug supply chain is working to ensure sustainable drug distribution in B.C., given the current situation. If in doubt of a certain drug’s supply, pharmacists should contact their wholesaler to confirm their allocation percentage, as each wholesaler has their own supply management policies.

To check for up-to-date information on any drug shortages, consult the Canadian Drug Shortages or the PharmaCare Drug Information websites. If you become aware of a drug shortage not included on PharmaCare’s Current Drug Shortages list and have confirmed this with your wholesaler, please report it to the PharmaNet Help Desk.

As of June 2, 2020, two imported salbutamol metered dose inhalers (MDIs) are temporarily added as non-benefits in PharmaNet, a UK-labelled product (manufacturer Teva) and a Spanish-labelled product (manufacturer Aldo-Union).

Salbutamol is a bronchodilator that has seen increased demand across Canada since March 2020 due to COVID-19 related impacts. The temporary inclusion of the UK-and Spanish-labelled products in PharmaNet follows amendments made to the Food and Drugs Act on March 25, 2020, affording Health Canada more provisional ability to support efforts against drug shortages, including limited import of foreign products. Supply for these inhalers has already arrived in B.C. however currently only the Spanish-labelled product is available for community pharmacists to order.

As usual salbutamol MDIs in BC are available, PharmaCare is not providing coverage for the foreign products but will have them listed as non-benefits for individuals who wish to access them and pay out-of-pocket. Pharmacists may use PIN 09858115 for the UK-labelled product and PIN 09858116 for the Spanish-labelled product when entering the product into PharmaNet. As with other drug products during the COVID-19 emergency period, the distribution of these MDIs will be subject to drug allocation strategies to ensure sustainable supply.

See Health Canada’s Important Safety Information for details on the importation of UK-labelled salbutamol and Health Canada’s Professional Letter for details on the Spanish-labelled product. For up-to-date information on any drug shortages, consult the Canadian Drug Shortages or the PharmaCare Drug Information websites.

Effective March 26, 2020, PharmaCare has implemented the following changes to ensure efficient access to medications and promote patient safety during the COVID-19 pandemic:

  • More staff are available on the Special Authority (SA) phone lines, to help resolve issues with faxing requests because the prescriber is not in the office.
  • Temporary manual extensions are available over the phone for select drugs where infusion dates are already planned, and the prescriber is not available for completion of renewal request.
  • Automatic uploads in PharmaNet to extend SAs for many limited coverage drugs that are expiring between March 19—July 1, 2020.

These have been prioritized based on urgency. The first and second groups of automatic uploads will be extended until October 1, 2020.

If a patient needs an extension for a limited coverage drug that is not on a list of those extended to October 1, you are unable to confirm its renewal with the prescriber, and you are adapting to refill the prescription, please call the PharmaCare Help Desk at 1 800 554-0225.

See the list of drugs for which coverage is extended at COVID-19 for Prescribers.

Effective immediately, the PharmaNet Reversal window is extended from 120 days to 180 days until further notice. This means providers may reverse a claim up to 180 days from the date of dispense. The extension reflects a need to reduce calls to the PharmaNet Help Desk during this time of decreased capacity.

Please be reminded that reversed claims are only appropriate when there is an error or incorrect transmission. For a list of reasons that constitute a reversed claim, see Section 3.16 of the PharmaCare Policy Manual.

1. What are expectations for stock and supply management?

Manage stock appropriately. Do not over-order. Dispense the full amount of a prescription wherever possible, not exceeding the maximum days’ supply indicated in PharmaNet. 

2. What is the expectation regarding early fills?

Provide early fills to people so they can self-isolate for a minimum of 14 days – longer for seniors and other more vulnerable people. Use intervention code “UF”. Please note the combination of the amount the patient has on hand, plus the amount the pharmacy dispenses, may not exceed the maximum days’ supply

3. How do I document early fills, emergency supplies and other dispenses due to COVID-19?

Dispenses made due to COVID-19 MUST be documented as “for COVID-19” or similar, for audit purposes.

4. Are pharmacists exempt from self-isolation requirements after travel?

Those pharmacists who are critical to the operation of their organization/pharmacy may be exempt from self-isolation requirements after travel. Pharmacists who have recently returned from outside Canada should self-isolate if they are not critical staff. If a pharmacist must work after travelling, they should self-monitor carefully and use a mask and gloves to protect others, if they have any respiratory symptoms.

5. I need additional informational signage for my pharmacy. Where can I request it?

Please visit the BCPhA’s website. (This is open to non-BCPhA members as well.)

6. Where can I stay updated on Professional Practice Policies that apply to the COVID-19 emergency?

Please see the College of Pharmacists of BC website.

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BC Pharmacy Association

College of Pharmacists of British Columbia

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