Canadian pharmacy in transition

January 2018 — A panel of Canadian pharmacy stakeholders weighed in on the inevitable changes that will affect the profession as pharmacy transitions to a more value-based model of care.  Speaking at the 2017 Pharmacy Forum hosted by the Canadian Foundation for Pharmacy, the panelists agreed on some key objectives: putting patients at the centre of care, and connecting key stakeholders across the healthcare system to collaboratively map out a sustainable future.

Calling for a standardized approach to care, panelist and Ontario College of Pharmacy Registrar Nancy Lum-Wilson noted that value-based services should be grounded in outcomes. “Our role is always going to be to protect the public and put the patient first,” she said. “Value-based pharmacy is a great place to begin but we have to look at it from an equity standpoint as well.”

Rather than risking inequitable care, or having “20 different insurers paying pharmacists in 20 different ways,” Lum-Wilson said we need a broader approach focused on outcomes rather than drugs. “When it comes to patients, we believe if you have a code of ethics and get pharmacists to standard all the time, we will have better outcomes.”

Perry Eisenschmid, former CEO of the Canadian Pharmacists Association, also advocated for a pharmacy system measured on patient outcomes. “Otherwise, there is risk of creating a system that is more punitive than rewarding, he said. “It’s not a far reach to imagine a world where we are taking money away from pharmacists not performing to key level…and that’s something we need to address.” 

Meanwhile, Neighbourhood Pharmacy Association CEO Justin Bates emphasized the need for a pan-Canadian approach to developing a new healthcare model that engages pharmacy and pharmacists. “I don’t know how you can do this without pharmacists at the table,” he said.

Neighbourhood Pharmacy is currently engaging stakeholders to move the pendulum forward in creating a pharmacy reimbursement model that moves from pills to patients. “We need a model working with private and public sector that establishes benefits on both sides,” he said.

While the prospect of value-based pharmacy is “daunting,” noted panelist and independent pharmacy owner Mike Cavanagh, he recognized that it could also be beneficial in encouraging better pharmacists and pharmacies. “As pharmacists, we’re going to need support with lots of tools, resources and examples. I’d like to see a road map on how exactly we get there.”