Information for Prescribers

This page links to the information prescribers need most as PharmaCare providers.

Key resources:

Search PharmaCare's formularies to see which drugs PharmaCare covers, and whether Special Authority approval is required.

For PharmaCare's plans B (Residential Care), C (Recipients of Income Assistance), F (Children in the At Home Program), and Fair PharmaCare:

Plan W (First Nations Health Benefits):

Others plans and programs:

Special Authority Transformation Project (SAT)

The Special Authority Transformation Project (SAT) is in full swing at the Ministry of Health. Prescribers will soon be able to submit SA requests online.

This means:

  • Quicker approvals
  • Automatic approvals (for some drugs)
  • Status updates for prescribers while the SA request is being processed
  • Improved tracking tools to help prescribers renew SA coverage without interruption
  • Increased security of personal health information
  • Better information for better treatment decisions

Once complete, SA requests will no longer be faxed but submitted online or directly from an electronic medical record. The new, entirely digital process will require no special software, will be phased in over a few months, and will result in improvements from end to end. Users can expect to see changes in early 2021. Watch the PharmaCare Newsletter for updates.

At the same time, the Ministry is continuing to increase patient access to personal health information, including details about their medication coverage. You can view your record of dispensed prescription medication online in the Health Gateway. See www.healthgateway.gov.bc.ca for more information.


SA approval may be granted for full coverage of a medical supply, device or drug that is partially covered or not covered.

For patients:

SA requests are nearly always submitted by prescribers, but under some circumstances pharmacists may request SA:

  • If pharmacist is acting as a prescriber (for instance, for OTC medications like acetaminophen or NRTs)
  • For adaptations of RDP drugs
  • To apply for Plan ZE coverage
  • To dispense vancomycin following a hospital stay
  • When working in a clinical setting in collaboration with a prescriber, with full access to a patient's clinical record

All policies


Clinical services fees

Dispensing fees

Frequency of dispensing - fee limits

High-cost drugs

Inducements

Low Cost Alternative (LCA) program

Medical assistance in dying (MAiD)

PharmaCare pays a clinical services fee to pharmacists for dispensing MAiD prescriptions.

Medication review services

Reference Drug Program (RDP)

Rural Incentive Program

Smoking cessation program

Vaccines

Pharmacists authorized by the College of Pharmacists of BC to administer injections receive payment for each publicly funded vaccination they administer to an eligible B.C. resident. The vaccine cost is covered by the Province of B.C. through Immunize BC.

PharmaNet is a secure network linking community pharmacies and other authorized clinical users in British Columbia. It records all medication dispensed in community pharmacies and gives health care providers controlled access to their clients' dispensing history. It protects against dangerous medication interactions, prescription fraud and drug abuse. Connection is provided by software vendors. Their software, installed at a single community medical practices is called a site. Practices using more than one vendor for PharmaNet access have more than one site.

As of December 1, 2020, all new PharmaNet users enrol in PRIME to request Ministry of Health approval to access PharmaNet.

PharmaNet patient profile corrections

The Ministry of Health is responsible for all PharmaNet patient profile corrections. When reporting an error or correction to a PharmaNet patient profile, contact either the HIBC Helpdesk or the PharmaNet Data Quality Services Team.

Learn how drugs coverage decisions are made at Drug Review.

Learn how patients, caregivers and advocacy groups can provide input for drug reviews at Your Voice.

For the results of PharmaCare drug coverage decisions, use the Drug Review Results search. Read more about Drug Review Decisions.

Fair PharmaCare (Plan I)

Fair PharmaCare is an income-based coverage plan available to all residents of B.C. if they

  • Have Medical Services Plan (MSP) coverage, and
  • Give PharmaCare permission to check their income with the Canada Revenue Agency. (Income is from two years prior)

Residents must register for the plan. Please encourage your patients to register. Fair PharmaCare information sheets are available in many languages.

Psychiatric Medications Plan (Plan G)

To secure coverage under the Psychiatric Medications Plan (Plan G) or the BC Palliative Care Benefits Program, a physician must submit an application on the individual's behalf.

BC Palliative Care benefits web page for prescribers.

First Nations Health Benefits (Plan W)

First Nations Health Authority (FNHA) clients are eligible for PharmaCare Plan W, which offers 100% coverage of eligible benefits.

Medical assistance in dying (MAiD)

Since March 20, 2020, PharmaCare coverage for MAiD prescriptions is provided automatically under Assurance (Plan Z). Prescribers can simply send their prescription to the pharmacy. Pharmacists enter the prescription in PharmaNet.

Prosthetic/orthotic coverage

Do you have a patient who needs a prosthetic or orthotic device?

BC Smoking Cessation Program

Is your patient ready to stop smoking or using other tobacco products? The BC Smoking Cessation Program

  • Covers 100% of the cost of certain nicotine replacement products
  • Contributes to the eligible cost of prescription smoking cessation drugs

For smoking cessation drugs, the patient requires a physician’s prescription.

Drug coverage for opioid use disorder

PharmaCare covers the following drugs as treatment for opioid use disorder:

  • Several formulations of methadone for maintenance
  • Buprenorphine/naloxone (Suboxone® and generics)
  • Kadian® 24-hour slow release oral morphine (under certain conditions)

PharmaCare covers these medications under the income-based Fair PharmaCare plan. It also provides 100% coverage under PharmaCare Plan C (Income Assistance), Plan G (Psychiatric Medications), and Plan W (First Nations Health Benefits).

Find information sheets on the Fair PharmaCare plan, the Prosthetics and Orthotics Program, the BC Palliative Care Benefits Program, specific drugs and other topics.

Drug coverage information sheets for prescribers