B.C. residents can seek treatment for 21 minor ailments and contraception directly from a pharmacist.

PharmaCare compensates pharmacies for providing the service. Pharmacies can claim the $20 Minor Ailments and Contraception Service (MACS) fee for assessing eligible B.C. residents for any of the 21 ailments and contraception, whether or not the assessment leads to a prescription. The program was launched on June 1, 2023.

Pharmacist requirements and procedures

Pharmacists must complete the PPMAC Regulatory Education module to provide MACS. To claim the MACS fee, they must comply with the standards, limits and conditions set out in the BC Health Professions Act Bylaws Schedule F, Part 8 – Pharmacist Diagnosing and Prescribing, and with the requirements of Minor Ailments and Contraception Service — Section 8.14, PharmaCare Policy Manual. Clinical and practice requirements are outlined by the College of Pharmacists of BC.

To claim the MACS fee, a pharmacist must also:

• Carry out MACS with the patient (or their legal representative) in person—not by telephone or other electronic means
• Provide MACS in a suitable area that the patient accepts as respectful of their right to privacy and that meets their requirements for cultural safety
• Document MACS in accordance with the requirements of Minor Ailments and Contraception Service — Section 8.14, PharmaCare Policy Manual, including using the MACS Form (PDF) or their own form that captures the same information

Pharmacists prescribing in HAs and PCNs

Pharmacists in health authorities and primary care networks can leverage their expertise to prescribe.

Pharmacists in health authorities and primary care networks can leverage their expertise to prescribe.

Pharmacists that receive a prescription from another pharmacist should fill the prescription as usual and enter in the prescribing pharmacist's name as the prescriber. They cannot claim a MACS assessment fee.

MACS and Plan W clients

Pharmacists are reminded that Plan W covers a variety of over-the-counter (OTC) items that can be recommended as part of MACS or during a regular pharmacy visit. If a pharmacist recommends a Plan W OTC item as part of a MACS assessment, they should:

• Document the recommended item on the MACS form only
• Submit the claim for the OTC in PharmaNet to have it covered under Plan W

If Plan W OTC items are recommended outside of MACS, pharmacists must use the Plan W OTC Recommendation form and enter the medication in PharmaNet.

Ensuring Plan W coverage of OTC medications for FNHA clients is a component of culturally safe pharmacy practice.

Steps for pharmacists

• Step 1: Inform the patient of the service, confirm the patient's coverage and clinical eligibility, and obtain consent.
• Step 2: Review the patient's PharmaNet profile.
• Step 3:Determine the nature of the patient’s symptoms, and assess their medical and medication history.
• Step 4: Recommend appropriate treatment, which may include medication, self-care advice, and/or advice to see other health care professionals.
• Step 5: Provide advice about taking the prescribed or recommended medication, advise them of any potential side effects or interactions, and ensure they know what to do if symptoms do not improve.
• Step 6: Establish, implement, document and inform the patient of their follow-up and monitoring plan.

Submitting a claim

A MACS claim must be entered in PharmaNet on the same day the service is provided. The corresponding PIN and College Registration Identification (Reg ID) of the pharmacist who provided MACS must be included.

Each ailment has 4 PINs to cover the possible outcomes of a MACS assessment. PINs and their descriptions are available on the PINs web page and in the MACS conditions, PINs and drugs reference guide (PDF). The pharmacist must enter the 10-digit pharmacy phone number at the start of the SIG field.

PINs are also required when providing MACS to ineligible patients or virtually. For non-benefit MACS, the pharmacist must enter the minor ailment assessed, at the start of the SIG field, in addition to the phone number .

Special Authority (SA) requests

MACS expands the opportunities for pharmacists to submit SA requests (e.g., through eForms). Pharmacists may request SA coverage for a patient when:

• Prescribing for minor ailments or contraception
• Recommending OTC medications, such as acetaminophen or NRTs
• Adapting a prescription
• Applying for exceptional Plan Z coverage
• Dispensing vancomycin following a hospital stay
• Working in a clinical setting in collaboration with a prescriber and with access to the patient’s full medical record (accessing only PharmaNet is insufficient)

Booking system

Pharmacies are required to use the provincial booking system to manage MACS appointment bookings, rather than their own systems. Pharmacies are encouraged to also provide MACS to patients who come into the pharmacy without booking an appointment. The MACS booking system is based on the GetVaccinated/ImmsBC booking system platform, and the pharmacist interface is very similar.

Pharmacies with ImmsBC admin access can log in to ImmsBC Classic to input appointment details. To request access, visit the BC Immunization Portal on the BC Pharmacy Association (BCPhA) website, whether or not you are a BCPhA member.