Frequently Asked Questions

Aren't pharmacists too busy preparing prescriptions to answer questions about medications?

On the contrary, an essential part of our job as pharmacists is to talk to you and discuss any questions you may have about your medications.

Can I ask my pharmacist about correct dosing and possible side effects of common over-the-counter (non-prescription drugs), supplements and herbal remedies?

Yes. Please talk to your pharmacist. Too few patients take advantage of the pharmacist's knowledge and ask questions about non-prescription drugs and alternative therapies.

How can I find out if the cost of my drugs is covered?

The British Columbia PharmaCare program offers a number of programs which cover some or all of the cost of prescription drugs for people who live in British Columbia.

Why does it take so long to get my prescription filled?

There is a lot more to preparing your prescription than counting pills, typing a label and sticking it on a container. Your pharmacist checks the medication, dose and instructions to make sure they are right for you. S/he reviews your confidential PharmaNet profile to check for possible problems. This may include allergies or interactions with other medications you are taking. Your pharmacist enters the details of your current prescription onto your PharmaNet profile. Once your prescription is filled and checked your pharmacist talks to you about why you have been prescribed this particular drug. S/he counsels you on how and when to take your medication, what potential side effects you may need to watch for and how to store your medication.

Why does the pharmacist ask me questions about my medical conditions? Do they really need to know that?

Your pharmacist’s main responsibility is to find, fix and prevent drug related problems. Many medications can be used for more than one medical condition. In order to ensure that your medications are appropriate for you and that you will get the most benefit from them, your pharmacist has to understand why you are taking the medications.

Sometimes my pharmacist phones my doctor with some questions. Why do they need to bother the doctor?

Your pharmacist’s main responsibility is to find, fix and prevent drug related problems. Many medications can be used for more than one medical condition. In order to ensure that your medications are appropriate for you and that you will get the most benefit from them, your pharmacist has to understand why you are taking the medications. Sometimes they need to contact your doctor to confirm the reason the medication has been prescribed, or they may have some suggestions on a different medication or a different dosage that might work better for you. They may also want to talk the doctor about the other medications you are on, especially if there is a possibility of an interaction between two or more of your medications.

How do I know the information on my PharmaNet profile is confidential?

PharmaNet is a province wide computer network managed by the Provincial government. This network contains confidential personal profiles of everyone receiving prescription medications in B.C., whether dispensed in a community pharmacy or hospital outpatient pharmacy. This means PharmaNet tracks your entire prescription history, regardless of where you get your prescription filled in B.C. Information stored on PharmaNet helps your pharmacist make decisions about your overall health care including making sure your new medication will not interact with other medications you are taking. Your PharmaNet profile is completely confidential. It can be accessed only by a registered pharmacist or other authorized health care professional, and only when medically necessary. The PharmaNet system contains many security features to prevent unauthorized access to your Patient Record. However, if you still have concerns about security, you may attach a confidential Keyword of your choice to your Patient Record. You can also ask for a PharmaNet printout of your prescription history at any time.

Is everyone who works behind the pharmacy counter a pharmacist?

No. Pharmacy staff can include pharmacy technicians and/or pharmacy assistants. Pharmacy technicians support pharmacists with daily technical functions so that pharmacists can use their medication expertise to focus on patient care. Pharmacy technicians perform duties that do not require clinical judgement such as counting pills, preparing drugs, entering drug orders, controlling pharmacy inventory, checking other technicians’ work, maintaining the function of complex equipment and obtaining insurance authorizations. Pharmacy technicians are licensed pharmacy professionals who are regulated by the College. They can be employed in every practice setting where there is a pharmacy including community, hospital and long-term care pharmacies.

Pharmacy assistants help in the pharmacy by supporting the work of pharmacists and pharmacy technicians, under the supervision of a pharmacist. Pharmacy assistants are not licensed or regulated by the College. 

Why does my morphine prescription need to be written on a duplicate/triplicate prescription form?

There are specific classes of drugs under the Controlled Prescription Program (including narcotics) which have the potential for inappropriate use. These drugs must be written on a Controlled Prescription Program form for tracking purposes to reduce the potential for inappropriate prescribing and to prevent forgeries.

Why is the College implementing the new Practice Review Program?

The College is implementing the Practice Review Program in order to enhance the quality of pharmacy practice by improving compliance through strengthened enforcement. One of the ways that the College can ensure best practices are being followed is to establish and communicate standards and guidelines to pharmacy professionals and review their individual performance in a pharmacy setting. By reviewing real practice in real time, the College is helping to maintain and elevate public confidence in the profession.

Who has been involved with the development of the Practice Review Program?

The Board has consulted widely on the program, and was actively informed not only by the Quality Assurance Committee, but by the 1500 practising pharmacy professionals across the province who participated in an online engagement opportunity.  Pharmacy managers and pharmacy professionals in community pharmacy practice also participated in two feedback forums held in April 2014.

At the April 2014 meeting, the Board established the Practice Review Committee which will oversee the development of the program, and its policies and processes for final approval by the Board.

What if there are scheduling conflicts for staff who are sick or on holidays?

The College understands that at certain times of the month or year it may be inconvenient to have compliance officers in pharmacies for an extended period of time. The College will do its best to work with the pharmacy manager to determine the least disruptive times, but it is the pharmacy manager’s responsibility to ensure that most, if not all, staff are present during the Practice Review.

In the event where pharmacy professionals miss the Practice Review, a compliance officer will return to the pharmacy to perform those reviews.

What is the College looking for during the Pharmacy Review?

Compliance officers will be reviewing pharmacies for adherence to practice standards and guidelines such as the Health Professions Act, College Bylaws, the Model Standards of Practice, the Pharmacy Operations and Drug Scheduling Act, Professional Practice Policies, and the Framework of Professional Practice and guidelines

What is the College looking for during the Pharmacy Professionals Review?

Pharmacy professionals will be reviewed on focus areas that have been deemed the most relevant to professional pharmacy practice in British Columbia. The Board has identified a total of six focus areas they believe to have the greatest impact on public safety. Focus areas differ between pharmacists and pharmacy technicians. Each will be reviewed on four focus areas depending on their registration type: 

The focus areas for Pharmacists are: 

  • Patient Identification Verification
  • Profile Check
  • Counseling
  • Documentation

The focus areas for Pharmacy Technicians are:

  • Patient Identification Verification 
  • Product Distribution 
  • Collaboration 
  • Documentation 

Note: The focus areas for pharmacy technicians in community practice are in the process of being updated. They will soon reflect the same focus for pharmacy technicians in hospital practice.

What criteria or specific details will the College be looking for under each of these four focus areas?

For information on specific assessment criteria, please refer to the following review forms: 

For Hospital Pharmacy: 

For Community Pharmacy: 

What happens after the review has been completed?

After the review has been completed, the compliance officer will forward the Pharmacy Review results to the pharmacy manager, and individual Pharmacy Professional Review results to each pharmacy professional. These results will be available in real time, accessible online through the confidential and secure eServices portal. The compliance officer will discuss results with the pharmacy manager and individual pharmacy professional for their respective reviews.

Where a compliance officer observes a standard/guideline that is not met, they may assign action item(s). These observations and action items are standardized to ensure consistency and fairness of all practice reviews. Pharmacies and pharmacy professionals will be given deadlines (typically 30 days) to complete these items, and compliance officers will verify whether the action items have been completed by the deadline. After all action items have been completed, the compliance officer will sign-off on the review, and a notice of completion will be issued to the appropriate party.

When is the Practice Review Program being launched?

The Practice Review Program launched in Community Practice in 2015 and in Hospital Practice in 2017. 

How can I stay informed on the development of the Practice Review Program?

Infomation will be available on the College website. In addition to ReadLinks, watch for updates by following the College on Facebook, Twitter, and LinkedIn.

How will pharmacy professionals who do not practice in a conventional community or hospital setting be reviewed?

The College recognizes that there are a variety of different practices in BC, and asked for feedback on this subject through online engagement with over 1500 pharmacy professionals. The College will be taking a phased approach in developing the Practice Review Program and, with input from the Practice Review Committee, will develop processes that address different practices within the province.

What is an “original” prescription?

In the glossary of terms included in the PPP-58 Orientation Guide a “new and/or original” prescription is defined as: the first fill of a prescription and does not need to be the beginning of a new drug therapy. Although this definition remains accurate further clarification is required.

An “original” prescription may be a new written, verbal or faxed authorization from any prescriber. In addition, an “original” prescription may be a fax-back or verbal refill request authorized by a prescriber.

Which of the new clinical services fee intervention codes should be used for missing information?

PharmaCare has not defined a specific intervention code for missing information, however, depending on the situation, pharmacists should use their professional judgment and choose the code that best fits the circumstance. For example: 

  • If no dose or no quantity was provided
    • use NI (dosage change)
  • If no directions were provided
    • use NK (directions for use modified)

For more information regarding clinical services fee processes and procedures refer to the BCPharmaCare Newsletter

December 22, 2008, Edition 08-012 www.health.gov.bc.ca/pharme/newsletter/index.html

As a community pharmacist (not working in a multi-disciplinary environment) what are the restrictions with respect to medications and/or medical conditions for adapting prescriptions?

There are differing guidelines for the three distinct ways in which a community pharmacist may adapt a prescription (change, renew or substitute), therefore the restrictions vary with each type of adaptation.

