All pharmacists in B.C. receive the Scope of Practice Round-up produced by the BC Pharmacy Association, highlighting important changes to the profession's scope. Updates will be distributed quarterly. Past editions can be found at bcpharmacy.ca/scope-practice-round.
MedSask Updates
Have you accessed medSask guidelines and PARs recently? If not, here are some of the recent changes to further align with B.C. MACS scope:
Guideline added for Atopic Dermatitis (March 27 2025)
Acne guideline, algorithm and PAR have been updated to include information on all topical therapies (April 24 2025)
Guideline on Contraception (updates expected in fall 2025)
To view updates to the medSask guidelines, please visit https://medsask.usask.ca/professional-practice/restricted-guidelines/guideline-updates.php
Updated Drug Products list for Minor Ailments and Contraception Services (MACS)
An updated version of the BCPhA resource listing drug products for MACS is now available at the MACS Portal on bcpharmacy.ca. Updates were made on April 8, 2025. The document is for informational purposes and may not capture all commercially available prescription products that fit under approved drug categories for pharmacist minor ailment and contraception prescribing, or non-prescription products that may be recommended.
College identifies top areas of non-compliance for adaptations, minor ailments
Areas of non-compliance for adaptations
Therapeutic Substitutions of Controlled Substances Therapeutic substitutions are not permitted for controlled substances. Compliance Officers have noted trends in therapeutic substitutions performed on controlled substances such as amphetamines (i.e. dextroamphetamine, lisdexamfetamine), anabolic steroids (i.e. testosterone) and narcotics (i.e. acetaminophen/codeine, tramadol). The prescriber must be consulted if a therapeutic substitution is required for controlled substances.
Documentation of Prescription Adaptations
The most common areas of non-compliance in adaptation documentation included not documenting the rationale for the decision to adapt and not documenting the name of the practitioner(s) notified and the date of notification.
- The intervention code description (i.e. dose change, formulation change, etc.) is not sufficient for documentation of rationale. Pharmacists are to document the client and drug therapy specific details that were considered in the decision to adapt.
- After adapting a prescription, a pharmacist must notify the prescriber, if available, (and the client’s primary health care provider, if different) as soon as reasonably possible after dispensing. Documentation of the name of the practitioner(s) notified and the date of notification must be retained. Retaining fax confirmations of notifications may fulfill this requirement in full or partially, as long as the required components are included. Click here to access the full version on the College of Pharmacists' website.
Areas of non-compliance for MACS
In a two-part series, the College of Pharmacists has published articles in January and October 2024 on areas of non-compliance observed by its officers when reviewing MACS.
In the January 2024 report, the College identified two issues.
Prescribing Out of Scope
Compliance Officers have identified instances where pharmacists have prescribed drugs that were not within the specified drug categories in Schedule A for the diagnosed condition. Examples include prescribing “triptans” for headaches and muscle relaxants for musculoskeletal pain. In both examples, pharmacists are limited to prescribing non-steroidal anti-inflammatories for these conditions.
Additionally, there were observed instances of pharmacists diagnosing and prescribing for urinary tract infections (UTIs) in cases where the patient presented with signs and symptoms of a complicated infection. Pharmacists may only prescribe for uncomplicated UTIs.
Documentation
Compliance Officers have noted missing or incomplete documentation. Required components such as the pharmacist’s rationale and the instructions provided to the patient, including the monitoring and follow-up plan, were the most common pieces missing from the documentation. Pharmacists should review templates to confirm all of the required pieces of documentation are accounted for. If a template is missing sections that are required by the standards, the pharmacist is still responsible for ensuring these pieces are documented.
The full January 2024 compliance report is available here.
In the October 2024 report, the College provided additional information on Prescribing Out of Scope. Compliance Officers have also noted some additional cases of prescribing out-of-scope which include:
1. Oral antibiotics for conditions other than uncomplicated UTIs: With exception to treating uncomplicated UTIs, if a pharmacist determines that an oral antibiotic is indicated based on a patient’s signs, symptoms and treatment guidelines, the patient must be referred to an appropriate healthcare professional.
