Blazing trails in most publicly funded services

Across the country, community pharmacies’ claims for publicly funded services grew—in some cases, by triple digits—for prescription renewals, assessments for minor ailments and common conditions, and the administration of vaccines other than vaccines for influenza and COVID-19.

On the flip side, claims for medications reviews declined in all provinces that offer this type of a program. Most provinces also saw declines in flu and COVID-19 vaccinations.

In Alberta, government cutbacks effectively doused year-after-year growth rates for Comprehensive Annual Care Plans and Standard Medication Management Assessments. That said, growth remains strong across all other publicly funded services.

The Canadian Foundation for Pharmacy (CFP) has collected provincial claims data for publicly funded pharmacy services since 2012, for inclusion in its annual Services Chart. Below we summarize claims-data trends over the past several years. The fiscal year for all provinces ends on March 31; therefore, the data reported here is for the fiscal year ending on March 31, 2025.

Influenza vaccinations

Nationally, flu shots in pharmacies have declined for the second year in a row. However, they remain well ahead of pre-pandemic levels.

Community pharmacies administered 5.4 million flu shots for the fiscal year 2024-25, down 4% from 2023-24 (5.6 million), which in turn was 5% lower than the record high of 5.9 million in 2022-23. Before the COVID-19 pandemic, in 2019-20, pharmacies had administered 3.7 million flu shots.

Quebec was the only province to report more flu shots in pharmacies for the second year in a row. Its count grew modestly in 2024-25 by 2%, following a 5% increase in 2023-24. Pharmacies in Canada’s second-largest province by population did not, however, administer the second-highest number of flu shots. That ranking went to B.C., Canada’s third-largest province, with a flu-shot count of 1.2 million compared to Quebec’s total of 690,000 in 2024-25.

The biggest declines occurred in Newfoundland and Labrador (15%), Nova Scotia (10%) and Manitoba (9%).

COVID-19 vaccinations

Nationally, community pharmacies administered fewer COVID-19 shots than flu shots for the first time since the mass COVID-19 vaccination campaigns of 2021 and 2022. The total for 2024-25 was 5.1 million, compared to 5.4 million flu shots. The COVID-19 count was 12% lower than in 2023-24 (5.8 million), which in turn was 34% less than in 2022-23 (8.8 million).

Two provinces to buck that downward trend were Quebec and Saskatchewan, where pharmacies boosted COVID-19 shots by 30% (to 648,000) and 23% (to 109,300), respectively. The biggest declines occurred in Newfoundland and Labrador (26%), Nova Scotia (25%) and Manitoba (22%).

Prescription renewals & adaptations

Prescription renewals soared in 2024-25 to reach 5.6 million, 20% more than in 2023-24 (4.7 million).

Pharmacies in all provinces—except in Manitoba and Ontario, where renewal services are not publicly funded—posted gains, led by Alberta (up 29% to 2 million), Nova Scotia (up 29% to 293,800) and B.C. (up 26% to 871,400). Pharmacies in Quebec renewed 1.5 million prescriptions in 2024-25, 15% more than in 2023-24.

Claims for prescription adaptations also saw significant growth, climbing 35% to reach 1.4 million. Quebec led the charge, growing from 740,900 in 2023-24 to just over one million in 2024-25, a gain of 38%. Nova Scotia soared 126% to 22,600, a reflection of the first full year of universal public funding (prior to June 2023, funding was limited to beneficiaries of the public plan). Growth is also strong in B.C. (up 25% to 85,400) and Alberta (up 19% to 250,600).

All provinces except Manitoba, Ontario and New Brunswick can bill for services to adapt prescriptions. Claims are limited to beneficiaries of public plans in P.E.I. and Newfoundland and Labrador.

Minor ailments & common conditions

Claims for assessing and prescribing for minor ailments and common conditions in 2024-25 grew at a healthy pace of 29% to reach 2.9 million across all provinces. The highest rates of growth were in Newfoundland and Labrador (up 132% to 34,800), New Brunswick (up 57% to 24,300) and B.C. (up 50% to 413,400).

Pharmacists in Quebec alone performed 376,000 additional assessments in 2024-25 for a new total of 1.5 million—a gain of 34% over 2023-24.

