PharmaCare Newsletter
Last updated on May 6, 2026
May 2026 PharmaCare Newsletter
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May 2026 PharmaCare Newsletter (PDF)
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Pharmacist scope of practice clarification: fentanyl patch application
The Pharmacists Regulation updates of April 1, 2026, clarify and confirm that pharmacists may apply topical medications as part of patient care. Transdermal fentanyl patches are recognized as a topical medication, and pharmacists may claim the PharmaCare prescribed alternatives (PA) witnessing fee for eligible related activities.
As described in the Ministry of Health’s Access to Prescribed Alternatives in British Columbia (PDF, 304KB), witnessed dosing of fentanyl patches includes pharmacist-led patch application and removal, as well as exchange programs where patients return used patches and receive new ones.
These activities are eligible for the PharmaCare PA witnessing fee, when other criteria are met. For details, visit the PharmaCare Policy Manual, Section 8.16: Prescribed Alternatives Witnessing Fee.
Read the British Columbia Centre on Substance Use’s (BCCSU) clinical guidance on Prescribed Alternatives for details on the role of pharmacists in in fentanyl patch prescribed alternative programs.
Resources
- PharmaCare Policy Manual, Section 8.16: Prescribed Alternatives Witnessing Fee
- Access to Prescribed Alternatives in British Columbia (PDF, 304KB)
- Prescribed Alternatives – BCCSU
- Fentanyl Patch Prescribed Safer Supply Protocols (PDF, 872KB) – BCCSU
Retroactive adaptation fee payment June 1
Following a complete review of adaptation fee payments since the College of Pharmacists of BC’s Professional Practice Policy-58 (PPP-58) authorized pharmacists to renew prescriptions (2022) and change the dose, formulation or regimen (2024) of narcotics, controlled drugs and targeted substances, some pharmacies will receive a retroactive payment of these fees on June 1, 2026.
Affected pharmacies will find two separate line items on the Pharmacy Remittance Form, corresponding to:
- Renewals provided from October 14, 2022 to January 31, 2026
- Renewals and adaptations provided from August 1, 2024 to January 31, 2026
Both payments will be identified under adjustment code AR (Adaptations Retro).
The system issue that delayed these payments has been resolved as of February 1, 2026.
Reminder: PharmaNet fan-outs and prescription forgeries
PharmaCare is reminding pharmacies that fan-out messages transmitted through PharmaNet are limited to warnings about lost or stolen prescription pads and unplanned PharmaNet outages. Prescription forgeries are not reported through fan-out messages.
If a client presents a forged prescription, the pharmacy should process it as a “refusal to fill” in PharmaNet, using the CF intervention code (falsified/altered prescription). If the prescription is suspected to be multi-pharmacy/multi-doctor, the pharmacy should use the intervention code CM.
For a list of PharmaNet intervention codes, refer to Appendix B—Intervention Codes, PharmaCare Policy Manual.
For more information, including instructions on how to report a lost, stolen or duplicated prescription pad, visit PharmaCare Policy Manual, Section 2.7: Fan-Out Messages.
Resources
- Appendix B—Intervention Codes, PharmaCare Policy Manual
- PharmaCare Policy Manual, Section 2.7: Fan-Out Messages
TI Letter: Surge in doses of proton pump inhibitors
The Therapeutics Initiative published a new Therapeutics Letter examining the rise in proton pump inhibitor (PPI) dosing following the introduction of single‑enantiomer products, such as esomeprazole and dexlansoprazole. Evidence shows no meaningful clinical advantage over older PPIs.
Read the full letter at [160] Surge in doses of proton pump inhibitors: a sleight of handedness?