2.Treatment of musculoskeletal pain: Pharmacists are limited to prescribing NSAIDs for the purposes of treating musculoskeletal pain. It is outside of scope to prescribe non-NSAID drugs such as colchicine and tramadol.
3. Treatment of allergies/allergic rhinitis: Prescribing of montelukast, a leukotriene receptor antagonist which is indicated for the treatment of asthma, is outside of a pharmacist’s scope.
New continuing education requirement for Indigenous Cultural Safety, Humility and Anti-Racism
The College of Pharmacists of BC has announced a new requirement that, starting Apr. 1 2025, all pharmacy professionals in B.C. must complete a minimum of three hours of continuing education learning per year related to Indigenous Cultural Safety, Humility and Anti-Racism. The three hours will count toward the existing 15-hour annual continuing education requirement, and the College is providing a list of suggested learning activities here.
B.C.'s first Physician Assistants start at Vancouver Island hospital
The College of Physicians and Surgeons of BC has begun registering physician assistants (PAs) to work under the direction of physicians in emergency departments in B.C. The first two PAs in the province started clinical shifts at Saanich Peninsula Hospital emergency department on Jan. 8, 2025, as part of a prototype project.
Pharmacies can expect prescriptions written by certified PAs. The PharmaNet practitioner reference ID for certified PAs is M9. Pharmacists must enter the prescriber’s 5-digit practitioner ID, last name, and enter or select the new practitioner reference ID (M9) for transactions to adjudicate correctly. PAs are not authorized to prescribe narcotics or controlled substances.
RAT kit distribution program winds down
PharmaCare’s distribution of COVID-19 rapid antigen test (RAT) kits has come to an end. The last day to order kits eligible for a distribution fee was on May 31, 2025, and the last day to submit claims is June 30, 2025. Distributors will continue to supply kits at no cost to pharmacies while supplies last, but pharmacies cannot claim the distribution fee on tests ordered after May 31, 2025. All provincially supplied kits must continue to be provided free to patients. Pharmacies may offer RAT kits privately once the program ends.
Changes to COVID-19 vaccine administration fee
Effective May 1, 2025, the fee for COVID-19 vaccine administrations is set to $12.10, the standard fee paid to pharmacists for administering publicly funded vaccines. When the COVID vaccine was launched in 2021, PharmaCare temporarily added a $5.90 supplement to the usual vaccine administration fee of $12.10, which brought the fee for COVID-19 vaccinations to $18.00.
BC Pharmacy Day at the Legislature
On May 1, 2025, dozens of delegates from the BC Pharmacy Association visited B.C.'s Legislative Assembly to showcase the work of community pharmacists and what more pharmacists can do for British Columbians.
Sponsored by B.C.'s Minister of Health, the Hon. Josie Osborne, the event included a mock pharmacy with stations on point-of-care testing for strep throat, dispensing and adaptations, pharmacy primary care clinics, rural care and immunizations. Members explained the role of B.C.'s community pharmacists and what government decision-makers could do to advance the practice and business of community pharmacy in British Columbia.
This year's Pharmacy Day at the Legislature was the first in a decade, and members held 1-on-1 meetings with MLAs and their staff members to discuss our advocacy issues.
Visit our Pharmacy Day page to see photos of the event.
Register for an updated Opioid Agonist Treatment workshop
Need training to offer Opioid Agonist Treatment (OAT)? There are multiple workshops coming up.
For new pharmacists or pharmacists who are new to British Columbia, and/or are now providing services related to OAT, the BCPhA continues to host virtual workshops for pharmacies to meet the PPP-66 OAT training requirement.
In June 2024, OAT CAMPP training underwent a major update to be aligned with the latest clinical and regulatory changes. See the Updated OUD Guidelines for more information.