As of June 2023, community pharmacy-based programs to assess and prescribe for minor ailments and common conditions were available in all provinces. However, levels of public funding vary widely. For example, pharmacies in Manitoba can bill for assessments for urinary tract infections (UTIs) only out of a total of 13 eligible conditions. In Quebec and P.E.I., pharmacies can bill for all 35 eligible conditions in their respective programs—which recently became the case in Nova Scotia, as well. Prior to February 2026, pharmacies in Nova Scotia could bill for only three out of 35 eligible conditions.

In Alberta, pharmacists with additional prescribing authority can prescribe any Schedule 1 drug for any health condition; however, claims data for minor ailments or common conditions are not recorded separately and therefore are not included in the numbers reported here.

It’s also worth noting that in Alberta and Saskatchewan, the first two provinces to fund programs for minor ailments—more than 10 years ago—pharmacies can bill only when assessments result in a prescription. In all other provinces, pharmacies can bill whether or not the assessment results in a prescription.

British Columbia

Public funding for pharmacist-administered vaccines is the most comprehensive in B.C. Not only can pharmacies bill for the administration of all publicly funded vaccines, but they can also bill for recommended vaccines that are not funded by the province (e.g., for respiratory syncytial virus [RSV]).

While vaccinations for influenza and COVID-19 were down in B.C., consistent with most other provinces, vaccinations for other infectious diseases rose 32% in 2024-25 to reach 97,300. The top three other vaccinations were for tetanus (61,000), pneumococcal disease (12,200) and measles (8,800).

As for the two most popular vaccinations, flu shots declined 7% to 1.2 million and COVID-19 shots declined 18% to 1.3 million. That said, B.C. is punching above its weight: its pharmacies administered 22% and 26% of flu and COVID-19 shots, respectively, for a population that represents 14% of the national population. As well, B.C. was one of two provinces, along with Nova Scotia, where COVID-19 shots continued to outnumber flu shots.

Claims for services to renew or adapt prescriptions climbed by double digits for the third year in a row, following expansions in authority in October 2022. For the most recent fiscal year of 2024-25, renewals grew 26% to reach 871,400 and adaptations grew 25% to 85,400.

Public funding for the administration of drugs by injection began in October 2022. After billings almost tripled in 2023-24, they climbed 23% during 2024-25 to reach 363,800.

B.C.’s Minor Ailments and Contraception Service (MACS) program recorded its first full year of claims data following implementation in June 2023. Claims for the 21 eligible minor ailments reached 413,400 in 2024-25, up 50% over the 10 months reported for 2023-24, and claims for contraception management (including emergency contraception) grew 52% to 70,200.

Two programs recorded fewer claims in 2024-25. Standard Medication Reviews declined 16% (to 183,000) following a surge of 30% in 2023-24 (218,000). Similarly, medication reviews requiring a consultation with a physician dropped 12% (12,500) following a gain of 11% (14,200) the previous year.

Therapeutic substitutions declined 7% (to 24,000). In 2023-24, substitutions had more than doubled (25,900) following an expansion in authority in October 2022.

Alberta

Government cutbacks significantly slowed growth rates for pharmacist-led care plans and medication assessments in Alberta.

The government chopped the fee for Comprehensive Annual Care Plans (CACPs) by 30%, from $100 to $70, effective November 2024. It also reduced the maximum number of billable follow-ups from 12 to four for both CACPs and Standard Medication Management Assessments (SMMAs).

The cutbacks impacted the five months remaining in fiscal year 2024-25, resulting in a much lower growth rate of 4% spread out across the full year for CACPs—following gains of 27% in 2023-24 and 29% in 2022-23. In actual numbers, pharmacists performed 499,400 CACPs in 2024-25, compared to 482,100 in 2023-24 and 380,400 in 2022-23.

The new cap of four CACP follow-ups effectively stopped the service for many patients during the last five months of 2024-25. The result was zero growth for the full fiscal year, with a total of 2.5 million follow-ups in both 2024-25 and 2023-24—compared to growth rates of 42% in 2023-24 and 40% in 2022-23.

The annual growth rate for SMMAs slowed to 3% in 2024-25 (for a total of 73,800 SMMAs) on the heels of much higher gains of 28% in 2023-24 and 40% in 2022-23. SMMA follow-ups grew by 7% to 323,900, after gains of 52% in 2023-24 and 51% in 2022-23.

For all other billable services, growth rates remained in the double digits—or even triple digits, for certain vaccines.

