Information for Prescribers

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Coverage of Specific Drugs

Reference Drug Program (RDP)

PharmaCare Formularies

Find out which drugs PharmaCare covers and whether or not the physician needs to submit a Special Authority request to PharmaCare.

Special Authority Information

Some drugs and medical devices are covered only for patients who meet specific criteria. For these drugs, a medical practitioner submits a request for Special Authority coverage. In the case of Blood Glucose Test Strips, a physician must submit a request for coverage if the patient requires more than the annual quantity limits that PharmaCare has established.

Drug Coverage & Drug Coverage Decisions

Find out about:

Drug Coverage Information Sheets for Prescribers

Getting Plan or Program Coverage for Your Patients

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.

Psychiatric Medications Plan (Plan G)

PharmaCare covers Methadose™ for maintenance, buprenorphine/naloxone, and Kadian slow-release oral morphine, for opioid use disorder treatment as regular benefits under Plan G. Read more…

Physicians and nurse practitioners can apply for Plan G on behalf  of eligible patients by completing an Application for PharmaCare Plan G (HLTH 3497) and faxing it to the local Mental Health Substance Use Centre, Child and Youth Mental Health Services Centre, or mental health contact at the local health authority.

>> See the full list of medications covered under Plan G.

BC Palliative Care Benefits

Please visit the BC Palliative Care Benefits web page for prescribers.

BC Smoking Cessation Program

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

  • covering 100% of the cost of certain nicotine replacement products
  • contributing to the eligible cost of prescription smoking cessation drugs.

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

NewFirst Nations Health Benefits (Plan W)

Effective October 1, 2017, First Nations Health Authority (FNHA) clients who were covered by Health Canada’s Non‑Insured Health Benefits (NIHB) program are eligible for PharmaCare Plan W which offers 100% coverage of eligible benefits. Most FNHA clients will be transferred to Plan W automatically, and most will not notice a difference in their prescription drug coverage.

The PharmaCare formulary differs slightly from the NIHB formulary. To ensure continuity of care for FNHA clients, Special Authorities are in place as follows:

  • All FNHA clients taking a drug before October 1, 2017, that is a non-reference drug under the PharmaCare RDP have indefinite, full PharmaCare coverage for that drug.
  • All FNHA clients taking a drug before October 1, 2017, that is a Limited Coverage drug under PharmaCare have continued coverage through Plan W via Special Authority (SA). The majority of these SAs are indefinite, and will not need to be renewed annually as they did under NIHB.
  • Many FNHA clients taking a drug before October 1, 2017, that is not a benefit under PharmaCare will receive temporary, exceptional coverage under Plan W via an SA.

Prescribers can check the status of a patient's SA by calling the PharmaCare/PharmaNet Medical Practitioner Line.

To assist you in understanding how your patient's coverage may change, see the FNHA-PharmaCare Coverage Continuity Prescriber Guide.

Medical Assistance in Dying

To access MAiD medication coverage for your patients, complete an Application for PharmaCare Medication Coverage for Medical Assistance in Dying (HLTH 5466) (PDF).

>> See also the Ministry of Health information about Medical Assistance in Dying and the List of Medical Aid in Dying Medications.

Prosthetic/Orthotic Coverage

Do you have a patient with a need for a prosthetic or orthotic device?

Information for Your Patients

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

PharmaNet

PharmaNet connects community pharmacies, physician offices, hospitals, emergency departments and other authorized users to a central database, allowing these users to access (and, in some cases, update) a patient’s medication history.

Publications

PharmaCare publications provides links to documents such as the annual PharmaCare Trends Report, PharmaNet data files, patient information sheets and various studies and reviews.