The Ontario government plans to reshape the publicly-funded drug system through new legislation introduced on April 13. The purpose of these changes is to get better value for money, enhance the quality of care patients receive and encourage greater collaboration across the drug system.

Several of these proposed changes reflect the valuable contribution to patient care made by pharmacists. There are be several proposed changes to the compensation model for pharmacies as well as opportunities for greater involvement by pharmacists in the care of their patients. The following is a summary of the proposed changes that directly affect pharmacists and pharmacies:

1. Compensation for professional pharmacy services, such as medication management reviews and providing care to patients. A framework for these services will be developed beginning immediately in collaboration with the Ontario Pharmacists’ Association.
2. A joint Pharmacy Council will be set up to identify support and training mechanisms for medication management reviews as well as to address pharmacy policy going forward.
3. There will be greater opportunities for pharmacists to work in primary care practices, including Family Health Teams. These will be developed in concert with the Pharmacy Council.
4. To better reflect the cost of dispensing, the dispensing fee for ODB prescriptions will rise from $6.54 per prescription to $7 – an increase of more than seven percent.
5. The mark-up paid for ODB prescriptions will be reduced from 10% to 8% and capped at $25 per claim.
6. Promotional allowances paid to pharmacies by generic drug manufacturers will be eliminated.
7. Generic manufacturers will be permitted to fund educational activities, which will be defined through a code of conduct.
8. Pharmacies supplying long-term care homes will be permitted to access Government Stock.
9. Alternative compensation models for pharmacies serving long-term care homes are being developed and recommendations will be made within three months.

Other proposed changes that will affect pharmacies include:

1. Lowering the generic drug price rule from the current 70/90 to a flat 50% of the price of the brand drug.
2. Enforcing prices for all drug products with penalties up to and including refusal to review new drugs for listing and also delisting.
3. Eliminating both the Limited Use and Individual Clinical Review listing categories and replacing them with Conditional Listing and Exceptional Access mechanisms that will require less paperwork and be more responsive.
4. Creating a dedicated role – the Executive Officer, Drug Benefits, to manage the publicly-funded drug programs. The Executive Officer would have the authority to make listing decisions, among others.

Further information on Bill 102, Transparent Drug System for Patients Act including the proposed legislation can be found here.