JULY 2020 - The pandemic has prompted numerous changes in policies and regulations affecting pharmacy practice. The Canadian Foundation for Pharmacy (CFP) has created a chart to summarize the changes and enable quick comparisons between provinces.
CFP sifted through official documentation from provincial pharmacy associations, regulators, ministries of health and Health Canada to gather initial information, then worked with the provincial pharmacy associations for fact-checking and updates. CFP will update the information on a regular basis.
So far one policy—namely, recommended or mandatory 30-day supply maximums—has been discontinued in all provinces. While the remaining changes are considered temporary, time will tell if some—such as the ability to provide and bill for services virtually—will continue on as part of the ‘new normal.’
By far the most debated possible permanent new authority is the ability for pharmacists to test for COVID-19 (and other infectious diseases, as part of point-of-care testing [POCT] under an expanded scope). So far, two provinces are active in this space: Alberta and Ontario.
Alberta implemented the “Assessment to Screen and/or Test for Infectious Disease” service in March. The pharmacist provides information and care in relation to COVID-19 and/or conducts an assessment to determine if the patient is at risk for COVID-19 (in which case the pharmacist refers the patient to testing centre). Pharmacies can bill $20 per assessment, for up to five assessments per day. In June, the government and the Alberta Pharmacists’ Association began a pilot program for pharmacists to sccreen and test people in the pharmacy, using a throat-swab test. Only asymptomatic individuals can be tested. Pharmacies in the pilot bill for a screening ($20) or a screening with testing ($42). For more on what's happened in Alberta, click here.
In Ontario, testing for COVID-19 would become part of a POCT program already in the works since mid 2019, which will enable pharmacies to become active in areas such as anticoagulation management, strep throat and HIV testing. The government and the Ontario Pharmacists Association are in discussions to add COVID-19 testing to the program, pending the resolution of several issues: i.e., additional changes to regulation, the test to be used, the provision of personal protective equipment (PPE), operational issues and the funding model. For more on what's happened in Ontario click here.
Other highlights from the chart include:
Virtual care – Most provinces enabled pharmacists to provide services that were formerly face-to-face only, such as medication reviews, by phone or videoconference. In Saskatchewan and Ontario, pharmacists have the option to use government-approved videoconference platforms already available to physicians prior to the pandemic.
Prescribing – Temporary changes to prescribing authority range wide by province, from early refills to 30-day supplies for emergency fills to waived requirements to notify primary prescribers. In Quebec, Nova Scotia and P.E.I., COVID-19 prompted the early adoption of new permanent authorities, some of which are also funded
Personal protective equipment (PPE) – All provincial pharmacy associations have lobbied their respective provincial government to give pharmacists access to the government supply of PPE. This typically requires that pharmacists be designated as essential healthcare workers. So far, only Alberta, New Brunswick and P.E.I. have enabled pharmacy access to their emergency supply of PPE (with limitations or conditions).