PharmaCare Newsletter

Last updated on December 3, 2025

December 2025 PharmaCare Newsletter

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Changes to dispensing fee, daily dispensing fee limits

Effective January 2, 2026, the Ministry of Health (the Ministry) will increase the maximum amount that PharmaCare will pay per dispense, from $10 to $11.

Pharmacies may charge more than PharmaCare’s maximum reimbursement amount when the Full Payment Policy does not apply.

Also effective January 2, 2026, the Ministry will decrease the maximum number of dispensing fees PharmaCare will pay per day, from three to two for clients receiving daily dispensing. This means PharmaCare will cover:

  • One (1) dispensing fee per patient, per drug (DIN), per day—to a maximum of two (2) dispensing fees per patient, per day

The decrease in daily dispensing fees is related to the ongoing reports of cash incentives provided to people receiving daily dispensing of medications, as described in the February 2025 PharmaCare Newsletter (PDF, 448KB).

As stated in the May 2024 PharmaCare Newsletter (PDF, 760KB), offering incentives to beneficiaries to use a pharmacy service is strictly prohibited.

The Ministry will continue to monitor cash incentives paid by pharmacies and will consider further changes to daily dispensing fees if necessary.

Resources

New policy for witnessing PA, pharmacy witness fee

The Ministry of Health has released the Access to Prescribed Alternatives in British Columbia: Policy Direction, which outlines updated witness requirements for clients taking prescribed alternatives (PA).

To help clinicians follow the new PA policy, the BC Centre on Substance Use (BCCSU) released a new Clinical Bulletin: Updated Prescribed Alternatives Policy—Implications for Clinical Practice. The bulletin replaces the Interim Clinical Resource published on April 29, 2025.

Existing PA clients transition to witnessed dosing by December 30, 2025

The policy direction requires that all clients who have a PA prescription must transition to witnessed dosing by December 30, 2025. This builds on previous requirements for witnessed dosing for new PA clients, as described in the February PharmaCare Newsletter (PDF, 448KB). 

There are limited exemptions to witnessed dosing for clients in exceptional circumstances. These include:

  • Clients from rural, remote and Indigenous communities who do not have routine access to a pharmacy
  • Clients with employment obligations, who may be permitted unwitnessed doses during work hours when they have achieved clinical stability
  • Clients titrating onto opioid agonist treatment (OAT)

Full details on exemptions to witnessed dosing can be found in Access to Prescribed Alternatives in British Columbia: Policy Direction. For case-based support, clinicians should consult BCCSU's 24/7 line at 778-945-7619.

PA witness fees for pharmacies

The Ministry is working on a new payment system to pay pharmacies a fee for witnessing doses of PAs. Pharmacies can expect to receive payments in spring 2026, once the new payment system is ready to be implemented. Pharmacies will receive retroactive payments for witnessed doses of PA recorded in PharmaNet from June 18, 2025, onwards.

Pharmacies will be paid a fee for each eligible dose of witnessed PA medications up to a daily maximum. Fee amounts are based on the type of medication.

To be eligible for a PA witness fee, the dose must be:

  • An eligible PA drug from the table below
  • Witnessed oral ingestion or topical application on June 18, 2025, or later
  • Witnessed by a pharmacist in a community pharmacy according to provincial policy instructions and BCCSU protocols

PharmaCare will pay a maximum number of daily witness fees per client per day, as detailed on the PA drug list below. Witnessed doses must be notated with the PharmaNet intervention code “VS – Other outcome or intervention”.

Claims must be submitted on the day the PA was dispensed and witnessed. Claim reversals will not be paid. Claims submitted on a different date than the actual dispense will not be paid and/or will be subject to recovery. 

PA drugs eligible for a witness fee – includes all dosages
Drug class Chemical type Formulation type Witness fee amount Daily maximum number of fees
Opioid Fentanyl Patch $10 1
Fentanyl Tablet (e.g., Fentora) $7 3
Hydromorphone Capsule 12h ER $4 2
Hydromorphone Tablet $4 3
Hydromorphone Syrup $4 3
Morphine Capsule 12h ER
(e.g., M-Eslon)		 $4 2
Morphine Tablet ER (e.g., MS Contin) $4 2
Morphine Syrup $4 3
Oxycodone Tablet 12h ER (e.g., Oxyneo) $4 2
Oxycodone Tablet $4 3
Benzodiazepine Alprazolam, clobazam, clonazepam, diazepam, lorazepam, oxazepam Tablet $4 3
Chlordiazepoxide Capsule $4 1
Lorazepam Sublingual tablet $4 3
Stimulant Dextroamphetamine Capsule ER (e.g., Dexedrine Spansule) $4 2
Dextroamphetamine Tablet $4 3
Dextroamphetamine Capsule ER 24h (e.g., Adderall XR) $4 1
Lisdexamfetamine Capsule $4 1
Methylphenidate CSBP 40-60 (e.g, Biphentin) $4 2
Methylphenidate Tablet ER 24h (e.g., Concerta) $4 1
Methylphenidate Tablet $4 3
Methylphenidate Tablet ER (e.g., Ritalin SR) $4 2