Change:

  • Will not change the dose or regimen of a prescription for: cancer, cardiovascular disease, asthma, seizures or psychiatric conditions, however pharmacists can complete missing information if there is historical evidence to support it.

Renew:

  • With the exception of narcotics and/or controlled substances, which are restricted from any type of adaptation and psychiatric medications which are reserved for pharmacists working in multi-disciplinary environments there are no restrictions for renewals as long as the condition is stable, chronic (defined as being on the same medication, without change, for a minimum of 6 months). The maximum renewal is up to approximately 6 months from the date of the original prescription.

Therapeutic Substitution:

  • Limited to: histamine 2 receptor blockers (H2 blockers), non-steroidal anti-inflammatory drugs (NSAIDs), nitrates, angiotension converting enzyme inhibitors (ACE inhibitors), dihydropyridine calcium channel blockers (dihydropyridine CCBs) and proton pump inhibitors (PPIs) – similar to government policies.
What happens to the authorized refills when a prescription is adapted?

The pharmacist takes responsibility for the adapted prescription as well as the authorized refills. The pharmacist could choose to provide an initial adaptation of the prescription but reduce or eliminate the authorized refills. If they did this they would need to provide the rationale for their decision in their documentation and inform the patient that they will need to return to their physician earlier than intended (note: a pharmacist cannot add refills that were not initially authorized by the prescriber). Whatever the final decision is, it must be properly documented and provided in the notification to the prescriber.

If the pharmacist adapts the prescription and maintains the authorized refills, when the patient returns for a refill the pharmacist would process the refill as they would any other refill prescription. The processing of a refill of an adapted prescription is not considered an adaptation per se, so the documentation and notification requirements of PPP-58 do not apply.

Should the patient return to the pharmacy for a refill and a different pharmacist is on duty that pharmacist would again process the refill as they would any other refill, keeping it under the adapting pharmacists ID. If they have a concern about the appropriateness of the adapted prescription they should do what they normally do if they have a concern about refilling a prescription; refuse to fill, provide an emergency fill if necessary and in this case either refer the patient back to the adapting pharmacist or to the original prescriber.

Finally it is important to note that when a pharmacist adapts a prescription and maintains the authorized refills they must inform the patient that as a result of them doing this the prescription is now non-transferable which means the patient will need to return to this specific pharmacy in order to get their refills.

I have just received a prescription with the following statement “Do Not Renew &/or Adapt” (or something similar) hand-written on it. Does this mean that I cannot adapt or renew this prescription?

Yes. Just like we honour notations like this from prescribers today regarding generic substitution pharmacists are expected to honour hand-written “Do Not Renew &/or Adapt” instructions on prescriptions. The College of Physician and Surgeons (CPSBC) have agreed that pre-printed prescription pads are not acceptable and if a physician electronically produces their prescription they must sign or initial beside the notation.

It is important to remember that should a pharmacist, presented with a valid notation on a prescription, still feel that an adaptation or renewal is in the best interest of the patient there are a number of options still available to them: contact the prescriber for prior permission to adapt or renew the prescription or provide an emergency fill (PPP-31) to ensure continuity of care giving the patient time to get in to see their physician.

What are the limits and conditions, including length of time, with respect to renewing prescriptions for my patients?

When considering whether or not to renew a prescription for a patient a pharmacist must ensure the following:

  1. They have the original prescription in their pharmacy and the prescription is still valid, and
  2. The patients’ condition is stable and chronic (defined as being on the same medication, without change, for a minimum of six months).

Assuming these conditions are met a pharmacist, by applying the seven fundamentals , could provide a renewal for up to six months from the date of the original prescription. Example(s):

  • Hydrochlorothiazide 25mg, daily, 100 – pharmacist could provide one renewal of Hydrochlorothiazide 25mg, daily, 100 (note: although this is slightly over the maximum six months timeline it is completely acceptable by the College and the CPSBC)
  • Hydrochlorothiazide 25mg, daily, 30 – pharmacist could provide one renewal for Hydrochlorothiazide 25mg, daily, 100, then after the 100 days, after assessment, provide a second renewal for 60 days.

Although there are no restrictions with respect to the types of conditions or drugs (other than narcotics and controlled substances which are restricted for all adaptations) to which a pharmacist could consider a renewal, special consideration should be taken with respect to psychiatric medications.

As a typical community pharmacist what are the circumstances in which I could provide a therapeutic substitution or make a change to a prescriptions dose, formulation or regimen?

Assuming that no collaborative relationships or appropriate protocols have been established which would provide more detailed patient medical information, therapeutic substitution in most typical community practices is limited to the following classifications (similar to government policies):

  • Histamine 2 receptor blockers (H2 blockers),
  • Non-steroidal anti-inflammatory drugs (NSAIDs),
  • Nitrates,
  • Angiotension converting enzyme inhibitors (ACE inhibitors),
  • Dihydropyridine calcium channel blockers (dihdropyridine CCBs), and
  • Proton pump inhibitors (PPIs)

With respect to making changes to a prescription dose or regimen, pharmacists working in typical community practice settings, as described above, would not adapt prescriptions for patients with: cancer, cardio-vascular disease, asthma, seizures or with psychiatric conditions. Changes to prescription formulations to ensure continuity of care, such as switching from a tablet to a liquid, as well as completing missing information from a prescription, if there is historical evidence to support it, would be acceptable.

A patient would like me to renew a prescription for them but the original fill was not done in my pharmacy. Can I have the prescription transferred and then renew it?

No. In order for a pharmacist to even consider adapting or renewing an existing prescription they must have the ‘original prescription’ in their pharmacy. The reason for this is because in order to adapt or renew a prescription a pharmacist must have all relevant information available to them and a transferred prescription does not physically transfer the ‘original’ prescription which may have some important notations on it. For similar reasons, once a prescription has been adapted it can not be transferred.

Why did the College establish PPP-58?

You probably already perform many prescription adaptation-related activities now, such as making minor adjustments to prescription details or giving patients an interim supply of a medication to maintain continuity of care. PPP-58 goes beyond what is available today and gives pharmacists independent authority and accountability for the adaptation of a prescription and provides the framework to guide pharmacists in safe and effective practice.

The policy, which provides the opportunity for pharmacists to maximize their full educational and professional competencies, also provides structure to, and refines the process of, exercising professional judgment in clinical practice. This becomes increasingly important as pharmacists evolve their role as medication experts.

Do I have to adapt a prescription?

No. Authorization does mean obligation. The decision to adapt a prescription or not is at the discretion of the individual pharmacist. Whenever a pharmacist chooses to adapt a prescription however, the adaptation must be done in accordance with PPP-58 and within the limits of the pharmacist’s own competencies.

Why should I care about adapting prescriptions?

It makes good practical sense that pharmacists are authorized to adapt prescriptions. With your training in drug therapy, being able to adapt prescriptions means that patients will have access to medication management services from pharmacists more effectively than in the past. Patients will have improved access to drug therapy renewals to ensure uninterrupted continuity of on-going therapy for chronic conditions. Pharmacists will be able to eliminate the delays associated with contacting a prescriber for clarification, modification or improvement of drug therapy with a prescription. Pharmacist involvement with adapting prescriptions will improve inter-professional communication, documentation of care and patient involvement in decision-making and consent, which are all positive steps for health care. The bottom line is that British Columbians have asked for quicker, more convenient access to prescription renewals and optimal drug therapies. PPP-58 is the first step in this process and has the potential to also free up physician time to see patients in need of their services.

Are there special requirements needed in order to adapt a prescription?

Yes. In order to adapt a prescription a pharmacist, in addition to having read and understood the Orientation Guide and Amendment to the Orientation Guide, must possess professional liability insurance (minimum $2 million) and must adhere to all of the seven fundamentals for adapting a prescription as outlined in PPP-58.

How will my patients know that I’m qualified to adapt prescriptions?

You are responsible for informing patients of your authority to adapt a prescription and for deciding whether or not you are prepared to make an adaptation when appropriate. All pharmacists who are licensed in British Columbia are required to have read the Orientation Guide and Amendment to the Orientation Guide by December 31, 2008 and pharmacists’ authority to implement PPP-58, and thereby adapt prescriptions, is effective January 1, 2009.

How will the College ensure quality medication management activities by pharmacists?

The College’s mission is to protect the public by ensuring that College registrants provide safe and effective pharmacy care to help people achieve better health. The College’s Quality Outcome Specialist Staff will include a review of the processes and procedures required to apply PPP-58 in their on-going site visits.

Will I be able to adapt prescriptions for narcotics?

No. PPP-58 does not authorize pharmacists to adapt prescriptions for narcotics, controlled drugs or targeted substances.

In Alberta, pharmacists are also authorized to provide medications by injection, initiate prescriptions, or modify prescriptions for ongoing therapy – is that being planned for British Columbia?

College council recently, through inclusion in the College’s strategic plan, has directed College staff to “develop a plan to encourage the government to authorize advanced professional practice for pharmacists in BC”.

Do I have to complete this orientation if I don’t plan to adapt prescriptions?

Yes. Although it is not mandatory that a pharmacist adapt a prescription, given that PPP-58 enhances pharmacists’ scope of practice, it is mandatory that all registrants acknowledge that they have read and understood PPP-58 (by signing the Declaration Form included in the Orientation Guide and the Amendment to the Orientation Guide) by December 31, 2008.

Why did the College update standards for methadone maintenance treatment (MMT)?

