Quebec PSP initiative empowers pharmacies

A new patient support program (PSP) for a specialty medication, the first of its kind in Quebec and possibly in Canada, is making waves. Almost half of the 1,900 pharmacies in Quebec and more than 8,000 patients have enrolled so far in Ostéoaccès, an adherence program for denosumab.

“That’s twice the objective we set for ourselves for the first year of Ostéoaccès. We’re very, very pleased,” says Nadia Khassassi, Vice-President, Operations, at Accessa, which has managed manufacturers’ PSPs for specialty medications for more than five years. As a subsidiary of the Quebec Association of Owner Pharmacists (AQPP), Accessa’s programs are available to all pharmacies in the province.

Ostéoaccès, launched in August 2025, is the first program not tied to a single manufacturer. “Ostéoaccès was envisioned as an agnostic solution. It’s a single program where multiple sponsors share the infrastructure cost,” says Khassassi.

The program focusses on supporting patients taking denosumab for osteroporosis, in large part because biosimilars had become available and most provincial insurance drug plans, including in Quebec, reimburse the biosimilar rather than the originator biologic.

However, the different commercial models for biosimilars meant that traditional PSPs are not financially viable. At the same time, the risk of non-adherence is high for denosumab. “The manufacturers share the desire to do something for patients since the injection is taken only once every six months, which means it’s very, very easy for dose reminders to fall through the cracks,” says Khassassi, adding that a single missed dose increases the risk of fracture.

“We brought all of this together into something that was cost-effective for pharma and empowering for pharmacies, and where patients ultimately benefit from the added structure,” she says.

Accessa promotes Ostéoaccès to physicians, pharmacists and patients at industry events, using promotional brochures, and by sharing information on its website and in newsletters.

Pharmacies are the main driver of enrollment. Pharmacists present the program to their patients, obtain their consent and create the patient’s profile in Accessa’s CURO® platform. “Feedback from pharmacies has been very positive, and we’re at the point where Ostéoaccès is growing by word of mouth,” says Khassassi.

Patients may also enroll themselves. “Our enrollment portal asks the patient to identify their usual pharmacy, and if that pharmacy isn’t already enrolled, we’ll let them know that they have a patient who wants to enroll in the program. And 99% of the time when we have that conversation, the pharmacy jumps right in,” says Khassassi.

Accessa’s CURO® platform sends emails that remind patients of their upcoming renewal, and pharmacies receive notifications within the platform as well. A standardized documentation tool captures when the patient received their last dose, whether the patient is experiencing any issues and other pertinent information, such as calcium levels.

That real-world data is collected, anonymized and aggregated to determine the impact of Ostéoaccès on adherence. AQPP will also use the research findings to advocate on behalf of pharmacy. “A significant objective behind all of this is to demonstrate what the pharmacist and their team can accomplish, and their impact on patient outcomes,” says Khassassi.

As well, the research will also help inform the development of additional PSPs operated by Accessa, she adds. “Ostéoaccès is a pilot project. We are currently brainstorming other therapeutic areas where we think this type of program could be a good fit.”

As specialty medications continue to grow their share of healthcare costs in a system increasingly pressured to manage costs and optimize resources, PSPs like Ostéoaccès could be win-win across the board—for patients, manufacturers, pharmacies and payers, says Khassassi. “We have a lot of agility and flexibility, backed by the infrastructure of pharmacy. It’s exciting to be able to spearhead these types of innovative projects and initiatives that are hopefully going to bring about waves of change.”