New PA requirement: Witness accountability logs

As of December 4, 2025, pharmacies witnessing PA must record each witnessed interaction in a witness accountability log. The log must include:

  • The date and time the drug was dispensed and witnessed
  • The prescription’s transaction number
  • The quantity of the drug ingested and witnessed
  • The quantity provided as unwitnessed doses (“carries”), if any
  • The total quantity dispensed
  • The signature or initials of the dispensing pharmacist, and the signature of the client

Any fees associated with the dispense, including the witness fee, will be recovered if the log is not filled out correctly.

Previous PharmaNet entry requirements are still in place, including “SA” and “VS” notation. For full details on PharmaNet entry instructions for witnessed PA doses, refer to the new webpage Prescribed alternatives.

Resources

NRT coverage continues under BC Smoking Cessation Program

The Ministry of Health has renewed its agreement with the supplier of Nicoderm-branded nicotine replacement therapy (NRT) products, effective January 1, 2026.

This means that coverage of Nicoderm- and Nicorette-branded NRT products, including Nicoderm® patches, Nicorette® gums and Nicorette® lozenges will continue under the BC Smoking Cessation Program (PharmaCare Plan S).

For a list of covered NRTs and prescription smoking cessation drugs, refer to Eligible smoking cessation products. For more information about the BC Smoking Cessation Program, visit PharmaCare Policy Manual, Section 7.10: Smoking Cessation Program (Plan S).

Resources

Recall – Freestyle Libre 3 Plus sensors

Abbott is issuing a recall for some FreeStyle Libre 3 Plus sensors, which it says may provide incorrect low glucose readings. People using FreeStyle Libre 3 Plus sensors should check their sensor's serial number to find out if it is affected by the recall.

The issue does not apply to the FreeStyle Libre 3 reader and app or any other Libre product (such as FreeStyle Libre 2). 

 Resources

Ensure correct Pract ID is used in local software user accounts

When creating a pharmacist or pharmacy technician user account in your local software, be sure that the Pract ID you enter is accurate. Regularly review staff profiles in your local software to confirm that Pract ID numbers match the correct employees and that no placeholders are being used.

Staff who no longer work at your location should be deactivated in your local software. This also applies to any supervisor and IT accounts. All PharmaNet transactions must be attributed to a licensed pharmacist or pharmacy technician. Please remember that PharmaNet is a production environment, not a test environment.

Finally, review all prescriber profiles to ensure they are only attributed to practitioners with valid prescribing authority.

Resources

New webpages – treating clients with substance use disorder

PharmaCare has launched new webpages to consolidate key resources for pharmacists and other clinicians who support B.C. residents with substance use disorders.

The new webpages include PharmaCare related information for treating clients with:

These webpages include information on recommended training for health care practitioners who support clients with substance use disorders, and BC PharmaCare coverage for drug treatment options.

Pharmacists and prescribers will find guidance on opioid agonist treatment (OAT) and PA prescription requirements, recordkeeping, full details on eligible pharmacy fees, drug use evaluation checks, and more.

Visit the new webpages to access PharmaCare resources for addiction care in B.C.

Resources

Reminder: Requirements for pharmacists referring for laboratory tests

Since August 30, 2024, pharmacists in B.C. can order certain laboratory tests for the purpose of medication management. As a reminder, before referring for laboratory tests, pharmacists must complete the following steps:

  1. Apply for and receive a unique MSP practitioner number by completing and submitting the Application for MSP Practitioner Number for Pharmacists (PDF, 1.1MB). Health Insurance BC will provide the pharmacist with their unique MSP practitioner number via mail.
  2. Register with laboratory operators by completing the Pharmacist Laboratory Registration Form (PDF, 243KB) and emailing it to the Provincial Laboratory Medicine Services (PLMS) at pracbenefitscheds@phsa.ca. PLMS will contact the pharmacist via email to confirm that registration was completed.