The College updated standards for MMT in collaboration with PharmaCare and other stakeholders. To transition compounded oral methadone 1 mg/ml and provide coverage for methadone commercially available 10 mg/ml oral preparation. The standards were developed to facilitate a safe transition from the current compounded methadone to the methadone concentrate of 10 mg/ml and to ensure that patients have access to standardized pharmacy services for MMT in BC. 

Is there a transition period when methadone for maintenance 1 mg / ml OR 10 mg/ml may be dispensed?

Yes. The month of February 2014 is the 'transition' period when pharmacists may dispense methadone 1 mg/ml for prescriptions written in January 2014 OR methadone 10 mg/ml for new prescriptions written in February 2014 and beyond. During the transition period it will be important for pharmacists to be extra vigilant when dispensing the two different strengths to minimize the risk of dispensing error(s). 

When can I start dispensing methadone 10 mg/ml for maintenance?

Methadone 10 mg/ml may be dispensed as of February 1, 2014; pharmacists may only accept prescriptions for methadone 10 mg/ml for maintenance that are written on the new Methadone Maintenance Controlled Prescription Form. 

What do I do if I have an existing prescription as of February 1, 2014 that authorizes home delivery?

A pharmacist may only provide home delivery of methadone as of February 1, 2014 if they have received written authorization from the prescribing physician on the Methadone Maintenance Controlled Prescription Form in accordance with Professional Practice Policy 71. As of February 1, 2014, existing prescriptions will no longer be valid for home delivery; the patient must obtain a new prescription on the new MMT CPP form to authorize home delivery.

Home delivery of MMT may only be provided if the prescribing physician has determined that the patient has severe mobility restrictions and the prescribing physician has provided written authorization by signing the delivery declaration box on the Methadone Maintenance Controlled Prescription Form. Pharmacy managers or staff pharmacists may not authorize the provision of home delivery for MMT in the absence of the prescribing physician’s written authorization. Refer to PPP-71 for requirements that must be met if and when a pharmacist provides home delivery of MMT. 

Note: The College of Physicians and Surgeons of BC has recommended to their MMT prescribers to cross out the declaration box if home delivery is not authorized. 

When can I no longer accept prescriptions for methadone 1 mg/ml for maintenance?

Effective February 1, 2014 all MMT prescriptions that are prescribed and started in February must be for methadone 10 mg/ml.

If you receive an old Controlled Prescription Form and it is prescribed in January and carries over or starts in February you may dispense methadone 1 mg/ml for maintenance until the prescription is complete or until February 28, 2014, whichever comes first.

Can I dispense methadone 1mg/ml for maintenance on or after March 1, 2014?

No. As of March 1, 2014 pharmacists are not permitted to dispense methadone 1mg/ml for MMT. Effective March 1, 2014 implementation of consistent dispensing standards will require all pharmacists to dispense only the commercially available oral preparation of methadone10mg/ml to support patient safety. 

Can I accept a prescription for methadone for maintenance on the regular controlled prescription program (CPP) form?

Effective February 1, 2014, there will be only one form for MMT; all new prescriptions for methadone maintenance written in February must be on the new Methadone Maintenance Controlled Prescription Program form that is pre-printed with methadone 10mg/ml. Effective March 1, 2014, CPBC inspectors will be inspecting to ensure all MMT prescriptions are on the new MMT prescription pads. 

Can I accept a prescription for methadone for pain on the Methadone Maintenance Controlled Prescription (MMT CPP) form?

No. Pharmacists may not accept prescriptions for methadone for pain on the Methadone Maintenance Controlled Prescription Program form. A Pharmacist may only accept prescriptions for methadone for pain that are written on the regular Controlled Prescription Program form 

Can physicians still fax methadone prescriptions to pharmacies in an emergency situation and send the original at a later date?

Yes. Faxed Methadone Maintenance Controlled Prescription forms may only be accepted in the event of an emergency that requires a faxed MMT Controlled Prescription form that has been initiated following direct consultation between the patient's pharmacist and prescriber. 

In this emergency situation, the pharmacist must obtain written documentation from the prescriber prior to dispensing any medication. CPBC's Policy Guide for MMT includes a sample form titled, 'Emergency Fax Methadone Maintenance Controlled Prescription Form Documentation', the pharmacist may fax this form to the physician. The physician must fax documentation requesting the pharmacist to accept a faxed transmission of the MMT Controlled prescription form for the specified patient, with the prescription for MMT to the pharmacy. The physician must send the original prescription form to the pharmacy by the next business day. A copy of the form is available in CPBC's Policy Guide for MMT, refer to page 25, Appendix 4; 'Emergency Fax Methadone Maintenance Controlled Prescription Form Documentation'.

Pharmacist acceptance of a faxed prescription for methadone for maintenance should be the exception and not the rule. 

Can I still accept out-of-province prescriptions?

Yes. Pharmacists may choose to dispense methadone prescriptions from prescribing physicians in provinces other than BC. If there is any doubt regarding the authenticity of the out-of-province prescription, the pharmacist must contact the out-of-province prescribing physician to confirm the legitimacy of the prescription (including the prescriber’s exemption to prescribe methadone). When satisfied that the prescription is authentic, the pharmacist may dispense and process the prescription in the same manner as other prescriptions from out-of-province prescribers; only methadone 10 mg/ml may be dispensed. 

What is the difference between prescribing date and start date?

The 'prescribing date' is the date the prescribing physician wrote the prescription while the 'start date’ is the date the prescribed therapy is to commence. If the 'start date' is blank the pharmacist may assume that the 'prescribing date' is the 'start date'. If the 'start date' overlaps with or leaves gaps from the existing prescription the pharmacist must seek clarification from the prescribing physician.  

When can I dispense compounded methadone for maintenance after March 1, 2014?

The only situation where compounded methadone may be dispensed is when a commercially available 10mg/ml oral preparation is not available. Refer to CPBC's Policy Guide for MMT, Section 6.3 Compounding in Exceptional Circumstances. In order for the patient to receive coverage for compounded methadone when there is a supply shortage, the pharmacist must follow PharmaCare's procedures to report the shortage before dispensing compounded methadone. The pharmacist MUST compound and dispense methadone at 10 mg/ml only. Refer to PharmaCare Policy Manual, Section 5.11, page 14 Manufacturer Shortages. http://www.health.gov.bc.ca/pharmacare/pdf/5-6to5-12.pdf

Does Professional Practice Policy 66 apply to methadone for pain?

No. Professional Practice Policy 66, sets the standards for practice for methadone for maintenance only. We do not have any specific practice standards for pain other than regulations in place that apply to all medications.

Any questions regarding coverage must be directed to PharmaCare. 

Is methadone 10 mg/ml available in other flavours? What if my patient has an allergy or is diabetic?

Only the cherry flavoured methadone 10 mg/ml is covered by PharmaCare. It was decided that flavoured methadone 10 mg/ml may be dispensed to diabetic patients as the smaller volume of medication is not significant enough to affect diabetic patients.

If the patient has a true allergy to any of the ingredients of the flavoured concentrate, the prescribing physician will need to obtain special authorization from PharmaCare for coverage of the unflavoured version. The pharmacist must compound the unflavoured methadone to 10 mg/ml if required.  

How can I safely and effectively measure small doses of methadone 10mg/ml volume?

The pharmacist must measure the methadone dose using a calibrated device with an error rate of no greater than 0.1ml, which is equal to 1mg. All devices used to measure methadone should be distinctive and recognizable and should be used only to measure methadone solutions. Devices should be labelled with a “methadone only” label and a “poison” auxiliary label with the international symbol of the skull and cross bones. Pharmacists may contact their wholesaler for assistance to locate a product that meets the required specifications. 

Can I dispense methadone 10 mg/ml to my patient in a syringe?

No. It has been deemed inappropriate to dispense methadone to former IV drug users in a syringe. If required the pharmacist may use a syringe with an error rate of no greater than 0.1ml, which is equal to 1mg, to measure small doses. 

Can I QS methadone 10mg/ml with juice?

Although the product monograph indicates that the product may be dispensed undiluted or diluted, the CPBC Methadone Dispensers Working Group decided that it was a better standard for patient safety to not qs methadone 10 mg/ml. The pharmacist is required to dispense the actual dose. Once the patient ingests the medication, the pharmacist must provide water to rinse the dispensing device i.e. cup, and then require the patient to ingest the water with the residual medication, the pharmacist will then engage the patient in a brief conversation to ensure that the patient ingests the entire dose and does not hold the dose in their mouth i.e. cheeking. 

Do I have to be present to witness?

Yes. The pharmacist must follow the prescription release processes defined in CPBC's Policy Guide for MMT. The pharmacist must assess the patient and then must witness ingestion of the dispensed methadone followed by ingestion of water provided by the pharmacist. The pharmacist must then engage the patient in a brief conversation to ensure that the entire dose is ingested and to reduce the risk of diversion. This function cannot be delegated to a pharmacy technician or any other pharmacy support staff. 

How can I ensure that the patient ingests the entire dose of methadone and is not able to divert the smaller volume of medication?

After witnessing the ingestion of the methadone concentrate, the pharmacist must provide water to rinse the dispensing device i.e. cup, to rinse any residual medication and must witness ingestion of the water and engage the patient in a short conversation to ensure that the entire dose has been ingested to reduce the risk of diversion by cheeking. 

Do I have to dispense carries for methadone 10 mg/ml in individual bottles?

