OCTOBER 2021 – In the past two years, three more provinces have put funding in place for pharmacists’ assessments and prescribing for uncomplicated urinary tract infections (UTIs)—enabled in part by research funded by the Canadian Foundation for Pharmacy.
The University of Alberta’s RxOUTMAP study, funded by a grant from CFP’s Innovation Fund in 2017, enrolled 39 community pharmacies and 750 patients with symptoms of UTI in New Brunswick. Clinical cure was achieved in 88.9% of the cases and patient satisfaction was very high. A subsequent economic analysis found that pharmacist-initiated UTI management was about half the cost of care provided by family physicians and about a fifth of the cost of care in an emergency department.
“The results of the original study were certainly helpful in making our case [to government],” says Allison Bodnar, CEO of the Pharmacy Association of Nova Scotia.
Pharmacists in Nova Scotia began billing the provincial drug plan a fee of $20 per UTI assessment in January 2020. They have the authority to assess and prescribe for 35 conditions in total, of which UTIs, herpes zoster and contraception management are the first to receive public funding.
Prince Edward Island was next. Public remuneration for UTI assessments began in April 2021 and Erin MacKenzie, Executive Director of the Prince Edward Island Pharmacists Association, confirms that the RxOUTMAP findings were referenced throughout discussions with government. Pharmacists in P.E.I. can assess and prescribe for 31 minor ailments in total; UTI is the first for which they can bill, at a rate of $20 per assessment.
Most recently, pharmacists in New Brunswick began billing $20 for UTI assessments in October 2021. They are authorized to assess and prescribe for an additional 31 conditions.
“It’s exciting to see how research can translate into public funding for the profession, which in turn supports the sustainability of a service that’s valued by patients. That potential for practical application is a key factor when we decide which projects to fund,” says Dayle Acorn, CFP’s Executive Director.
Ontario’s government is widely expected to announce its minor ailments program in pharmacies by the end of this year, starting with a list of 12 conditions (including UTIs). The Ontario Pharmacists Association (OPA) has proposed a fee of $20 per assessment.
RxOUTMAP as well as several studies on pharmacist prescribing for minor ailments by the University of Saskatchewan from 2015 to 2017, also funded in part by CFP, played an important role during negotiations. “The research provided insights and data that enhanced our proposal and reinforced why it is important for the Ontario government to enable this scope of practice, with a reasonable and fair reimbursement fee,” says Justin Bates, OPA’s CEO.