Temporary Exemption for Dispensing Drugs for the Purposes of Medical Assistance in Dying (MAiD) Now in Effect
A temporary exemption allowing injectable drugs, previously dispensed for the purpose of providing Medical Assistance in Dying (MAiD), to be returned to inventory, is now in effect.
This means that during the COVID-19 public health emergency in British Columbia, if there is a shortage for any injectable drug dispensed for the purpose of MAiD, all unused injectable MAiD drugs dispensed and returned within the same, original sealed tamper-proof kit may be returned to inventory.
Shortages may include manufacturer reported shortages (i.e. those listed on Drug Shortages Canada), or those proactively assigned by Health Canada, such as a Tier 3 Drug Shortage.
Prior to returning unused medications to inventory, the pharmacist must be satisfied that the following conditions have been met:
- The medication has not left the possession of the prescribing medical practitioner or nurse practitioner, or a licensed health care professional assigned by the physician or nurse practitioner; and the integrity of the medication can be verified.
- Each dose is unused and in the original sealed tamper proof kit; and
- The medication has been maintained in accordance with the manufacturers requirements and any other applicable requirements.
Recently, a number of the drugs used in the MAiD intravenous drug protocol have been included in Health Canada’s ‘Tier 3 Drug Shortages’ list, which lists shortages that have the greatest impact on Canada’s drug supply and health care system.
Many of these drugs are also used in the treatment of patients with COVID-19, who require critical care.
In response to these shortages of drugs used for MAiD, the Board approved amendments to the Health Professions Act Bylaws Schedule F Part 5 – Dispensing Drugs for the Purposes of MAiD Standards, Limits and Conditions to temporarily allow injectable drugs, previously dispensed for the purpose of providing MAiD, to be returned to inventory.
Health Professions Act Bylaws Schedule F Part 5 – Dispensing Drugs for the Purposes of MAiD Standards, Limits and Conditions
If there is a shortage of medication for medical assistance in dying, a pharmacist may accept for return to inventory, injectable medication previously dispensed for the purpose of providing medical assistance in dying if they are satisfied that:
The temporary exemption will be in effect during the COVID-19 public health emergency in British Columbia.
To support this exemption, consequential amendments to Section 22 of the Pharmacy Operations and Drug Scheduling Act (PODSA) Bylaws have also been implemented.
Registrants may now accept for return to stock or reuse, any drug previously dispensed in accordance with the temporary amendments to the Dispensing Drugs for the Purposes of MAiD Standards Limits and Conditions, as noted above.
Pharmacy Operations and Drug Scheduling Act (PODSA) Bylaws
Proper Storage of Injectable MAiD Drugs
When dispensing drugs for the purpose of MAiD, the pharmacist should ensure the prescribing medical practitioner or nurse practitioner knows how to appropriately store the medications. Pharmacists may consult the Medical Assistance in Dying British Columbia Pharmacy Protocols (available on e-Services) and other sources (e.g. the manufacturer’s requirements) for information on how to store injectable MAiD drugs.