Yes, this is a new requirement due to the smaller volume of methadone. Each dose must be measured and dispensed in individually labelled, appropriately sized, child resistant containers. It is not acceptable to dispense multiple carries in one container and have the patient measure individual doses at home. 

When can I provide home delivery of MMT?

Effective February 1, 2014, in accordance with Professional Practice Policy 71, home delivery of MMT may only be provided if the prescribing physician has determined that the patient has severe mobility restrictions AND if the prescribing physician has provided written authorization by signing the delivery declaration box on the methadone maintenance controlled prescription form.

Pharmacy managers or staff pharmacists may not authorize the provision of home delivery for MMT in the absence of the prescribing physician’s written authorization on the prescription. Refer to PPP-71 for pharmacy requirements that must be met if and when a pharmacy provides home delivery of MMT. Note: The College of Physicians and Surgeons of BC has recommended to their MMT prescribers to cross out the declaration box if home delivery is not authorized.

Note: The College of Physicians and Surgeons of BC has recommended to their MMT prescribers to cross out the declaration box if home delivery is not authorized.

Do the patient and pharmacist need to sign to confirm the release of Methadone for Maintenance?

Yes. Prior to releasing the initial methadone prescription, the pharmacist and the patient must sign the Methadone Maintenance Controlled Prescription form in the space indicated on the bottom of the form to confirm the patient has received theinitial dose of the prescription. The patient and pharmacist must also sign the daily patient/prescription-specific log to acknowledge receipt of each witnessed ingestion dose, each partial dose and each take-home dose.

Neither the pharmacist nor the patient is permitted to pre-sign for future doses. The pharmacist must store the signed prescription and the patient/prescriptionspecific log together.  

What is a Learning Record?

A Learning Record is an online form that assists you in documenting your learning activities. Registrants must complete a minimum of 15 hours of learning documented on a minimum of 6 Learning Records prior to renewal of licensure each year. A minimum of 5 hours must be accredited learning and supporting documentation needs to be provided as part of the Learning Record. 

Can I put all my 6 learning goals and activities for the year on one learning record?

No, you must identify and fill out 6 separate Learning Records- one for each goal- every year. Individual learning activities that you have undertaken during the year can be combined based on the goal and documented on one of these 6 Learning Records. You must have a minimum of 15 hours of learning documented on a minimum of 6 Learning Records. A minimum of 5 hours must be accredited learning and supporting documentation needs to be provided as part of the Learning Record. 

If I have more than the minimum hours and/or Learning Records, does it roll over to the next year?

No, hours cannot be carried over from year to year. Learning has to take place within the 12 months prior to your individual renewal date. 

When are my CE-Plus submissions due?

You have 12 months from when you renew your registration to complete your CE requirement, which must be submitted to the College prior to your next annual renewal. For example, if your renewal is on August 31st, 2013, you have 12 months to complete your CE requirements and for this example, CE-Plus submissions would have to be submitted online prior to Midnight on August 31st, 2014. 

Do I have to complete my CE before I can pay for my renewal for the next year?

Besides CE, there are many other requirements for renewal, including payment. You can begin the renewal process at any time, but in order to complete the renewal process, including payment, you must have fulfilled and submitted your CE requirements for the previous year. 

Do I have to have a specific amount of accredited vs non-accredited hours?

A minimum of 5 hours must be accredited learning and supporting documentation needs to be provided as part of the Learning Record. 

Do CEU’s (Continuing Education Units) count?

CEU’s are assigned by accrediting bodies through the accreditation process (see Accredited hours FAQ). Assigned CEU’s vary with the type of learning activity such as lecture (1 hour= 1CEU), workshop, online learning etc. Your CE Plus submission for a specific Learning Record could include the time required to complete a course as well as additional time you spent adding to or implementing your new knowledge. For example, if you attended a course for 2 hours and spent 3 hours completing a follow-up assignment or self-directed learning, you could document 5 hours of learning in that Learning Record. 

Does out of country learning count?

Yes, learning from any source is acceptable as long as it is within your scope of practice as a pharmacist or pharmacy technician. 

How do I know if I have completed all the requirements?

Once you have submitted your Learning Record(s), the Minimum Requirements section in the Learning Record Summary will indicate if you have satisfied the requirements. 

What happens if I do not complete all the requirements by my renewal date?

If you do not complete all requirements by your renewal date, your registration cannot be renewed.

Aren't pharmacists too busy preparing prescriptions to answer questions about medications?

On the contrary, an essential part of our job as pharmacists is to talk to you and discuss any questions you may have about your medications.

Can I ask my pharmacist about correct dosing and possible side effects of common over-the-counter (non-prescription drugs), supplements and herbal remedies?

Yes. Please talk to your pharmacist. Too few patients take advantage of the pharmacist's knowledge and ask questions about non-prescription drugs and alternative therapies.

How can I find out if the cost of my drugs is covered?

The British Columbia Pharmacare program offers a number of programs which cover some or all of the cost of prescription drugs for people who live in British Columbia.

Why does it take so long to get my prescription filled?

There is a lot more to preparing your prescription than counting pills, typing a label and sticking it on a container. Your pharmacist checks the medication, dose and instructions to make sure they are right for you. S/he reviews your confidential PharmaNet profile to check for possible problems. This may include allergies or interactions with other medications you are taking. Your pharmacist enters the details of your current prescription onto your PharmaNet profile. Once your prescription is filled and checked your pharmacist talks to you about why you have been prescribed this particular drug. S/he counsels you on how and when to take your medication, what potential side effects you may need to watch for and how to store your medication.

Why does the pharmacist ask me questions about my medical conditions? Do they really need to know that?

Your pharmacist’s main responsibility is to find, fix and prevent drug related problems. Many medications can be used for more than one medical condition. In order to ensure that your medications are appropriate for you and that you will get the most benefit from them, your pharmacist has to understand why you are taking the medications.

Sometimes my pharmacist phones my doctor with some questions. Why do they need to bother the doctor?

Your pharmacist’s main responsibility is to find, fix and prevent drug related problems. Many medications can be used for more than one medical condition. In order to ensure that your medications are appropriate for you and that you will get the most benefit from them, your pharmacist has to understand why you are taking the medications. Sometimes they need to contact your doctor to confirm the reason the medication has been prescribed, or they may have some suggestions on a different medication or a different dosage that might work better for you. They may also want to talk the doctor about the other medications you are on, especially if there is a possibility of an interaction between two or more of your medications.

How do I know the information on my PharmaNet profile is confidential?

PharmaNet is a province wide computer network managed by the Provincial government. This network contains confidential personal profiles of everyone receiving prescription medications in B.C., whether dispensed in a community pharmacy or hospital outpatient pharmacy. This means PharmaNet tracks your entire prescription history, regardless of where you get your prescription filled in B.C. Information stored on PharmaNet helps your pharmacist make decisions about your overall health care including making sure your new medication will not interact with other medications you are taking. Your PharmaNet profile is completely confidential. It can be accessed only by a registered pharmacist or other authorized health care professional, and only when medically necessary. The PharmaNet system contains many security features to prevent unauthorized access to your Patient Record. However, if you still have concerns about security, you may attach a confidential Keyword of your choice to your Patient Record. You can also ask for a PharmaNet printout of your prescription history at any time.

Is everyone who works behind the pharmacy counter a pharmacist?

No. In many pharmacies, pharmacists have pharmacy technicians to assist with the day-to-day technical functions, so that pharmacists can focus their time on patient care responsibilities. Pharmacy technicians support pharmacists by performing duties that do not require the professional skills and judgement of a pharmacist and assisting in those duties that do require the expertise of a pharmacist. They are often involved not only with counting pills but also with preparing drugs, entering drug orders, controlling pharmacy inventory, checking other technicians’ work, maintaining the function of complex equipment and obtaining insurance authorizations. Pharmacy technicians may be trained on-the-job or certified through a formal technician program. Pharmacy technicians are employed in every practice setting where there is a pharmacy including community, hospital and long-term care pharmacies.

Why does my morphine prescription need to be written on a duplicate/triplicate prescription form?

There are specific classes of drugs under the Controlled Prescription Program (including narcotics) which have the potential for inappropriate use. These drugs must be written on a Controlled Prescription Program form for tracking purposes to reduce the potential for inappropriate prescribing and to prevent forgeries.

Why is a criminal record check required?

Under the Health Professions Act (HPA), which took effect April 1st, 2009, all applicants and registrants of the College of Pharmacists of BC are required to consent to an ongoing criminal record check (CRC) at least once every 5 years.

The criminal record check is a requirement of the Criminal Records Review Act (CRRA) and is applicable to applicants and registrants of all professional regulatory bodies governed by the HPA. The Criminal Records Review Act is intended to help protect children from physical and sexual abuse or vulnerable adults from physical, sexual or financial abuse. All applicants and registrants must undergo a CRC regardless of whether or not they work directly with children or vulnerable adults.

Consent to a CRC is mandatory. If an applicant or registrant refuses to provide consent, the College will not be able to register or renew their registration. Without registration, an individual cannot practise as a pharmacist or pharmacy technician in BC

I am on the non-practicing pharmacist or pharmacy technician registration / student pharmacist registration category. Do I have to consent to a Criminal Record Check?

Yes, all registrants of the College must consent to an ongoing criminal record check at least once every 5 years.

What are relevant criminal records?

The Criminal Records Review Act lists relevant offences associated with physical and sexual abuse, including indecent acts, neglect, assault, trafficking in drugs and serious crimes. They are used as a basis to determine if a person presents a risk to children or vulnerable adults. Convictions related to provincial or minor criminal offences, not related to the protection of children or vulnerable adults, are not included. 

