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Claims data strong for flu shots

Claims data strong for flu shots | Picture of claims chart - The Canadian Foundation For Pharmacy

Claims data strong for flu shots

NOVEMBER 2017 – Pharmacists administered almost 2.5 million flu shots during the 2016-2017 season, a 19% gain over the previous season and virtually quadruple the number delivered in 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. Alberta also continues to blaze trails with its unique authorities and programs, while Ontario’s medication review program has taken a hit due to new documentation requirements.

Claims for flu shots chart - The Canadian Foundation For Pharmacy

Each year the Canadian Foundation for Pharmacy gathers provincial claims data for its online chart entitled, Fees and claims data for government-sponsored pharmacists services,” which also appears in its annual Changing Face of Pharmacy report. The theme of this year’s report is “Increasing Our Value to Canadians.”

Fees & claims chart for Alberta - The Canadian Foundation For Pharmacy

For a number of provinces, five years’ worth of data are now available. And year after year, Alberta sets itself apart. The combination of care plans (in which pharmacists set health goals with patients, with unlimited follow-ups), independent additional prescribing authority (APA), the ordering and interpreting of lab tests and a generous fee schedule have contributed to rates of uptake that are exponentially higher than anywhere else. Consider, for example:

  • Claims submitted for its two care plan programs (comprehensive annual care plans and standard medication management assessments) increased 28% in 2017 over 2016; even more impressive, however, is the number of follow-ups jumped by 53% to reach almost 941,000 claims. That translates into an average of 2.9 follow-ups per care plan (compared to 0.5 follow-ups per medication review in Ontario, and 0.1 follow-ups per review in B.C.)
  • Alberta pharmacists adapted 685,100 prescriptions in 2017 compared to 226,300 by pharmacists in B.C., despite the higher population in B.C.
  • Alberta pharmacists with APA wrote 206,400 prescriptions in 2017, a 63% gain over 2016. About 35% of pharmacists (2,111) in the province now have APA, according to the Alberta College of Pharmacists.

In Ontario, although flu shots crossed the important threshold of one million, other claims are flat or declining. Its MedsCheck medication review program in particular was hit hard by new documentation requirements initiated in the fall of 2016. Claims for annual MedsChecks dropped by 26% to 543,900 in 2017, and claims for expanded MedsCheck programs (such as MedsCheck for Diabetes) also dropped by 26% (to 257,800). Follow-ups for all MedsCheck programs declined 21%, to 406,100.

When it comes to minor ailment assessments, Saskatchewan is so far the only province with year-over-year claims data (since Alberta’s data is included under APA prescribing activity). It reported 14,500 claims for 16 conditions, a 10% increase over 2016 and almost twice the amount submitted during year one in 2014 (7,500). Quebec, meanwhile, completed its first full year of assessing and prescribing for 19 eligible minor ailments, with 107,700 claims submitted by the end of 2016.

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