Changes Impacting the Province of Quebec

Quebec’s Bill 31 (An Act to amend mainly the Pharmacy Act to facilitate access to certain services) got signed into law on March 17, 2020. The bill stipulates that pharmacists can, in some situations, or in compliance with the regulatory conditions and procedure:

  1. prescribe and administer vaccines and, in emergency situations, certain other medications;
  2. prescribe all non-prescription medications;
  3. administer a medication by intranasal route;
  4. adjust or renew prescriptions of all prescribers, not only those of physicians;
  5. stop medication therapy according to a prescription or following a consultation conducted at the request of a prescriber;
  6. substitute, for a prescribed medication, another medication even if it does not belong to the same therapeutic subclass; and
  7. prescribe and interpret not only laboratory analyses but also any other test, for the purpose of monitoring medication therapy.

Similarly to Ontario, Quebec has also classified the drug supply chain as an essential service, including pharmacies, wholesalers and pharmaceutical manufacturers certified by the Minister of Health and Social Services.

Changes Impacting the Province of Ontario

In an attempt to minimise the likelihood of drug shortages in the province during the COVID-19 epidemic, the Ontario government has made improvements to the Ontario Drug Benefit (ODB) system. ODB-eligible medications are immediately subject to the following amendments to the dispensing rules and fees:

  1. The dispensing of medication is limited to no more than a 30-days’ supply. Dispensers may use professional judgment to provide a longer supply in exceptional cases, but should not exceed the patient’s usual supply
  2. Prescriptions should not be refilled more than 10 days in advance of a patient depleting their current supply. In exceptional cases where there is a clinical reason to refill a prescription early, the dispenser may provide a refill and document the reason.
  3. Previously, dispensing fees would only be paid for 100-days’ supply of medication or the total quantity of the prescription. Now, all medicines on the ODB Formulary and accessible through the Exceptional Access Program (EAP) are eligible for a dispensing fee based on a 30-days’ supply even if dispensed quantity is less than prescribed or less than the 100-days supply payable under the ODB program.
  4. The list of chronic medications subject to a limit of 5 dispensing fees per 365 days is temporarily removed.

In addition, pharmacists may be reimbursed for MedsChecks performed online, or over the phone. Adequate documentation is required and subject to audit and inspection.

Furthermore, the EAP authorises the automatic extension of all EAP approvals set to expire or expiring between 1 February 2020 and 31 May 2020 for an additional 90 days from the expiry date set out in the initial letter of approval.

Ontario has also declared the drug supply chain an essential service during the pandemic, including “manufacturers, wholesalers, distributors and retailers of pharmaceutical and medical supplies, including medications, medical isotopes, vaccines and antivirals; medical equipment and medical supplies;”