How long does it take to process my pre-registration application?

Allow up to 20 business days to process your pre-registration application. Once completed, a confirmation letter will be sent to you. To avoid delays in processing, ensure that all your documents are complete. 

How long does it take to process my Full Pharmacist registration application?

Allow up to 5 business days to process your Full Pharmacist application. Once completed, your registration number will be emailed and a Certificate of Registration and registration wallet card will be mailed in 3 to 4 weeks. 

I am an International Pharmacy Graduate. How do I know if my pharmacy degree will be recognized for practice in Canada?

To ensure that your pharmacy degree will be recognized for practice in Canada, contact the Pharmacy Examining Board of Canada (PEBC) to have your documents evaluated. Visit the PEBC website (www.pebc.ca) for more information.

Will you recognize the Foreign Pharmacy Graduate Equivalence Certification (FPGEC) from the US?

No, pharmacists who wish to practice in Canada are required to certify with the Pharmacy Examining Board of Canada (PEBC). Visit the PEBC website (www.pebc.ca) for more information.

How do I obtain a work permit?

The College is not responsible for providing advice regarding work permits. These questions should be directed to Citizenship and Immigration Canada (www.cic.gc.ca). 

How many hours of Structured Practical Training (SPT) are International Pharmacy Graduates required to complete?

International Pharmacy Graduates are required to complete 500 hours (3 months) of SPT. 

Can my previous work experience as a pharmacy intern/pharmacy technician/pharmacy assistant be applied towards a reduction in my SPT hours?

Previous experience as a pharmacy intern/pharmacy technician/pharmacy assistant cannot be applied towards your SPT hours. Only hours worked as a registered pharmacist in the U.S. or Canada can be considered.

Do I get paid for SPT?

Whether or not you are paid during your SPT, is an arrangement that is made between you and your site. UBC-OEE or the College is not involved in this arrangement.

Where can I find a testing centre for the English language Proficiency (ELP) test?

You may find testing centre locations on the following websites:

I am an International Pharmacy Graduate but English is my first language. Do I still have to take an English Language Proficiency (ELP) test?

Yes. According to the standards set by the National Association of Pharmacy Regulatory Authorities (NAPRA), all pharmacists who have obtained their pharmacy degree outside of Canada or the U.S. are required to complete one of the approved ELP assessments. Refer to RCP–1 English Language Proficiency.

What scores do I need to meet the English Language Proficiency (ELP) requirements?

The ELP requirements can be found in RCP–1 English Language Proficiency.

You may compare your test scores to those listed in Appendix 1, under the “Minimum score with SEM” column. The College does not verify scores over the phone or by email. 

How should I provide you with my English test scores?

Place a request with the English language testing agency to send an official score report directly to the College of Pharmacists of BC. Copies of the score report submitted directly from the Applicant will not be accepted. Once the scores have been processed your results will be emailed. 

How do I arrange to write the Jurisprudence Exam outside of Vancouver?

If you wish to write the Jurisprudence Exam outside of Vancouver, there will be preselected cities that you can choose from when registering through eServices: Nanaimo, Kelowna, Prince George, Calgary, Saskatoon, Winnipeg, Toronto, Ottawa, Montreal, Halifax, and St. John’s. Information regarding the exact time and location of the sitting will be determined by the College and provided to you via email about one month prior to the date of the exam.

How should I study for the Jurisprudence Exam (JE)?

For information on what to study for the JE, view the JE information guide and orientation presentation on the College website: 

I am a first year UBC pharmacy student. When should I submit my student (UBC) registration application?

Your application should be received by the College office no later than September 1, before the start of your first year in the pharmacy program. 

Where can I obtain liability insurance to be a Full Pharmacist?

If you are already employed, you can confirm with your employer if liability insurance is provided, otherwise you may obtain it through an insurance broker or membership with the BC Pharmacy Association (http://www.bcpharmacy.ca). Please ensure the insurance provided meets all 3 criteria listed in the application form.

Do I have to become a regulated pharmacy technician?

No, becoming a regulated pharmacy technician is voluntary; however, regulation will restrict the title of’”pharmacy technician’ and therefore, those who choose not to become regulated, or are unsuccessful in becoming regulated, will no longer be able to refer to themselves as pharmacy technicians as of January 1, 2011 and will likely be called ‘pharmacy assistants’.

What is regulation/certification/registration?

‘Registration’, ‘Certification’ and ‘Regulation’ are different terms that are currently being used to describe the same thing:

  • Establishes a new ‘regulated healthcare professional'
  • Establishes a new member (registrant) with the College of Pharmacists of BC
  • Restricts the title ‘pharmacy technician’ effective January 1, 2011
  • Holds the ‘pharmacy technician’ responsible, accountable and liable for a specific scope of practice (job description)
When will ‘pharmacy technician’ become a restricted title?

The Ministry of Health (MOH) approved the restriction of the title ‘pharmacy technician’ (amendment) effective January 1, 2011. At the same time, the MOH approved the revised HPA Bylaws which was the final step in the approval process regarding the legislative authority to register pharmacy technicians as registrants of the College of Pharmacists of BC. 

What will my responsibilities be (Scope of Practice) as a regulated pharmacy technician?

Specifically, regulated pharmacy technicians will have independent authority, responsibility and liability (required by legislation to have liability insurance) to prepare, process and compound prescriptions, including:

  • Ensuring the accuracy of drug and personal health information in the PharmaNet patient record
  • Receiving and transcribing verbal prescriptions from practitioners (within the law)
  • Ensuring that a prescription is complete and authentic
  • Transferring prescriptions to and receiving prescriptions from other pharmacies (within the law)
  • Ensuring the accuracy of the drug preparation
  • Performing the final check of the drug preparation 

Pharmacists will continue however, to be involved in every new and refill prescription as they remain solely responsible for assessing the appropriateness of drug therapy (patient assessment, confirm dose and interval, check PharmaNet profile, and identify drug interactions) and for providing patient consultation. A prescription cannot be released to a patient without a pharmacist having performed these cognitive functions. 

If I am working in a pharmacy as a regulated pharmacy technician and I make an error, will I be held liable?

Yes, regulated pharmacy technicians are recognized as healthcare professionals under the HPA and as such are granted an expanded scope of practice which allows them to have independent authority and responsibility. Along with that comes liability for their actions in the preparation, processing and compounding of prescriptions. 

Will it be possible for a prescription (new or refill) to be released to a patient without a pharmacist involved in the process?

No. Pharmacists will continue to be involved in every new and refill prescription as they remain solely responsible for assessing the appropriateness of drug therapy (patient assessment, confirm dose and interval, check PharmaNet profile, and identify drug interactions) and for providing patient consultation. A prescription cannot be released to a patient without a pharmacist having performed these cognitive functions. 

Will there be a different class of regulated pharmacy technician registrant for hospital and community pharmacy?

No, the scope of practice for regulated pharmacy technicians is the same regardless of practice setting. There will only be one class of registrant with the College of Pharmacists of BC. This is consistent with the pharmacists’ structure. 

Is liability insurance required?

Yes, in accordance with legislation, all registrants of the College are required to carry professional liability insurance that meets the following criteria:

  • Provides a minimum of $2 million coverage.
  • Provides occurrence based coverage or claims made coverage with extended reporting period of at least 3 years.
  • If not in the pharmacists’ or regulated pharmacy technicians’ name, the group policy covers the pharmacist or pharmacy technician as an individual.
Will I be required to participate in the Professional Development and Assessment Program (Continuing Education and Assessment)?

Yes, as a registrant of the College of Pharmacists of BC, you are required by legislation, just as pharmacists are, to participate and successfully complete the Professional Development and Assessment Program (PDAP) which includes a continuing education component and an assessment component. 

What are the steps to regulation for pharmacy technicians?

In order to become a regulated pharmacy technician, current technicians will need to successfully complete the required steps outlined in Registration & Licensure.

When do I need to pre-register with the College?

Pre-registration with the College of Pharmacists of BC is required prior to registering for the Bridging Program for those on the ‘Current Technicians’ path. The application form for pre-registration is available on the College website. 

Is it true that I am required to have a criminal record check?

Yes, in accordance with legislation, all current and new registrants of the College of Pharmacists of BC are required to consent to a criminal record check at least once every 5 years. It is a requirement of the Criminal Records Review Act and is applicable to current and new registrants of all professional regulatory bodies governed by the HPA. Additional information is available in the FAQ.

What is Structured Practical Evaluation (SPE)?

The Management of Drug Distribution Systems (MDDS) Bridging Program course will be followed by a Structured Practical Evaluation (SPE) to verify the learner’s ability to consistently perform accurate product release in the workplace (independent double check). The SPE is administered by the College of Pharmacists of BC. 

How do I know if I meet the minimum requirement of 2000 hours of ‘pharmacy practice’ in the past 3 years?

The PEBC website (http://pebc.ca/PharmacyTechnicians/index.html) defines what are acceptable pharmacy practice activities. Prior to sitting the PEBC Evaluating Exam or enrolling in the Bridging Program, technicians must provide documentation from their supervisor verifying that they meet this minimum requirement.

Is the Bridging Program mandatory?

Yes, the completion of the Bridging Program is required by all current technicians seeking regulation. For more information on the Bridging Program go to Registration & Licensure.