• Billings for assessments that resulted in prescriptions to initiate or manage drug therapy by pharmacists with additional prescribing authority, including for minor ailments, reached 1.1 million, a 39% increase over 2023-24 (781,400)—and more than triple the number recorded five years ago (352,500 in 2020-21).
• Prescription renewals climbed 29% to just shy of 2 million. Adaptations grew 19% to reach 250,600.
• Vaccinations for tetanus, diptheria and pertussis grew six-fold, to 95,000 from 15,900 in 2023-24. Vaccinations for pneumococcal disease more than quadrupled, to 48,200 from 10,300.
• Authority and public funding for the administration of vaccines for RSV began in October 2024. After six months, pharmacists had administered 92,600 RSV vaccines.

Flu and COVID-19 shots declined by 1% and 14%, respectively, in Alberta pharmacies, compared to national declines of 4% and 12%, respectively.

Saskatchewan

In June 2024, the Saskatchewan government increased the service fee for its community pharmacy minor-ailments program to $25 from $18, for 28 of the 30 eligible conditions. Claims for the 2024-25 fiscal year increased by 28% to 54,900, bettering the double-digit gains of 17% in 2023-2024 (42,700) and 13% in 2022-23 (36,400).

For the first time, CFP received separate reporting for prescribing services for renewals and adaptations in Saskatchewan. In 2024-25, pharmacists completed 419,200 renewals and 11,400 adaptations. When the claims are combined and reported together, as in previous years, growth rates in both 2024-25 and 2023-24 were 5%.

Public funding for Saskatchewan’s medication-review programs is available only to beneficiaries of the public plan. The most recent fiscal year recorded declines across the board: Medication Assessments for Seniors dropped 11% to 9,400 reviews, following a jump of 31% in 2023-24 (10,600); Medication Assessments for Home Care decreased 8% to 1,100; and follow-ups for both services plummeted 67% to only 1,100 follow-ups.

In the vaccinations space, public funding for pharmacist-administered vaccines is available only for influenza and COVID-19. Flu shots declined by 9% to 149,100, the third-highest rate of decline among provinces. Interestingly, however, COVID-19 shots increased significantly, by 23% to 109,300, compared to a national decline of 12%. In 2023-24, COVID-19 shots had dropped by more than half (59%), the biggest decline in Canada.

Manitoba

Manitoba significantly lags behind all other provinces in public funding for non-dispensing services authorized under the scope of practice. Outside of fees for vaccinations, direct public funding is limited to assessments for a single minor ailment, UTIs, out of 13 eligible conditions.

The fee for UTI assessments began in early 2022. For the most recent fiscal year, pharmacists completed 11,900 assessments. Claims data for the two previous years are not available.

Vaccinations for infectious diseases other than influenza and COVID-19 climbed by 28% in 2024-25 to reach 10,400, following gains of 12% in 2023-2024 (8,100) and 58% in 2022-23 (7,200). The two most popular other vaccinations are for pneumococcal disease, skyrocketing by 62% in 2024-25 (5,300), and tetanus, diptheria and possibly pertussis (4,000, up 7%).

Flu shots declined by 5% in Manitoba in 2024-25 to 171,400, consistent with the national decline of 4%, and COVID-19 shots dropped by 22% to 146,900, compared to the national downturn of 12%.

Ontario

Ontario’s fully funded minor-ailments program began in January 2023 for 13 conditions and increased to 19 in October 2023. During the fiscal year 2024-25, pharmacists conducted and billed for 793,400 assessments, almost 10% more than in 2023-24 (722,500).

After two years of strong growth, MedsCheck medication reviews faltered in 2024-25. Claims for a MedsCheck Annual dropped 34% to 599,600, after reaching a record high of 910,600 in 2023-24. Follow-ups fell 26% to 128,400 after surging by 54% in 2023-24 (173,900). Similarly, MedsCheck for Diabetes reviews and their follow-ups tumbled 27% (to 215,500) and 56% (142,300), respectively. By contrast in 2023-24, diabetes reviews rose 57% (295,300) and follow-ups almost quadrupled (322,800).

Ontario’s Pharmaceutical Opinions (POs) program has existed since 2013. Available to beneficiaries of the provincial drug plan only, community pharmacists conducted 236,400 in 2024-25, 4% fewer than in 2023-24 (245,600). This comes after two years of double-digit gains (17% in 2023-24, 20% in 2022-23).

