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Blazing trails with flu shot claims

Blazing trails with flu shot claims | Picture of flu vaccine container with an injection needle on top of it - The Canadian Foundation For Pharmacy

Blazing trails with flu shot claims

NOVEMBER 2018 – Pharmacists administered just shy of 3 million flu shots during the 2017-2018 season, a 20% gain over the previous season and a continuation of consistently strong gains in uptake since 2012-2013. These numbers from provincial ministries of health confirm that flu shots appear to be the most consistently successful service under an expanded scope of practice, in all provinces where it’s available (i.e., every province except Quebec).

Each year the Canadian Foundation for Pharmacy gathers provincial claims data for its online chart entitled, “Professional service fees and claims data for government-sponsored pharmacists services,” which also appears in its annual Changing Face of Pharmacy report. The theme of the 2018 report is “Making Value Connections.”

The charts shown here present highlights in claims data trends for many of the provinces. Unless otherwise stated, the year ending date is March 31.

The annual number of Standard Medication Reviews in B.C. appears to have leveled off, while the rate of prescription renewals/adaptations in that province appears to climb steadily.

Alberta continues to set itself apart with its rates of uptake for a number of its services, some of which are unique to that province (i.e., comprehensive annual care plans [CACPS], additional prescribing authority). However, claims for both comprehensive annual care plans (CACPs) and standard medication managments (SMMAs) took a tumble–and just two months later, in May 2018, the government announced cuts to professional fees for these services (affecting pharmacists who have additional prescribing authority). The dip in SMMAs is partly due to a change in reporting methodology, as SMMAs for Diabetes and SMMAs for Smoking Cessation are now reported separately. On the positive side, the growth in number of follow-ups for CACPs continued unabated, so much so that pharmacists conducted roughly five follow-ups for each initial, annual CACP.

The number of pharmacists in Alberta with additional prescribing authority continues to steadily grow, reaching approximately 44% today; as a result, claims for prescriptions to initiate or manage ongoing therapy steadily grow.

Saskatchewan is one of three provinces in Canada (with Alberta and Quebec) where pharmacists can bill government for assessing and prescribing for minor ailments, and claims steadily climb year after year.

Pharmacists in Ontario, meanwhile, appear to still be struggling with the onerous documentation requirements for its MedsCheck programs, implemented in late 2016, as evidenced by the continued descent of claims submissions. They are having more success with Pharmaceutical Opinions, available to beneficiaries of the public plan only.

In Quebec, while an expanded scope of practice took longer to implement, pharmacists there appear to be making up for lost time, judging from just two years’ worth of claims data so far. Claims submitted for minor ailments jumped by 130% in just over a year, while gains for prescription renewals (78%) and prescribing to manage ongoing therapy (84%) were also impressive.

Claims data for services other than the flu shot in Manitoba and the Atlantic provinces are not reported here due to the lack of public funding, or because funding is limited to beneficiaries of public plans only.

* Year ending December 2016 for Quebec
** Year ending June 2018 for Quebec

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