For any registration-related questions, pharmacists should contact PLMS at pracbenefitscheds@phsa.ca.

For any other issues or questions, visit Laboratory Services for health professionals or contact the team at labservices@gov.bc.ca.

Resources

TI Letter: Escitalopram vs citalopram

The Therapeutics Initiative published a Therapeutics Letter comparing escitalopram and citalopram. Evidence suggests no meaningful advantage of escitalopram over citalopram, despite higher costs.

Visit TL 159: Escitalopram vs Citalopram to read the Letter.

Resources

Reminder: Pharmacist interviews about nicotine cessation support in B.C.

A Ministry-funded research study by the University of British Columbia continues to seek input from community pharmacists providing non-pharmacologic nicotine cessation support to patients in B.C.

Community pharmacists who complete a 30-minute one-on-one interview with the research team will receive a $50 honorarium for their participation. To take part in the study, contact Dr. Karen Dahri at karen.dahri@vch.ca.

Smoking cessation is part of the Minor Ailments and Contraception Services (MACS) provided by B.C. community pharmacists. The goal of the interviews is to determine how community pharmacists in B.C. deliver non-pharmacologic nicotine cessation support to individuals who smoke and/or vape and related barriers and facilitators to providing this service.

Resources

Reminder: Pharmacist survey about PharmaCare

Pharmacists know their community well—and we want to learn from you. The PharmaCare Community Outreach Survey is open from November 13, 2025 to January 2, 2026, to solicit pharmacist experience and ideas for improving public knowledge about PharmaCare.

The BC PharmaCare communications team is launching a project to help community organizations, from libraries to refugee settlement agencies, share information about PharmaCare with the people they serve.

By completing our short survey, pharmacists can help us understand what pharmacy clients don’t know about PharmaCare and what they should know. The survey also invites ideas for ways for us to share information.

We want to create more opportunities for people to learn about PharmaCare coverage. We hope the project will mean fewer questions for pharmacists about BC PharmaCare.

Visit PharmaCare Community Outreach Survey to take part. The survey has seven questions and will be open from November 13 to January 2, 2026.

You can email us at pharmacareinfo@gov.bc.ca if you'd rather share your thoughts by email or to set up a call. If you are not a pharmacist, you are also welcome to reach out.

Pharmacist survey questions

  1. Do your clients express difficulty understanding PharmaCare coverage or policies?
  2. What do you wish your clients knew about PharmaCare?
  3. Which community organizations do you interact with most?
  4. What do you wish students or new graduates in health care knew about PharmaCare before starting work?
  5. What types of communication materials are helpful for sharing PharmaCare information with staff?
  6. What types of communication materials are helpful for sharing PharmaCare information with clients?
  7. Is there anything else you would like to add?

Non-pharmacists can email us with thoughts, ideas or questions at pharmacareinfo@gov.bc.ca.

Resources

2025 year-end reminders

PharmaNet Help Desk holiday closure

The PharmaNet Help Desk will be closed from 10:15 pm on Wednesday, December 24 until 10:15 pm on Thursday, December 25, 2025.

If you experience problems connecting to PharmaNet during this time, please call 778-875-4287. The interactive voice response system will be available.

Fair PharmaCare registration holiday closure

To allow for annual maintenance, the Application for Health and Drug Coverage (AHDC) for MSP and Fair PharmaCare will be unavailable as follows:

  • Online applications unavailable:
    • 8 am, Wednesday, December 31 to 8 am, Thursday, January 1, 2026 (24 hours)
  • Phone applications unavailable:
    • 8 am, Wednesday, December 24 to 8 am Friday, December 26, 2025 (48 hours)
    • 8 am, Wednesday, December 31 to 8 am, Friday, January 2, 2026 (48 hours)

2026 provider payment schedule

The weekly and monthly provider payment schedule for 2026 is available on the Information for pharmacies webpage. Pharmacies should note that payments may be remitted earlier than dates indicated in the schedule. Published dates remain the authorized payment dates and should be the guide for claims-related accounting.

Blood glucose test strip annual quantity limits

On January 1, 2026, clients will be assigned their annual limit of blood glucose test strips (BGTS). Beginning January 1, please ensure you use the regular BGTS PINs for claims until clients exceed their annual limit.

All strips purchased by a client, regardless of the payer, count toward the client’s annual limit.

BGTS information for clients

Information for the public is available online about annual quantity limits for BGTS and in the printable information sheet, Blood glucose test strips – annual limits (PDF, 167KB). (Translations are available in 15 languages on the PharmaCare information sheets webpage).