How long does the online Bridging Program take?

The structure for the online Bridging Program is designed to mirror the in-class Bridging Program in length. It is not intended to be an expedited means of completing the Bridging Program.

Why is the Professional Practice module in the Bridging Program mandatory and not eligible for Prior Learning Assessment and Recognition (PLAR)?

As this is a new regulated profession and this course deals with the legal and ethical obligations of a regulated technician, technicians would have no prior experience or knowledge in this area, and therefore, it would not be possible to challenge it.

Is the PEBC Pharmacy Technician Evaluating Exam mandatory?

Yes, the completion of the PEBC Pharmacy Technician Evaluating Exam is required by all current technicians seeking regulation. Those who hold certification from either PTCB-AB (up to 2008) or OCP (up to 2008), or have successfully completed an accredited pharmacist degree program in Canada or in the continental United States, or have successfully complete the PEBC Pharmacist Evaluating Exam are exempt from completing the PEBC Pharmacy Technician Evaluating Exam as per PEBC policy, but are still required to complete the Bridging Program. 

How do I know what to study for the PEBC Pharmacy Technician Evaluating Exam?

For information on how to prepare for the PEBC Pharmacy Technician Evaluating Exam, please refer to the PEBC website.

What is the cost of the PEBC Pharmacy Technician Evaluating Exam?

Exam fees are set by PEBC and not by the College of Pharmacists of BC. Current fee information can be found on the PEBC website: www.pebc.ca.

How many opportunities do I have to pass the PEBC Pharmacy Technician Evaluating Exam?

Candidates are permitted a maximum of three (3) attempts for the PEBC Pharmacy Technician Evaluating Examination, with one, final (fourth) attempt available upon successful completion of remediation as specified by the PEBC Board. For more information please visit www.pebc.ca.

Do I need to take a Jurisprudence Exam (JE)?

Yes, the requirement to successfully complete a Jurisprudence Exam is consistent with the registration process for pharmacists and is designed to test relevant provincial and federal legislation and ethics which is not included on the national PEBC Qualifying Exam. 

What is the format of the PEBC Qualifying Exam?

The PEBC Qualifying Exam consists of two parts, which is consistent with the pharmacists’ exam:

Part 1: Written multiple choice question (MCQ) exam
Part 2: Performance based exam called an Objective Structured Performance Exam (OSPE)

For more information on the PEBC Qualifying Exams, please visit www.pebc.ca

When is the PEBC Qualifying Exam offered?

The PEBC Qualifying Exam is offered by PEBC nationally at key locations twice a year. For more information, including the Exam Schedule, please visit www.pebc.ca.

Can I sit the PEBC Qualifying Exam before completing the Bridging Program?

Yes, but it is not recommended. If you have successfully completed the PEBC Pharmacy Technician Evaluating Exam (or hold certification from PTCB-AB (up to 2008) or OCP (up to 2008), or have successfully completed a pharmacist degree program in Canada or in the United States, or have successfully completed the PEBC Pharmacist Evaluating Exam which exempts you from having to sit the PEBC Pharmacy Technician Evaluating Exam), you can choose to sit the PEBC Qualifying Exam prior to completing the Bridging Program, however, the College strongly recommends that you complete the Bridging Program first.

The content within the Bridging Program is specific to the expanded scope of practice for regulated pharmacy technicians and should therefore help technicians prepare for the PEBC Qualifying Exam. It is also important to note that successful completion of the PEBC Qualifying Exam does not exempt you from the Bridging Program. You must successfully complete all the required steps outlined on the College website prior to the College registering you as a regulated pharmacy technician.

As a ‘current pharmacy technician’, how long do I have to go through the process of regulation?

The ‘current pharmacy technician’ path is only available until 2015. In other words, current technicians utilizing this path must have completed all of the requirements and register with the College of Pharmacists of BC before December 31, 2015. It is intended to provide current technicians the opportunity to become regulated without having to go back to school full-time. After 2015, current technicians who wish to become regulated will have to take the steps described under the ‘future pharmacy technician’ path.

What are the steps to regulation for new to practice pharmacy technicians?

In order to become a regulated pharmacy technician, new to practice pharmacy technicians will need to successfully complete the required steps outlined on the College website.

Who determines which post-secondary programs are accredited?

The Canadian Council for Accreditation of Pharmacy Programs (CCAPP), the same organization that accredits pharmacists’ university programs, is responsible for accrediting ‘regulated pharmacy technician’ programs in Canada. The accreditation process ensures that accredited programs contain the necessary content to teach the competencies (knowledge, skills and abilities) necessary for successful graduates to safely and effectively perform the job of a regulated pharmacy technician. See: http://www.ccapp-accredit.ca/index.php

Which post-secondary institutions are currently offering a CCAPP Accredited Pharmacy Technician Program?

Please check the CCAPP website for the list of Accredited Pharmacy Technician Programs: http://www.ccappaccredit.ca/accredited_programs/technician/history_by_program/ and the College website for more information.

When do I need to pre-register with the College?

Pre-registration with the College of Pharmacists of BC is required prior to starting the Structured Practical Training (SPT) for those new to practice. The application form for pre-registration is available on the College website.

Is it true that I am required to have a Criminal Record Check?

Yes, in accordance with legislation, all current and new registrants of the College of Pharmacists of BC are required to consent to a criminal record check at least once every 5 years. It is a requirement of the Criminal Records Review Act and is applicable to current and new registrants of all professional regulatory bodies governed by the HPA. Additional information is available on the College's FAQ.

Why do I need to take Structured Practical Training (SPT)?

Once a student has graduated from a CCAPP Accredited Program, the next step is to successfully complete the Structured Practical Training (SPT) program; a supervised competency based training period within a pharmacy that includes regular assessment by a pharmacist or another regulated pharmacy technician. SPT provides the student an opportunity to apply the knowledge, skillls and abilities they learned in their training program to practice, in a supervised environment. The College of Pharmacists of BC has partnered with UBC’s Office of Experiential Education (OEE) to administer the SPT (Note: Pre-registration as a Pharmacy Technician with the College of Pharmacists of BC is required prior to registering for the SPT). The Application for Pre-Registration is available on the College website.

Why do I need to take a Jurisprudence Exam?

The requirement to successfully complete a Jurisprudence Exam is consistent with the registration process for pharmacists and is designed to test relevant provincial and federal legislation and ethics which is not included on the national PEBC Qualifying Exam. The Jurisprudence exam is administered by the College of Pharmacists of BC and is available on the College's website.

How do I order a replacement registration certificate?

To order a replacement registration certificate please go to eServices > Online Shop.

How do I order a certificate of standing?

To order a certificate of standing please go to eServices > Online Shop.

A long-time patient asked if she could purchase pure grain alcohol. Can I sell pure grain alcohol directly to patients?

A long-time patient asked if she could purchase some pure grain alcohol. She's starting up a small business and says she needs it to prepare herbal extracts. I told her that we have a supply on hand since we use it for compounding, and that I wasn't sure whether I could sell it to her. Am I allowed to sell pure grain alcohol directly to patients?

No, according to the Liquor Control and Licensing Act, you may not sell pure grain alcohol directly to the public for any reason. Pharmacists may only purchase and possess pure grain alcohol for the following reasons in connection with the pharmacy business:

  • To compound medicine.
  • To use as a solvent.
  • To use as a preservative.
  • To sell to physicians and hospitals as a sterilizing agent.

Non-pharmacists engaged in a manufacturing business may apply to the Liquor Control Board manager to get a permit to purchase. Direct them to the Liquor Control and Licensing Act website: www.pssg.gov.bc.ca/lclb/ 

Are prescriptions from a physician who left their practice still valid?

A physician in my small rural community left his medical practice without arranging for another physician to take over. None of the other physicians in the community are accepting new patients, and the walk-in clinic is overbooked. The physician gave most patients refills to last three months, but these are no longer valid because his license is no longer valid. What can I do?

Using professional judgment, a pharmacist may dispense an emergency supply of prescription drugs to a patient. The days supply will depend on the situation, the drug involved, and how long it will take the patient to see a physician. For example, if a patient is on well-established maintenance therapy, it may be appropriate for a pharmacist to dispense a one-month supply. However, for narcotics and controlled drugs, the pharmacist must assess each situation on a case-by-case basis. Most often, only a one- or two-day supply is warranted, but if you have a palliative care patient, a one-week supply may be appropriate. In each case, process the prescription as an emergency supply prescription using the pharmacist’s ID as the prescriber ID, and clearly document the situation on the prescription. 

Are e-signatures an acceptable form of prescriber authorization?

An electronic prescriber’s signature is only acceptable if the signature is unique. Health Canada considers a unique electronic signature to be equivalent to a paper-and-pen signature. It must be a fresh, new signature written on the prescription with an electronic pen pad, similar to signing a pen to paper prescription. It is an illegal electronic signature if it is cut and pasted into an electronic prescription.

To ensure the signature is unique, the pharmacist should compare the signature each time with an old prescription. The signatures should be slightly different if they are unique, as is an original signature each time.

If you don’t have an old signature with which to compare the current signature, please call the prescriber to determine if a new, original electronic signature is generated for each new prescription.

A computer-generated prescription that is given to the patient or faxed to the pharmacy must have an original prescriber’s signature or a unique electronic signature.

Can a pharmacist accept a prescription for a controlled prescription (formerly called triplicate/duplicate) drug written by an out-of-province physician?