Like Saskatchewan, public funding for vaccinations is currently limited to vaccines for influenza and COVID-19 (although that is expected to change in 2026). Flu shots were down 4% to 1.9 million, mirroring the national decline of 4%. COVID-19 shots declined 16% to 1.8 million, somewhat more than the national decline of 12%. For both flu and COVID-19 vaccines, pharmacists in Ontario administered 35% of the reported total, somewhat below the province’s share of the national population (40%).

Quebec

For the fourth consecutive year, assessments for the 35 conditions included in Quebec’s minor-ailments program soared. They rose 50% in 2024-25 to reach 1.7 million, following gains of 35% in 2023-24 (1.1 million), 76% in 2022-23 (822,000) and 113% in 2021-22 (467,100). Meanwhile, assessments for emergency contraception were down by 3%, to 122,800, following a decline of 4% in 2023-24 (126,800).

Prescribing services to renew prescriptions climbed 15% to 1.7 million, almost neutralizing the decline of 18% in 2023-24 (1.5 million). Prescription adaptations surged 38% to hit the 1-million milestone, propelled by a claims count that almost tripled in 2022-23 (585,000) and grew 27% in 2023-24 (740,900). Meanwhile, therapeutic substitutions declined 18% to 95,200, following growth rates of 5% in 2023-24 (116,500) and 31% in 2022-23 (111,000).

Pharmacists in Quebec have the authority to assess and prescribe to help patients manage therapy and reach clinical targets. Claims climbed 36% in 2024-25 to reach 676,000, following a jump of 60% in 2023-24 (498,200). However, within those numbers, assessments and follow-ups for anticoagulation management, including INR tests, declined 5% in 2024-25 to 179,600, following an 18% drop in 2023-24 (189,800).

Pharmacists administered drugs by injection more than 12,800 times in 2024-25, an increase of 33% over 2023-24 (9,600).

As in other provinces, immunizers in pharmacies in Quebec administered significantly more vaccines for infectious diseases other than influenza and COVID-19 (note: in Quebec pharmacies, vaccinations can be administered by authorized nurses, pharmacy technicians and pharmacy students as well as by pharmacists). The number jumped by 79% in 2024-25 to reach 422,200 vaccinations, of which more than a third (39%) were for herpes zoster (164,200). Breakdowns are not available for other authorized vaccines.

As for flu and COVID-19 shots, Quebec stands out as the only province to report increases for both: 2% more flu shots (689,500), and 30% more COVID-19 shots (647,700). Their respective shares of the national total are 16% and 13%, and the province accounts for 22% of the national population.

New Brunswick

Claims more than doubled to 24,300 for assessments for minor ailments in 2024-25, compared to 10,500 in 2023-24. Since 2022-23, pharmacists in New Brunswick can bill for 10 of the 35 eligible conditions.

Claims for contraception management, for which funding began in June 2022 and which are reported separately, climbed 15% in 2024-25 to 1,800.

Pharmacists in New Brunswick renewed 181,000 prescriptions in 2024-25, 6% more than in 2023-24 (171,500). While they have the authority to adapt prescriptions, the service is not publicly funded.

The provincial government began funding pneumococcal vaccinations in 2022-23. After claims more than doubled in 2023-24 to 5,100, they declined slightly, by 2%, in 2024-25 (5,000). Funding for RSV and tetanus, diptheria and pertussis vaccines began in November 2024; during the remaining five months of the fiscal year, pharmacists administered 400 and 1,800 vaccines, respectively.

Pharmacists administered 133,700 flu shots, 4% fewer than in 2023-24 (139,600), consistent with the national decline of 4%. COVID-19 vaccinations fell by 21% to 647,700, compared to a 12% decrease nationally.

Nova Scotia

Pharmacists adapted 22,600 prescriptions in 2024-25, more than double the number in 2023-24 (10,000)—which itself was a five-fold increase compared to 2022-23 (2,000). The steep escalation reflects the move to universal funding in June 2023; prior to that, pharmacies could submit claims for beneficiaries of the public drug plan only.

Prescriptions renewals climbed 29% in 2024-25 to 293,800, compared to growth rates of 8% in 2023-24 (227,600) and 16% in 2022-23 (211,300).

Public funding for therapeutic substitutions began in June 2023. For the 10 months remaining in the 2023-24 fiscal year, pharmacies submitted claims for 20,000 substitutions. In 2024-25, substitutions declined 7% to 18,600.

