Ask the Experts: Frequent dispensing via verbal prescription

Updated on May 30, 2018 (Originally posted on May 29, 2018)

If a physician has authorized frequent dispensing via a verbal prescription or faxed refill authorization, how do I document it in compliance with PharmaCare requirements?

Verbal prescriptions must be documented at the time of dispensing. As required by the Health Professions Act bylaws, pharmacies must retain a written record of the prescription, signed or initialled by the pharmacist.
As of March 1, 2013, under PharmaCare’s Frequency of Dispensing Policy (section 8.3), verbal authorization doesn’t count as documentation for claiming fees for frequency of dispensing. Use the following steps to ensure you are correctly documenting the order:

The Do’s:

  • Complete a Frequent Dispensing Authorization (FDA) form and add “Physician authorized frequency of dispensing” to the “Rationale For Frequent Dispensing” section of the form.
  • Fax the form to the prescriber and retain the form with the fax verification/confirmation report. This must be done before medication is dispensed. Claims associated with forms created after the fact are subject to recovery.  
  • As stated in the Feb. 19, 2016 BC PharmaCare Newsletter, it is strongly recommended that the forms be kept in a separate binder/folder each year, filed alphabetically by patient’s last name, then chronologically.
  • FDA forms should be kept at the pharmacy. In the event of an on-site audit PharmaCare will not accept records of verbal prescriptions or FDA forms provided after the visit.
  • Complete one frequency per form. Each form must specify only one frequency of dispensing (weekly, bi-weekly or other). If a patient has medications dispensed on two different frequencies, a separate form is required for each group of medications.
  • Complete one form per prescriber. If a patient has multiple physicians and all the patient’s prescriptions will be frequently dispensed (e.g., in a weekly blister pack), notify all the prescribing physicians.
  • If a prescription with two to 27-day dispensing frequency is transferred from one pharmacy to another, the receiving pharmacy is responsible for completing an FDA form and faxing it to the prescriber(s).
  • The FDA form for each patient must be renewed each year, on or before the date the patient signed the original form.

The DONT’S:

  • Prescriptions with daily dispense instructions cannot be taken verbally, as PharmaCare will only accept a prescriber’s written instructions with “Dispense Daily/Daily Dispensing” on the prescription. (The annotation “DD” by a prescriber is not accepted by PharmaCare).
  • Do not mail or hand FDA forms in-person to the prescriber’s office. A fax transmission report is required for proof of date and time that the form was sent to the prescriber.
  • Do not use fax reports listing multiple faxes. PharmaCare will only accept fax transmission reports listing a single number.

If a pharmacy transmits a refill authorization to a practitioner requiring frequent dispensing with no FDA form in place, the pharmacy must either: 

  • Request that the practitioner include an authorization/order for frequent dispensing on the prescription returned to the pharmacy (without a completed FDA form this authorization must be included on every subsequent prescription) OR 
  • Obtain verbal authorization for frequent dispensing as described in this article. 

Questions? With each issue of The Tablet, the Pharmacy Practice Support team will answer one or more common questions they hear on a regular basis from pharmacists in the field.

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