Resources
Formulary and listing updates
Limited Coverage benefits: ferric carboxymaltose (Ferinject®), teduglutide (Revestive®), cladribine (Mavenclad®), leuprolide (Eligard), relugolix, estradiol and norethindrone acetate (Myfembree®)
PharmaCare has added the following limited coverage items to the PharmaCare drug list. Special Authority approval is required for coverage.
| Drug name | ferric carboxymaltose (Ferinject®) | ||
|---|---|---|---|
| Date | April 8, 2026 | ||
| Indication |
|
||
| DIN | 02546078 | Strength & form | 50 mg/mL (100 mg/2 mL, 500 mg/10 mL, 1000 mg/20 mL) single-dose vials for intravenous infusion |
| Notes | When entering claims for Ferinject, the unit of measurement is volume in millilitres, as per Correct quantities for PharmaCare claims. | ||
| Drug name | teduglutide (Revestive®) | ||
|---|---|---|---|
| Date | April 15, 2026 | ||
| Indication | For the treatment of adults and pediatric patients 1 year of age and above with short bowel syndrome (SBS) who are dependent on parenteral support. | ||
| DIN | 02445727 | Strength & form | 5 mg/vial powder for solution for injection |
| Notes | When entering claims for Revestive, the unit of measurement is number of vials, as per Correct quantities for PharmaCare claims. | ||
| Drug name | cladribine (Mavenclad®) | ||
|---|---|---|---|
| Date | April 22, 2026 | ||
| Indication | For the treatment of adult patients with relapsing-remitting multiple sclerosis (RRMS). | ||
| DIN | 02470179 | Strength & form | 10 mg tablet |
| Notes | Effective April 22, 2026, Mavenclad is available as a limited coverage benefit as first-line monotherapy for adults with RRMS. Patients are no longer required to demonstrate prior treatment failure or intolerance to other disease-modifying therapies to be eligible for Special Authority coverage of Mavenclad. | ||
| Drug name | leuprolide acetate (Eligard®) | ||
|---|---|---|---|
| Date | May 6, 2026 | ||
| Indication | For the treatment of central precocious puberty. | ||
| DIN | 02268892 | Strength & form | 45 mg extended-release injectable suspension |
| Drug name | relugolix, estradiol and norethindrone acetate (Myfembree®) | ||
|---|---|---|---|
| Date | May 6, 2026 | ||
| Indication | For the management of heavy menstrual bleeding associated with uterine fibroids in premenopausal women. | ||
| DIN | 02541742 | Strength & form | 40 mg relugolix, 1 mg estradiol, 0.5 mg norethindrone oral tablet |
Non-benefits: iptacopan (Fabhalta®)
PharmaCare has decided not to cover the following drugs for the noted indication.
| Drug name | iptacopan (Fabhalta®) | ||
|---|---|---|---|
| Date | April 13, 2026 | ||
| Indication | For the treatment of paroxysmal nocturnal hemoglobinuria. | ||
| DIN | 02554313 | Strength & form | 200 mg capsule |
Discontinuations: nirmatrelvir and ritonavir (Paxlovid), Omnipod Personal Diabetes Manager, Dexcom G6 Continuous Glucose Monitor, hypromellose (Alcon Tears 1%)
Pfizer Canada has discontinued 20-tablet blister cards of nirmatrelvir and ritonavir (Paxlovid) 150 mg nirmatrelvir/100 mg ritonavir (DIN: 02527804). The last lot expires on October 31, 2026. This formulation was marketed for dosage in patients with renal impairment.
30-tablet blister cards of 300 mg (150 mg x 2) nirmatrelvir/100 mg ritonavir (DIN: 02524031) remain available and maintain PharmaCare coverage under Plan Z.
If using the full dose packaging for patients requiring the renal impairment dose adjustment:
- Remove 1 nirmatrelvir 150 mg (pink tablet) from both the morning and evening dose of each daily card, and
- Discard the extra nirmatrelvir tablets
| Drug name | nirmatrelvir and ritonavir (Paxlovid) | ||
|---|---|---|---|
| Expiry of current lot available | October 31, 2026 | ||
| Indication | Patients with moderate renal impairment with SARS-CoV-2 infection at high risk of progression to severe illness. | ||
| Drug class | Antiviral | ||
| DIN | 02527804 | Strength & form | 150 mg, 100 mg tablet |
Insulet Canada Corporation has discontinued the Omnipod Insulin Management System and the system’s compatible Pods. Effective June 30, 2026, these products will no longer be available for purchase. Patients with compatible Pods must use them by the expiry date listed on the Pod package.
The Pods are not compatible with the other Insulet insulin delivery systems. Unused Pods are not available for exchange or refund. Patients who are still within the warranty period on their Omnipod Insulin Management System should reach out to Insulet directly for support.
