Add two more to the list: Pharmacy advocate suggests more scope of practice expansions in Ontario

The latest regulatory amendments that will authorize Ontario pharmacists to do even more come Oct. are a positive step forward for the profession—but regulators should consider two more scope of practice additions. In a recent letter to the Ontario College of Pharmacists, the Neighbourhood Pharmacy Association of canada—which represents leading pharmacy organizations across the country—recommended further changes that would allow pharmacy professionals to administer all immunizations and to prescribe all vaccines. “Pharmacy professionals are only authorized to administer 10 of the 17 vaccine preventable diseases targeted by the Publicly Funded Immunization Program in Ontario,” wrote Neighbourhood Pharmacy CEO Sandra Hanna. “In many situations where the patient is eligible for a publicly funded vaccine, the pharmacist must refer the patient back to their primary health care provider or local public health unit who can administer the vaccine free of charge to the patient. This creates a barrier to access which can impact uptake of regular immunization opportunities.” Hanna noted that the Ontario Ministry of Health is now exploring options for allowing pharmacy professionals to administer all publicly funded, routinely recommended immunizations. Providing pharmacists with the scope to prescribe all vaccines can also help address the “fragmented” system for those vaccines. “Some vaccines require a prescription, some do not. This leads to confusion and miscommunication to the public on the steps they need to take to obtain a vaccine at their pharmacy,” wrote Hanna. “Enabling pharmacists with the scope to prescribe all vaccines would serve to uncomplicate the patient journey and minimize interactions with the health system. “Ontarians could be assessed at a pharmacy in their community, at a time that is convenient for them, have their vaccine prescribed and administered all in one place. This means faster service, fewer demands on the healthcare system and better access overall to care.” Read: A slow roll-out of a full scope of practice is not a safe one The proposed regulatory amendments—now awaiting provincial government approval after consultations closed on Aug. 12—call for authorizing pharmacists and pharmacy technicians to administer the RSV vaccine and allowing pharmacists to prescribe oseltamivir, also known as Tamiflu. If approved, the changes would also give pharmacy technicians authority to administer Schedule 3 vaccines and remove age restrictions for the administration of the flu vaccine and other Schedule 3 vaccines by pharmacists and pharmacy technicians. It would also transition authority for pharmacists and pharmacy technicians to administer the COVID-19 vaccine and for pharmacists to prescribe Paxlovid from the Regulated Health Professions Act to the Pharmacy Act. In addition to recommending two more scope of practice expansions, Hanna highlighted three “key enablers” that will help support pharmacy professionals with the proposed scope of practice enhancements. These include leveraging the existing pharmaceutical supply chain to streamline the distribution of vaccines to pharmacies—a solution that will “vastly expand” communities’ access to publicly funded vaccines across the province. “Wholesale distribution will streamline the process, supporting more efficient delivery by getting products to patients in less time,” wrote Hanna. “In addition, better line of sight into the supply channel will also result in less vaccine wastage.” Hanna also underlined the importance of implementing centralized immunization records and of providing ‘“fair and reasonable remuneration” to pharmacies that administer publicly funded vaccines. “Ontario’s pharmacies currently have the lowest immunization fee across the country,” she wrote. “Ensuring that pharmacies can sustainably deliver this service will support maximal participation of pharmacies and increase timely and convenient access to routine immunizations in communities across the province.” Read: Integrating safe and effective e-prescribing

Add two more to the list: Pharmacy advocate suggests more scope of practice expansions in Ontario

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