Information for prescribers: changes to pharmacists’ authority to renew prescriptions, prescribe and administer medications

The Ministry of Health has announced a new health workforce strategy to improve access to health care. One of the actions is that beginning October 14, pharmacists will adapt and renew prescriptions for a wider range of drugs and conditions, and they will be able to administer, further to a prescription, a wider range of drugs by injection or intranasally. The Province is also working toward extending the valid period of prescriptions to two years, which is anticipated to be in effect on the same date.

The College of Pharmacists of BC (CPBC) has prepared the following messaging.

Summary of the changes 

Removal of restrictions on drug administration by injection and intranasal route 

Amendments to the Drug Administration by Injection and Intranasal Route Standards, Limits and Conditions now allow pharmacists to administer any Schedule I, IA and II drugs by injection and intranasal route. This includes controlled drugs. These amendments restrict pharmacists from administering allergy serums and cosmetic drugs and substances.  

In addition, pharmacists may only administer a drug if it has been prescribed by a practitioner, unless it is being administered for the purpose of immunization, or to treat certain medical emergencies including:  

  • Anaphylaxis arising from administering a drug or substance, or 
  • Administering naloxone to a person suspected of suffering from an opioid overdose 

Pharmacists must have a valid Drug Administration Certification in order to administer drugs by injection and intranasal route.  

Removal of restrictions on adapting prescriptions  

Amendments to Professional Practice Policy 58: Medication Management (PPP-58) remove most restrictions on the drugs and conditions that pharmacists can adapt prescriptions for. PPP-58 provides the framework to guide pharmacists in the safe and effective adaptation of existing prescriptions through the following professional activities:  

  1. Change: changing the dose, formulation, or regimen of a prescription to enhance patient outcomes;  
  1. Renew: renewing a prescription for continuity of care; and  
  1. Substitution: making a therapeutic drug substitution within the same therapeutic class for a prescription to best suit the needs of the patient.  

These changes allow pharmacists to use their professional judgement to renew a current, valid prescription for clients who have stable, on-going medical conditions with the exception of cancer chemotherapy prescriptions.  

Renewals of narcotics, controlled drugs or targeted substances will also be allowed, as permitted by Health Canada’s section 56 exemption, however they may only be renewed for the same duration as originally prescribed. Additionally, amending the dose/formulation or making a therapeutic substitution for these substances will continue to be restricted.  

Extending the prescription validity period 

Amendments to the Pharmacy Operations and Drug Scheduling Act Bylaws and the Health Professions Act Bylaws extend the period of time a prescription is valid from one year to up to two years. These changes have been posted for public comment on CPBC’s website. 

Extending the prescription validity period will help to enhance continuity of care for those patients who cannot practically access a primary care provider for a prescription renewal. Pharmacists will continue to be able to renew or adapt valid prescriptions for an appropriate time, so long as they do not exceed the expiry date on the original prescription. 

These changes would enable pharmacists to use their professional judgment to provide renewals of stable medications up to two years past the original prescribing date if appropriate. 

Providing an emergency supply of medications for continuity of care as needed 

In order to provide continuity of care for clients, pharmacists continue to be able to exercise their professional judgment to provide an emergency supply of medication to clients without a valid prescription.  

This includes prescriptions for narcotics and other controlled drug substances. 

Professional Practice Policy 31 Emergency Supply for Continuity of Care provides latitude for pharmacists’ decisions on emergency supplies, provided it is in the patient’s best interest and all decisions are properly documented with rationale.  

Pharmacist prescribing for minor ailments and contraception 

Work is now underway to enable B.C. pharmacists to prescribe medications for minor ailments and contraception by Spring of 2023. CPBC supports the implementation of an optimized scope of practice for BC pharmacists that includes prescribing authority for minor ailments and contraception, in order to enhance patient health outcomes and maintain continuity of care.  

CPBC will continue to work with the Ministry of Health and other partners to ensure that B.C. pharmacists are qualified and able to deliver these new services in a way that ensures the health and safety of British Columbians.