Yes and no. In certain emergency situations, a pharmacist can receive a prescription for a controlled prescription drug from an out-of-province physician that's not on the "approved" form. In these situations, as with any emergency, you should use your professional judgment as to whether you dispense the prescription or not. You can base your decision on the medical condition of the patient and surrounding circumstances.

However, it's your responsibility to make sure the prescription is legitimate and the physician is licensed to practise medicine in Canada. It may be reasonable for some patients, for example those who live close to the B.C./Alberta border, to have a physician in Alberta, and their pharmacy in B.C. In those cases, it may be appropriate to continue to dispense a controlled prescription from outside of B.C.

In most other circumstances, however, if a particular patient makes a habit of asking you to dispense prescriptions for controlled prescription drugs written by out-of-province physicians, you should refer the patient to a physician licensed to practise in B.C. You should not continue to dispense the prescriptions.

Do all BC nurses have prescribing privileges in our province?

No, only nurses registered as nurse practitioners (NPs) with the College of Registered Nurses of BC (CRNBC) have prescribing privileges, according to their scope of practice, which can be found on the CRNBC website: https://www.crnbc.ca/Standards/ScopePractice/Pages/Default.aspx 

I just received a prescription written by a nurse practitioner from Alberta. Do out-of-province nurse practitioners have prescribing privileges in B.C.?

Out-of-province nurse practitioners are recognized as prescribers in B.C. But for now, pharmacists in B.C. cannot process the prescriptions under the out-of-province nurse practitioner’s identification number because that category of practitioner has not been added to the PharmaNet system. Depending on the drug and the situation, pharmacists should use their professional judgment to decide if it is appropriate to process a new or transferred nurse practitioner prescription as an emergency supply prescription using the pharmacist’s ID as the prescriber. In all cases, clearly document the situation on the prescription.

Can I fill a prescription using product compounded by another pharmacy?

Pharmacists who do not provide specialty compounding services have two options:

1. Refer the patient to a pharmacy that can prepare the product.

2. Obtain the specialty compound by contracting with another pharmacist who provides the service. A contract between the two pharmacies must be signed and retained by both pharmacy managers if the service is contracted out.

If you have any questions or concerns, please email practicesupport@bcpharmacists.org

Can I fill the prescription prescribed in Alberta?

A patient visiting from Alberta wanted to get a prescription for an eye drop transferred to my pharmacy. When I spoke with the pharmacist in Alberta, he said the prescription was from an optometrist licensed to prescribe in Alberta. Can I fill the prescription?

You cannot fill the prescription under the optometrist's name because we do not have that category of prescriber in B.C. If the prescription makes sense clinically, one option would be to accept the transfer and based on your professional judgment, fill the prescription as an emergency fill, using your ID as the prescriber. Ensure you document what you did and why you did it.

I just received a request for a prescription transfer from a pharmacist in Seattle, Washington. May I transfer the prescription?

According to Bylaw 5(39)(3), upon request a pharmacist must transfer prescriptions to another pharmacy licensed in Canada, if the drug or drug product does not contain a narcotic or controlled drug and the transfer occurs between two pharmacists. The Bylaw is silent on transferring a prescription to the U.S. In the interest of positive patient outcomes pharmacists may use professional judgement and decide to transfer a Schedule F prescription to a state that is allowed to accept transfers from Canada. However, once the prescription is transferred out of B.C. the pharmacy is not allowed to transfer the unused refills back to B.C.

I suspect my coworker may have a substance use issue. Do I need to report this to the College?

I think that a pharmacist may have a substance use issue. I've never seen him use drugs on the job but his behaviour and appearance indicate that there may be a problem. He makes a lot of dispensing errors and since I hired him, I've noticed that a number of narcotics have been missing. Do I need to report this to the College even if I'm not sure that he has a substance abuse disorder and even though I'm not sure he is the cause of the missing narcotics?

Section 32.1 to 32.4 of the Health Professions Act states that “If a practitioner or registrant has reason to suspect that a person registered under this Act is suffering from a physical or mental ailment or an excessive personal use of alcohol or drugs that might constitute a danger to the public, the practitioner or registrant must immediately report this to the registrar.” This means that even if you don’t know for sure that a problem exists, but you have reason to be suspicious, you must report your concern to the college. College staff will ask you a number of questions and may suggest strategies for improving your monitoring systems so you can find out more about what is happening to your drug supply. They will also need to gather information about the pharmacist’s behaviour. If it turns out that the pharmacist does have a substance abuse problem, the College’s key interest will be to work with the pharmacist on a recovery program. This can be done through a mutual agreement with the pharmacist; an adversarial discipline process is not usually required. 

A deceased patient's wife recently brought the patient's unused narcotic medications to my pharmacy. Do I have to obtain authorization from Health Canada before I can destroy these narcotics?

No. Although the pharmacist still accepts legal responsibility for the drug and its destruction, Health Canada no longer requires pharmacies to request and receive pre-authorization for local destruction of unserviceable narcotics and controlled drugs. This means that pharmacists may proceed with destruction without notifying and receiving acknowledgment from Health Canada in advance. All other requirements, including documentation, remain in place.

Health Canada Letter - RE: Destruction of CDSA Drugs

I have a patient with cancer who wants to receive medical marijuana. What does the patient need to do to?

The patient must apply to Health Canada's Office of Cannabis Medical Access. Application forms are available online at Medical Use of Marihuana, by telephone toll-free 866.337.7705, or by mail:

Office of Cannabis Medical Access 
Drug Strategy and Controlled Substances Programme 
Healthy Environments and Consumer Safety Branch 
Health Canada 
Address Locator 3503B 
Ottawa, Ontario K1A 1B9

Can a pharmacist accept a prescription for a controlled prescription (formerly called triplicate/duplicate) drug written by an out-of-province physician?

Yes and no. In certain emergency situations, a pharmacist can receive a prescription for a controlled prescription drug from an out-of-province physician or Canadian Armed Forces (CAF) physician that's not on the "approved" form. In these situations, as with any emergency, you should use your professional judgment as to whether you dispense the prescription or not. You can base your decision on the medical condition of the patient and surrounding circumstances.

However, it's your responsibility to make sure the prescription is legitimate and the physician is licensed to practise medicine in Canada. It may be reasonable for some patients, for example those who live close to the B.C./Alberta border, to have a physician in Alberta, and their pharmacy in B.C. In those cases, it may be appropriate to continue to dispense a controlled prescription from outside of B.C.

In most other circumstances, however, if a particular patient makes a habit of asking you to dispense prescriptions for controlled prescription drugs without an approved form written by out-of-province or CAF physicians, you should refer the patient to a physician licensed to practise in B.C. or a CAF physician with approved controlled prescription program forms.  You should not continue to dispense the prescriptions.

What is the proper way of documenting part-fills for controlled drugs and substances (including narcotics)?

In the past, Health Canada has expected pharmacists to document part-fills of controlled drugs and substances (including narcotics) by recording the quantity dispensed on a given date on the reverse side of the original prescription, along with the handwritten initials of the pharmacist responsible for dispensing the part-fill. In addition, a "paper trail" copy of the prescription, for information purposes, had to be included in the daily prescription file on each part-fill date.

Health Canada is now determined that the software commonly used in community pharmacies in British Columbia has automated many recordkeeping functions. It is now not necessary to add part-fill documentation to original prescriptions when a second and subsequent part-fill is processed, provided that the software program allows tracking between the part-fills (quantity, date, prescription number) and the original prescription. A "paper trail" copy of the prescription must continue to be filed in the daily prescription file on each part-fill date.

In the case of methadone prescriptions, pharmacists must continue to document each part-fill on the reverse side of the original prescription. A "paper trail" copy filed on each part-fill date is not required for methadone part-fills.

A patient brought in a prescription for two drugs. The patient only wants me to dispense one of these drugs and wants another pharmacy to dispense the other drug. What do I need to do?

The process you need to follow is different, depending upon which drug you dispense.

Amoxil® dispensing (non-narcotic) - you need to return the original prescription to the patient:

  • Process the prescription for Amoxil®.
  • On the original prescription, indicate that you have dispensed the Amoxil® and note your pharmacy name, your initials, and the date.
  • Photocopy the original prescription for your records.
  • On the photocopy, make a note that the original prescription was returned to the patient.
  • Return the original prescription to the patient. The patient can then have the undispensed narcotic prescription dispensed at the pharmacy of his/her choice.

Tylenol with Codeine No.3® dispensing (narcotic) - you need to keep the original prescription:

  • Process the prescription for Tylenol with Codeine No.3®.
  • Log the prescription for Amoxil®.
  • Photocopy the original prescription for your records.
  • On the original prescription, indicate that you have dispensed the Tylenol with Codeine No.3® and logged the Amoxil®. Note your pharmacy name, your initials, and the date.
  • You may photocopy the original prescription and provide the photocopy to the patient. Be sure to note your pharmacy name and telephone number on the photocopy so that the other pharmacy can contact you to transfer the Amoxil® prescription.
We were working on a prescription for 100mL of Tussionex suspension and the bottle tipped over. The contents spilled onto the counter and floor - what should I do?

As required by the Regulations to the Controlled Drugs and Substances Act, you should report the loss (or theft) of controlled drugs and substances directly to the federal Office of Controlled Substances within ten days of discovery. You can order loss and theft reporting forms from:

Compliance, Monitoring and Liaison Division
Office of Controlled Substances
Health Canada
Address Locator: 3502B
Ottawa, Ontario K1A 1B9

Will all pharmacies dispense Mifegymiso?

