Assessment and Prescribing for Mild to Moderate Eczema by Pharmacists

The assessment and prescribing for mild to moderate eczema by a pharmacist may be eligible for coverage by the Department of Health effective May 15, 2023. Each patient is eligible for a maximum of two (2) mild to moderate eczema assessments per one-year period.

This program does not cover drugs, or the costs associated with dispensing or administering drugs.

The assessment and prescribing service is not eligible if the patient qualifies for a prescription renewal service under the Prescription Renewals by Pharmacists program.

Assessment of mild to moderate eczema, with or without prescribing, may be eligible for coverage provided all the following criteria are met:

Patient

• The patient presents with a rash consistent with a diagnosis of mild to moderate eczema.
• The patient does not present with symptoms suspect of contact dermatitis (allergic or irritant), seborrheic dermatitis, diaper dermatitis or other types of dermatoses.
• The patient is 2 years of age or older.
• The patient must have a valid Medicare card and not reside in a nursing home or a correctional facility.
• A maximum of two (2) eczema assessment services per patient within the past 12 months.

Pharmacist

• The service is conducted in person by a pharmacist licensed with the NB College of Pharmacists (NBCP).
• The pharmacist must comply with all applicable NBCP requirements and standards.
• The pharmacist must obtain consent from the patient, guardian, or substitute decision maker for the service being provided.  
• The pharmacist must document a follow-up plan that is sufficiently detailed to monitor the patient’s progress and ensure continuity of care.
• When prescribing a drug, the pharmacist will notify the patient’s physician or nurse practitioner when one exists.  If one does not exist, the pharmacist will provide the patient with a copy of this notification.

Prescription

• If a Schedule 1 drug is prescribed, it must be:
  • dispensed on the same day as the assessment is submitted for payment; and
  • dispensed from the pharmacy submitting the assessment, unless the patient chooses to fill the prescription at another pharmacy, however this must be documented on the assessment and prescribing tool.
• If an over-the-counter (OTC) product is prescribed, it must be:
  • approved by Health Canada for mild to moderate eczema or is widely accepted as best practice in Canada and supported by medical literature demonstrating safety and efficacy for mild to moderate eczema; and
  • provided to the patient with specific dosing instructions.
• If OTC products are provided to the patient without documented specific instructions for use, the assessment fee is not eligible.
• If the patient has eczema on different locations of the body which require different products the pharmacist may prescribe more than one product, however, only one assessment fee may be claimed.

The Department of Health will pay participating providers for each claim billed for eligible patients in New Brunswick. The participating provider is not permitted to charge additional fees to the patient for services which have been paid for by the Department of Health. The applicable assessment fees are outlined below:

Table 1

Pharmacists must document how the patient meets the eligibility criteria for this policy and use an appropriate assessment and prescribing tool.

The assessment and prescribing tool must be used to document the following (as applicable):

• Patient, guardian, or substitute decision maker consent
• Patient assessment
• Treatment plan, including:
  • Prescription(s)
  • Specific instructions for use for over-the-counter products
• Follow-up plan
• Referral
• Notification of the patient’s physician or nurse practitioner when one exists. If one does not exist, the pharmacist will document that they have provided the patient with a copy of this notification.
• Completed follow-up information

Manual claims will not be accepted. Claims must be submitted online and include the following information:

All claims submitted by participating providers for reimbursement are subject to audit and recovery.

Claims for service fees for providing the following types of assessment services are excluded:

• Assessments resulting in the following therapies:
  • Over-the-counter products provided to the patient without documented specific instructions for use.
  • Over-the-counter products not approved by Health Canada for the treatment of mild to moderate eczema, or not widely accepted as best practice in Canada and supported by medical literature demonstrating safety and efficacy for mild to moderate eczema.