A paradigm shift for Quebec pharmacists

JANUARY 2020 – Quebec is preparing for a reimbursement model that is based on the complexity of clinical services, heard attendees at the Canadian Foundation for Pharmacy’s annual Pharmacy Forum held in November 2019.

Expected to take effect this spring, the Association québécoise des pharmaciens propriétaires (AQPP) is hoping its new reimbursement model will break down barriers that have prevented pharmacists from fully using their scope of practice. This is particularly timely given Quebec’s Bill 31 announced last year, which allows pharmacists to prescribe and administer vaccines among other new services.

“Our objective is fair and adequate reimbursement..and to assure revenue is stable across pharmacies,” said Ramy Fahmy-Demian, Director, Association québécoise des pharmaciens propriétaires (AQPP). To that end the new model will eliminate professional allowances and the influence of third parties, in favour of transparent reimbursement based on the complexity of pharmacy services. It includes a fee for regular pharmacy services needed for medication distribution, as well payment for clinical activities that fully utilize the pharmacist’s skill. 

The new model will also implement a monitoring fee based on at least four levels of medication complexity. Level one could be a straight forward monitoring of acetaminophen use, for example, while a level four would involve something more complex like anticoagulation management. “We are trying to place the relationship back towards the patient and pharmacist,” said Fahmy-Demain. “We can’t impose anything on anybody (only the Colllege can do that) but we want to make the training and tools available to pharmacists to follow these guidelines within their current workflow.”

Using accumulated data on all pharmacies in Quebec, AQPP CEO Jean Bourcier told Forum attendees that his organization has been able to see exactly how stores have been doing in terms of number of prescriptions and pharmacy services over the last 12 months. “Then we can come and apply the new model to each pharmacy and compare the results,” said Boucier. “We want to make sure that at the end of the day, the new model will be fair across a network of pharmacies.”