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This content was originally published as part of the June 2025 PharmaCare Newsletter. |
Recording witnessed PA consumption
Important: Enter "VS – Other Outcome or Intervention" in PharmaNet to record witnessed PA consumption
Effective immediately, all prescribed alternative (PA) doses dispensed must be accompanied by either the intervention code “VS – Other outcome or intervention” for witnessed PA or the intervention code “SA – Prescribed safer alternative” for non-witnessed PA.
Entering the code for each witnessed consumption of PA is required for Ministry recordkeeping and to support PharmaCare tracking of pharmacy services provided. Pharmacies are also encouraged to indicate the frequency of witnessed ingestion in the SIG field.
The VS code must be entered for each instance of witnessed consumption of a PA (e.g., hydromorphone, fentanyl patch or tablets, oxycodone, sufentanil).
- If more than one dispense is required per day, enter both the witnessed intervention code VS and “UF – Patient gave adequate explanation, Rx filled as written.” This will ensure the drug cost is accepted
- This may mean entering the VS code multiple times a day, depending on the prescriber’s direction
If a patient is still receiving PA without witnessed consumption, continue to enter the “SA – Prescribed safer alternative” intervention code.
Prescribers will continue to write the “SA” code on all PA prescriptions (for “safer alternative”) and will not write “VS”; the pharmacist is required to enter “VS” when the PA must be witnessed and “SA” if not witnessed.
If the prescriber neglected to add “SA” to the original prescription, but you confirmed – with the prescriber or the patient – that it was for safer supply, remember to add “SA” during processing.
| Prescribed alternative scenario | Intervention code to use |
|---|---|
| Witnessed | VS – Other outcome or intervention |
| Witnessed – more than one dispense per day | VS and UF |
| Not witnessed | SA – Prescribed safer alternative |
| Not witnessed – more than one dispense per day | SA and UF |
Do not enter SA for opioid, stimulant or benzodiazepine drugs when they are prescribed for non-PA indications.
Whether you enter SA or VS, the dispense will be recorded as a PA dispense for provincial health system tracking.
The Ministry is currently exploring a payment model for pharmacies witnessing PA.
New prescription directions for prescribers
On Tuesday, May 20, 2025, the BC Centre on Substance Use updated its Interim Clinical Resource: Transition to Witnessed Dosing for Prescribed Alternatives to include clearer instructions for prescribers on how to write PA witnessing directions on prescriptions so that directions are clearly communicated to pharmacists and other health care professionals.
The updated Interim Clinical Resource includes sample prescriptions, showing how prescribers should write directions for PA.
Background
On February 19, 2025, the Provincial Government mandated that all PAs must be consumed under the direct supervision of a health professional. The policy is intended to ensure these medications are used by their intended recipients as part of harm reduction strategies, and to prevent diversion into illicit markets.
The requirement for witnessed consumption applied immediately to all new clients receiving prescribed alternatives. Clinicians have been transitioning existing clients to witnessed doses, ensuring continuity of care.
Sample prescription in BC Centre on Substance Use’s updated Interim Clinical Resource