November 2018

Pharmacist compensation reform

A look back at Bill 41 (Bill 28)

In May 2015, we published a memo on the passing of Bill 28. This bill included a host of budget measures regarding health care, including allowing pharmacists to provide a series of professional services starting June 20, 2015. Once adopted, the bill included the following pharmaceutical services:

These pharmaceutical acts were meant to provide all Quebecers with better access to care. According to Normandin Beaudry’s databases, these new services—some of which had been provided free of charge until now—represented 0.3% to 0.4% of medical care costs for Quebec’s group benefits plans in 2017.

Changes in the coming months

On June 27, the Association québécoise des pharmaciens propriétaires (AQPP) announced the ratification of an agreement with the Ministère de la Santé et des Services sociaux (MSSS). Among other things, this agreement provides for adjusting the compensation of acts dispensed by pharmacists and the addition of new eligible acts:

  • Since October 31, 2018, the following pharmaceutical acts can be compensated, whereas they had been previously dispensed free of charge:
    • Adjusting a doctor’s prescription
    • Substituting the prescribed medication for another in case of a product shortage
    • Administering a medication to demonstrate proper usage
  • Furthermore, two new compensated pharmaceutical services will eventually be added following the adoption of regulations governing this reform:
    • Caring for a patient in palliative care
    • Caring for a patient following a hospitalization

Given that these acts are to be reimbursed by the Provincial Prescription Drug Insurance Plan, private plans will have to cover them. This means all pharmaceutical acts will be compensated.

We expect these changes will have minor impact on private plans in terms of costs, as we have observed so far with the impact of Bill 41.

Pharmacist compensation reform under way

The agreement also provides for the continued review of the compensation method for pharmacists. The purpose of which is to establish a compensation with a greater focus on advice and services rendered by pharmacists than on dispensing medication. Unless there’s a major political shift, this reform will come into force in 2020.

A potential change in pharmacist compensation could have a direct impact on the prescription drug costs of insured individuals, and ultimately on private group insurance plans. However, there currently is no way of assessing the impact of such a reform on drug costs.

For private plan sponsors, a better correlation between the fees charged and the services rendered is good news. This correlation, combined with transparency of pharmacy invoices, can only help insureds better understand the cost of their medications and the value of services provided by their pharmacist.

Next steps

In the coming months, we will keep a close eye on pharmacist compensation reform and its impact on private plans. Since the anticipated impact on private plan costs is minor, insurers have yet to inform their clients of short-term pricing adjustments. We will keep you informed of any developments.

Would you like more information?
Contact your Normandin Beaudry consultant or email us

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