Any pharmacy where pharmacy professionals have the appropriate knowledge, skills and judgement, may dispense Mifegymiso®.  To order Mifegymiso®, completion of the Medical Abortion Training Program is required by the manufacturer Celopharma.

If a pharmacist declines to dispense Mifegymiso® on the basis of a conscientious objection, he or she is required to adhere to the Colleges’ Code of Ethics, Standard 1 (g)(iii), cooperating in effective transfers of care initiated by the patient (without needing to make a referral). Pharmacies should also have a process in place to ensure that in the case where a pharmacy professional conscientiously objects to providing a service, the patient can be directed to an alternate provider for the service in a timely manner.

Learn more about the options for providing Mifegymiso® to patients in BC at bcpharmacists.org/mifegymiso.

How does conscientious objection work in pharmacy practice?

If a pharmacy professional declines to provide a pharmacy service on the basis of a conscientious objection, he or she is required to adhere to the Colleges’ Code of Ethics, Standard 1 (g)(iii), cooperating in effective transfers of care initiated by the patient (without needing to make a referral).

Pharmacy professionals need to inform their pharmacy manager and employer of a conscientious objection either before they accept employment or at the earliest opportunity.

Pharmacies should have a process in place to ensure that in the case where a pharmacy professional conscientiously objects to providing a service, the patient can be directed to an alternate provider for the service in a timely manner.

Standard 1: Registrants Protect and Promote the Health and Well-Being of Patients

(g) Registrants must provide pharmacy services requested by patients and may only refuse to provide these services for any of the following reasons:

(iii) the provision of the product or service is contrary to the sincerely held conscientious or religious belief of a registrant, in which case the registrant must ensure that:

  • they have informed and explained to the pharmacy manager and employer of their conscientious or religious belief before they accept employment;
  • if the belief is formed after employment is accepted, they inform the pharmacy manager and employer at the earliest opportunity; o they do not discuss their personal beliefs or ask patients to disclose or justify their own beliefs;
  • they participate in a process designed to exercise their freedom of conscience and religion in a manner that respects the patient's right to receive products and services in a timely manner and in a way that minimizes suffering and hardship to the patient;
  • they fulfill their duty of care to the patient in a manner that is nonjudgmental, continuous and non-discriminatory;
  • in the event of failure of the system developed to ensure the timely delivery of the product or service, and notwithstanding the registrant’s conscientious or religious beliefs, they provide patients with enough information and assistance to allow them to make informed choices for themselves;
  • they cooperate in effective transfers of care initiated by the patient and are not required to make a referral; and
  • they do not rely on conscientious or religious beliefs in order to discriminate against any patient on morally irrelevant grounds including those outlined in Standard 3, Guideline g of this Code.
Are registered pharmacy technicians and pharmacists still required to comply with legislated requirements and their professional obligations, even if they are not working as a pharmacy technician or pharmacist?

Pharmacy technicians and pharmacists registered with the College are health professionals under the Health Professions Act and must uphold legislative requirements and professional obligations at all times.

This means that regardless of job title or role, a registered pharmacy technician or pharmacist must meet requirements under the Health Professions ActPharmacy Operations and Drug Scheduling Act and in the College’s bylaws. As health professionals, they are held responsible to their own scope of practice and can be subject to disciplinary action for practice issues.

How will scheduling work?

Every pharmacy will be reviewed cyclically on a multi-year time frame. The College will be looking at a number of factors when scheduling reviews.

The College will confirm a date for the Practice Review with feedback from the pharmacy manager. It is the pharmacy manager’s responsibility to ensure that their staff are available during the scheduled Practice Review.

With over 1200 community pharmacies and 3700 community pharmacy professionals in the province, scheduling will be challenging but it will be achievable with your help.

How will the Practice Review Program work?

The Practice Review Program will have two components: the Pharmacy Review and the Pharmacy Professionals Review. The Pharmacy Review component will be a familiar process, as it mirrors the College’s current pharmacy inspection process. For the Pharmacy Professionals Review, a College compliance officer will observe and assess individual pharmacy professionals in four key areas of practice. Compliance officers will ensure that pharmacies meet College standards/guidelines and that pharmacy professionals are appropriately applying their knowledge, skills, and abilities to deliver consistent pharmacy care.

With the new program, pharmacy managers and pharmacy professionals will receive advance notice of a Practice Review and will know what will be reviewed. Pharmacy managers and professionals will also receive their results once the review is completed.

Do the requirements for Prescription Product Preparation and Final Check have to follow a specific workflow?

No, registrants must complete all the requirements for Prescription Product Preparation and Final Check as set out in the Health Professions Act – Bylaws, Schedule F, Part 1, Part 2 and Part 3, however the specific workflow can be determined by the pharmacy.

This means each requirement can be performed by different registrants at different times, in any particular order as long as all the requirements are met before the drug is released to the patient, patient’s representative or practitioner.

For example, under the Community Pharmacy Standards of Practice final check requirements, different registrants could complete (a), (b), (c), and (d).

Some of these requirements may have multiple sub-components to them, (e.g. ensuring information matches with respect to the drug, dosage form, strength, quantity and DIN). All sub-components of any individual requirement should be completed by the same registrant.  

What is the difference between accredited and non-accredited hours?

Accredited learning activities have been reviewed using stringent criteria to ensure they are of high quality, unbiased, and clearly identify learning objectives for participants. Accredited programs indicate the number of accredited hours (CEU's) assigned, and identify the accrediting body (such as UBC CPPD, CCCEP, ACPE, MAINPRO (M1 and MC), etc).

Non-accredited hours are informal learning activities. For example, if you identify a learning need in the area of compounding, then identify and read a publication on compounding and incorporate this learning into your practice, you could include the time spent in this activity into one of your 6 Learning Records. 

Will I be told about the results of the Criminal Record Check?

You will only be notified by the Ministry of Public Safety and Solicitor General directly if a possible relevant record is found.

What is the process for current registrants?

The process is as follows:

  1. All applicants applying for pre-registration and current registrants as part of the registration renewal process, are required to consent to and pay for a CRC.

  2. The information required for the CRC is forwarded to the Ministry of Public Safety and Solicitor General.

  3. The Ministry runs the CRC against provincial data and RCMP information. If criminal records are found, they are examined to determine relevancy to physical, sexual or financial abuse.

  4. The College is informed when no relevant record is found.

  5. If a possible relevant record exists, the Ministry may request additional information from the applicant/registrant including providing fingerprints to the RCMP.

  6. The Ministry informs the College when a relevant record exists, but provides no other information about the record. The file is forwarded to the Deputy Registrar of the Criminal Records Review Program to determine the risk of sexual or physical abuse to children or physical, sexual or financial abuse to vulnerable adults.

  7. If the Deputy Registrar of the Criminal Records Review Program determines there is no risk to children or vulnerable adults, the College is informed.

  8. If the Deputy Registrar of the Criminal Records Review Program determines that a risk exists, the registrant, the College and the employer(s) are informed. The College will take action in accordance with the Registration/Inquiry and Disciplinary process outlined in the HPA.

  9. The registrant may appeal the decision of the Deputy Registrar of the Criminal Records Review Program. 

Where do I find more information on the Criminal Record Check program?

For more information on the Criminal Record Check program, please visit the Ministry of Public Safety and Solicitor General website: http://www2.gov.bc.ca/gov/content/safety/crime-prevention/criminal-record-check

I just had a criminal record check done for employment or another organization (e.g. volunteer, schools, sports, events, or clubs). Will I require another?

Yes, all new applicants and current registrants must consent to a CRC. As specified in the Criminal Records Review Program the check must be done through the Ministry of Public Safety and Solicitor General. In addition to checking RCMP records, other records that are not usually part of a CRC by the RCMP (e.g., provincial and young offenders’ records) will be checked.

How long will it take to do a Criminal Record Check?

If there are no relevant criminal records, the College is informed approximately 20 days after the authorization is submitted to the Ministry of Public Safety and Solicitor General. If there is a possible relevant record and fingerprints are required, it may be six months or more before the outcome is known. If you are applying for pre-registration, your application will be complete after the CRC is cleared. If you are renewing your registration, you will remain registered while the check is being processed.

If I have a criminal record, who will have access to this information?

If you have a criminal record, but it is not relevant to the protection of children or vulnerable adults, the Ministry of Public Safety and Solicitor General does not release this information. If you have a relevant record the College is informed that there is a relevant record but no other information is provided. If the Deputy Registrar of the Criminal Records Review Program determines there is no risk to children or vulnerable adults, the College is informed of the Deputy Registrar’s decision and may request a copy of the written reasons for the decision. If the Deputy Registrar determines that a risk to children or vulnerable adults exists, the registrant, the College and the employer(s) are notified. The College would take action using existing Registration/Inquiry and Disciplinary procedures however; information would be protected as it falls within the Freedom of Information and Protection of Privacy Act

If a learning activity was accredited at the time I completed it and the accreditation is now expired, can I still document it as accredited learning?

Yes, if the learning activity was accredited at the time you completed it, you can document it as accredited learning. Learning activities must occur within the last year (past 12 months) of your next renewal date to be considered current.

If I complete more than the minimum hours of accredited learning for my current yearly renewal, does it roll over?

No, the completion date of the learning must occur within the 12 months prior to your individual renewal date, even though the accreditation is still valid (not expired) beyond that date.