Fair PharmaCare annual deductibles reset in the new year

On January 1, 2026, PharmaNet will be updated with 2026 annual deductible and family maximum amounts. Deductible accumulations will be reset to zero.

Fair PharmaCare coverage levels for 2026 are based on a family’s 2024 net income. Income from Universal Child Care Benefits and Registered Disability Savings Plans and some BC Housing subsidies are not included when determining coverage levels.

Deductible information for patients

This can be a stressful time for Fair PharmaCare beneficiaries as many are paying the full cost of their drugs. Please let them know that they may be eligible for PharmaCare’s monthly deductible payment option. Once they register, PharmaCare immediately pays for 70% of their eligible drug costs. Fair PharmaCare registrants can get information about their deductible and family maximum by:

  • Requesting a confirmation of Fair PharmaCare coverage letter or
  • Calling us Monday to Friday, 8 am to 8 pm and Saturdays 8 am to 4 pm from the Lower Mainland at 604-683-7151 or from the rest of B.C., toll-free, at 1-800-663-7100

Policy Spotlight: Fan-out messages

Resources

RAT kits available free of charge until supplies run out

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).

Formulary and listing updates

Limited Coverage benefits: tenofovir alafenamide (Vemlidy®), cannabidiol (Epidiolex®)

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

Drug name tenofovir alafenamide (Vemlidy®)
Date December 3, 2025
Indication Treatment of chronic hepatitis B (CHB) in adults with compensated liver disease
DIN 02464241 Strength & form 25 mg tablet
Notes Patients who have existing Special Authority coverage for tenofovir disoproxil fumarate (Viread® or generics) will automatically receive Special Authority coverage for tenofovir alafenamide
Drug name cannabidiol (Epidiolex®)
Date December 3, 2025
Indication For the treatment of seizures associated with Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex in patients 2 years of age and older
DIN 02543079 Strength & form 100 mg/mL oral solution

Non-benefits: isotretinoin (Absorica LD™), isotretinoin (Epuris™), etrasimod (Velsipity™), clascoterone (Winlevi®), lebrikizumab (Ebglyss™), remdesivir (Veklury®)

PharmaCare has decided not to cover the following drugs for the noted indications.

Drug name Isotretinoin (Absorica LD™)
Date November 5, 2025
Indication For the treatment of severe nodular and/or inflammatory acne, acne conglobata, and recalcitrant acne
DINs 02539047
02539055
02539063
02539071		 Strength & form 8 mg capsule
16 mg capsule
24 mg capsule
32 mg capsule
Drug name Isotretinoin (Epuris™)
Date November 5, 2025
Indication For the treatment of severe nodular and/or inflammatory acne, acne conglobata, and recalcitrant acne
DINs 02396971
02396998
02397005
02397013		 Strength & form 10 mg capsule
20 mg capsule
30 mg capsule
40 mg capsule
Special notes Epuris was previously announced as a non-benefit in the December 2013 newsletter. This non-benefit listing is the result of a resubmission
Drug name etrasimod (Velsipity™)
Date November 12, 2025
Indication For the treatment of adults with moderately to severely active ulcerative colitis who have had an inadequate response, lost response, or were intolerant to either conventional therapy or an advanced treatment
DIN 02544903 Strength & form 2 mg tablet
Drug name clascosterone (Winlevi®)
Date November 19, 2025
Indication For the topical treatment of moderate to severe acne vulgaris in patients 12 years of age and older
DIN 02538881 Strength & form 1% topical cream
Drug name lebrikizumab (Ebglyss™)
Date November 19, 2025
Indication Treatment of moderate to severe atopic dermatitis in adult and adolescents 12 years of age and older with a body weight of at least 40 kg, whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable
DINs 02549123
02549131		 Strength & form 250 mg/2 mL pre-filled pen solution for subcutaneous injection
250 mg/2 mL pre-filled syringe solution for subcutaneous injection
Drug name remdesivir (Veklury®)
Date November 26, 2025
Indication For the treatment of adults with moderately to severely active ulcerative colitis who have had an inadequate response, lost response, or were intolerant to either conventional therapy or an advanced treatment
DIN 02502143 Strength & form 100 mg solution for injection
Notes Remdesivir is funded by hospitals or Health Authority infusion clinics managed by the Provincial Health Services Authority (PHSA)

EDRD coverage: maralixibat (Livmarli®), burosumab (Crysvita®)

PharmaCare has initiated funding of the following drug through the Expensive Drugs for Rare Diseases (EDRD) process.