Insulet’s Omnipod Dash Personal Diabetes Manager and Omnipod 5 Automated Insulin Delivery System remain PharmaCare benefits.
For more information, refer to Insulet’s Discontinuation of the Omnipod® Insulin Management System announcement.
| PIN | Product name | ||
| 45230011 | Omnipod Personal Diabetes Manager (PDM) CAT45E English | ||
| 45230012 | Omnipod Personal Diabetes Manager (PDM) CAT45F French | ||
| 46340028 | OmniPod® Pod | ||
| Indication | For the management of insulin-dependent diabetes | ||
| Discontinuation date | June 30, 2026 | ||
Dexcom Canada has discontinued the Dexcom G6 Continuous Glucose Monitor (CGM) Sensor and G6 Transmitter, effective July 1, 2026. These products will still be available for purchase until wholesaler stock has been depleted. The Dexcom G6 Sensor and Transmitter will no longer be PharmaCare benefits as of December 2027. This aligns with the expiry date of the last lot of G6 Sensors sold.
Existing Dexcom G6 patients are expected to transition to the G7 Sensor and Transmitters. Dexcom Canada will continue providing technical support to all Dexcom G6 CGM users until the end of 2026.
Dexcom G6 patients who pair their insulin delivery system with the mylife Ypsopump should contact Ypsomed directly if they have questions regarding their transition to the Dexcom G7 CGM.
For more information, refer to Dexcom Canada’s Transition to G7 page.
| PIN | Product name | ||
| 43120002 | Dexcom G6® sensor | ||
| 43120003 | Dexcom G6® transmitter | ||
| Indication | For the management of insulin-dependent diabetes | ||
| Discontinuation date | June 30, 2026 | ||
| PharmaCare non-benefit as of | December 2027 | ||
PharmaCare received notice that Alcon Canada will be discontinuing hypromellose (Alcon Tears 1%) in May 2026. Note that other lubricating eye drops remain available, and are benefits under Plan B and Plan W.
| Drug name | Hypromellose (Alcon Tears 1%) | ||
|---|---|---|---|
| Last lot expiry | September 30, 2028 | ||
| Drug class | Lubricating eye drops | ||
| DIN | 00000817 | Strength & form | 1% drops |
Price reduction: filgrastim (Nivestym)
Effective June 5, 2026, the prices of the following products will be reduced. Prices include 8% markup.
| Drug name | Nivestym | ||||
|---|---|---|---|---|---|
| Date effective | June 5, 2026 | ||||
| DIN | Strength & form | Current price per syringe / vial | New price per syringe / vial | ||
| 02485575 | 300 mcg/0.5mL syringe | $149.6206 | $114.1342 | ||
| 02485583 | 480 mcg/0.8mL syringe | $239.3971 | $182.6142 | ||
| 02485591 | 300 mcg/1mL vial | $149.6206 | $114.1342 | ||
| 02485656 | 480 mcg/1.6mL vial | $239.3971 | $182.6142 | ||
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 | ||
| ubrogepant (Ubrelvy®) | The acute treatment of migraine, with or without aura, in adults. | April 29 to May 26 at 11:59 pm | ||
| bempedoic acid (Nilemdo™) | Primary hyperlipidemia and cardiovascular disease. | April 29 to May 26 at 11:59 pm | ||
| plozasiran (Redemplo™) | Adult patients with genetically confirmed or clinically diagnosed familial chylomicronemia syndrome (FCS) for whom standard triglyceride lowering therapies have been inadequate. | April 29 to May 26 at 11:59 pm | ||
| ritlecitinib (Litfulo™) | The treatment of alopecia areata (AA) in adults and adolescents aged 12 years and older. | April 29 to May 26 at 11:59 pm | ||
| anifrolumab (Saphnelo® SC) | The treatment of adult patients with active, autoantibody positive, systemic lupus erythematosus (SLE). | April 29 to May 26 at 11:59 pm | ||
About the PharmaCare Newsletter
The PharmaCare Newsletter is published on the first Wednesday of each month, with occasional mid-month 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
spironolactone tablets; disopyramide capsules; olanzapine for injection; peginterferon alfa-2a (Pegasys®) injection
Visit Drug shortages for full list and details.