On February 2, 2026, the government expanded funding to include all 34 conditions in the province’s minor-ailments program. Prior to that, community pharmacies could bill for assessments for three conditions, as well as for contraception management services. In 2024-25, assessments for the three conditions soared 79% to reach 38,600. A comparison to the previous year is not possible due to missing data for one of the three conditions.

Claims for contraception management, including follow-ups, grew 27% to reach 5,100, following a decline of 22% in 2023-24 (4,100).

Pharmacists participating in Nova Scotia’s Community Pharmacist-led Anticoagulation Management Service submitted 19,400 claims in 2024-25, slightly less than the 19,700 submitted in 2023-24.

Public funding for Nova Scotia’s two programs for medication reviews—Basic Medication Reviews and Advanced Medication Reviews for Seniors—is limited to beneficiaries of the public plan. Basic reviews dropped by 51% in 2024-25 to 2,500, and reviews for seniors declined 15% to 3,400. There were 1,300 follow-ups for both services, a 28% increase over 2023-24.

In May 2023, public funding for pharmacist-administered vaccines expanded to include vaccines for pneumococcal disease and meningococcal B. Claims data was not available for the 2023-24 fiscal year. During 2024-25, pharmacists administered 3,300 pneumococcal and 1,700 meningococcal B vaccines.

Flu and COVID-19 shots in pharmacies declined by 10% (190,200) and 20% (to 209,900), respectively, compared to national declines of 4% and 12%. It’s also worth noting that Nova Scotia and B.C. are the only two provinces where pharmacists continue to administer more COVID-19 vaccines than flu vaccines.

Prince Edward Island

Funding for all 35 eligible minor ailments and common conditions (including hormonal contraception) began in October 2022. Pharmacists completed 29,300 assessments in 2024-25, 10% more than in 2023-24 (26,700).

October 2022 also marked the start of public funding for prescription renewals. Claims climbed by 19% in 2024-25 to reach 53,700. Funding for prescription adaptations remains limited to beneficiaries of the public plan; nonetheless, growth rates were brisk in the past two years. After almost quadrupling in 2023-24 to reach 1,400, claims for adaptations climbed another 34% in 2024-25 to reach 1,900.

Medication reviews in P.E.I. are limited to beneficiaries of the public plan. Basic Medication Reviews declined 20% in 2024-25 to 2,800, following a gain of 19% in 2023-24 (3,600). Diabetes Medication Reviews totalled 1,500 in 2024-25, a 12% decline after a 22% gain in 2023-24 (1,700).

In addition to vaccines for influenza and COVID-19, P.E.I. funds pharmacist-administered vaccines for herpes zoster (shingles). During the first full year of funding in 2022-23, pharmacists administered 19,700 shingles vaccines. The number was less than half that in 2023-24 (6,700), then climbed 26% in 2024-25 to reach 8,500.

Flu shots declined 4% in 2024-25 to 29,500, consistent with the rate of decline nationally. COVID-19 shots dropped 25% to 25,700, double the national decline of 12%.

Newfoundland and Labrador

Public funding for nine out of 33 minor ailments, plus hormonal contraception, began in April 2023. Out of the gate, community pharmacists completed assessments for 15,000 minor ailments and almost 1,000 for contraception (including follow-ups) in 2023-24. In 2024, minor-ailment assessments more than doubled, to 34,800, while assessments for hormonal contraception grew slightly, to just over 1,000.

Universal funding for prescriptions renewals also began in April 2023 (before then, it was limited to public-plan beneficiaries). The claims count more than doubled in 2023-24 to 166,100. During the most recent fiscal year of 2024-25, claims grew 6% to 175,400. Funding for adaptation remains limited to beneficiaries of the public plan. Claims dropped by almost half in 2024-25 to 3,100 from 6,800 in 2023-24.

Public funding for medication reviews is not only limited to beneficiaries of the public plan, but pharmacies are also limited to submitting no more than 72 claims in total annually. Claims declined 36% in 2024-25 to 1,500, following an increase of 7% in 2023-24 (2,400).

Declines in flu and COVID-19 shots in Newfoundland and Labrador outpaced national declines: flu shots were down 15% to 68,400 in 2024-25 (compared to a national decline of 4%), and COVID-19 shots were down 26% to 48,800 (12% nationally).

Looking ahead, results for 2025-26 will include claims to administer vaccines for tetanus, measles, pneumococcal disease, herpes zoster and RSV. Public funding for these vaccines began in June 2025.