Drug name maralixibat (Livmarli®)
Date October 30, 2025
Indication Cholestatic pruritus in patients with Alagille syndrome (ALGS)
DIN 02539888 Strength & form 9.5 mg/mL solution for oral use
Notes Clinicians may apply for funding for eligible patients for the treatment of cholestatic pruritus in patients with Alagille syndrome (ALGS). Initial applications will be approved for up to six months. The prescribing physician is responsible for requesting continued Ministry funding every twelve months thereafter 

Maralixibat will be distributed by A&D Wholesale. For ordering, please contact: orders@andrx.ca
Drug name burosumab (Crysvita®)
Date November 12, 2025
Indication X-linked hypophosphatemia (XLH) in adult patients
DINs 02483629
02483637 
02483645		 Strength & form 10 mg/mL solution for subcutaneous injection
20 mg/mL solution for subcutaneous injection
30 mg/mL solution for subcutaneous injection
Notes Clinicians may apply for funding for eligible adult patients with X-linked hypophosphatemia (XLH). Initial applications will be approved for up to one year. The prescribing physician is responsible for requesting continued Ministry funding every one to two years thereafter 

Additions to designated high-cost drugs list

The following drugs will be added to B.C.’s list of designated high-cost drugs, effective January 2, 2026.

DIN Chemical description Product name Allowable markup
02470179 cladribine 10 mg tablet Mavenclad® 5%
02497867 vedolizumab 108 mg/0.68 mL pre-filled pen Entyvio® 5%
02497875 vedolizumab 108 mg/0.68 mL pre-filled syringe Entyvio® 5%
02496429 siponimod 0.25 mg oral tablet Mayzent® 5%
02496437 siponimod 2 mg oral tablet Mayzent® 5%

Discontinuation: somatropin (Humatrope®), adrenaline bitartrate (Emarade), epinephrine (Allerject)

On December 22, 2025, somatropin (Humatrope®) 6 mg cartridge (DIN 2243077), 12 mg cartridge (DIN 2243078) and 24 mg cartridge (DIN 2243079) for injection will be discontinued. The last lot expiry dates are expected to be late 2026 and early to mid-2027. Please note that other brands remain available and maintain the same Special Authority coverage criteria.

Drug name somatropin (Humatrope®)
Expiry of last lot June 1, 2027
Drug class Growth hormone
DIN 02243077 Strength & form 6 mg cartridge
Drug name somatropin (Humatrope®)
Expiry of last lot October 26, 2026
Drug class Growth hormone
DIN 02243078 Strength & form 12 mg cartridge
Drug name somatropin (Humatrope®)
Expiry of last lot January 7, 2027
Drug class Growth hormone
DIN 02243079 Strength & form 24 mg cartridge

As of January 14, 2026, adrenaline bitartrate (Emarade) and epinephrine (Allerject) will become PharmaCare non-benefits, as these products are being discontinued.

Drug name adrenaline bitartrate (Emarade)
Drug class sympathomimetics
DIN 02382059 Strength & form 0.15 mg/0.15 mL pre-filled autoinjector
Drug name epinephrine (Allerject)
Drug class sympathomimetics
DIN 02382067 Strength & form 0.3 mg/0.3 mL pre-filled autoinjector

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
osilodrostat (Isturisa®) Cushing’s disease in adults with persistent or recurrent hypercortisolism November 19 to December 16 at 11:59 pm
mepolizumab (Nucala®) Chronic obstructive pulmonary disease (COPD) in adults November 19 to December 16 at 11:59 pm
finerenone (Kerendia®) Heart failure (HF) in adults November 19 to December 16 at 11:59 pm
olezarsen (TBC) Familial chylomicronemia syndrome (FCS) in adults November 19 to December 16 at 11:59 pm
vutrisiran (Amvuttra®) Wild-type or hereditary transthyretin-amyloidosis in adult patients with cardiomyopathy November 19 to December 16 at 11:59 pm

In 2023, contraceptives were added to PharmaCare Plan Z. Read PharmaCare Trends 2023-24 (PDF, 1MB) for more PharmaCare facts.

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About the PharmaCare Newsletter

The PharmaCareNewsletter 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.

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 

spironolactone tablets; ipratropium nebules; disopyramide capsules; olanzapine for injection; oxycodone/acetaminophen 5/325 mg; peginterferon alfa-2a (Pegasys®​) injection

Visit Drug shortages for full list and details.