Navigating the challenges of the Manulife-Loblaw PPN arrangement

In the world of Canadian healthcare, the recent Manulife and Loblaw Companies Limited deal is more than an announcement; it's a harbinger of change with profound implications for community pharmacy across Canada. As a pharmacy owner, I feel it's essential to shed light on the concerns and the potential fallout from this arrangement, particularly from the perspective of pharmacies that don’t belong to the Shoppers Drug Mart/Loblaw umbrella.The preferential reimbursement arrangement between Shoppers Drug Mart/Loblaw Companies and Manulife for its Specialty Drug Care program, which came into effect January 22, 2024, is represented as a strategic move for efficiency and expanded access. However, it casts a long shadow over a significant portion of the pharmacy sector, especially the independents, other chains, and rural pharmacies. This decision doesn't just alter the landscape; it risks transforming it in ways that will stifle competition, innovation and the very essence of personalized care that most pharmacies champion. Some would argue that this a cost saving arrangement for employers and insurers. I disagree. Many pharmacies offer or are willing to offer more competitive prices, yet they will not awarded an opportunity to maintain or grow their business.To community pharmacy this should be a wake-up call. It's not merely about losing out on a business opportunity; it’s about what this deal signifies for the future of healthcare delivery in Canada and the way in which things seems to be heading. Many of us pride ourselves on offering competitive prices and offering services based on our specialization and certification as well as customized care and convenience. Yet, this deal sidelines us—not on merit, but by virtue of a reimbursement inducement scheme that favours the largest player in the pharmacy space and excludes other pharmacies from providing their patient care services to this payers’ clients.Read: Rexall in PPN partnership with Reformulary GroupAnother concern is the innovation dilemma. Pharmacies attract customers through a variety of mechanisms. Some independents and notable chains offer much more competitive prices, while others offer staff certified in specialty conditions, hire reimbursement navigators, nurses and contract case workers. Preferred pharmacy arrangements such as this one take away the opportunity for other pharmacies to attract these patients. These arrangements stifle innovations in care and service delivery. When the market’s dynamics shift to favor a few large players, the incentive for innovation diminishes. This is not just a loss for pharmacies, but for the entire healthcare ecosystem and most importantly, for patients.This isn’t just about us as businesses (the many smaller independent practitioners); it's about the broader principle of equitable access to healthcare and the preservation of a diverse and dynamic pharmacy sector; especially in rural settings and for independent pharmacies. We need policies and practices that recognize the value and fairness of all pharmacies and other health care providers, regardless of their size or affiliation.Read: Pharmpreneur of the week: Michael Nashat: "The biggest challenge in being an entrepreneur is getting started.”The conversation around the Manulife-Loblaw deal should be a catalyst for broader discussions about the future of pharmacy and healthcare in Canada. It's a call to action for policymakers, healthcare providers and the public to consider the implications of such deals and to work towards a system that values diversity, promotes innovation and serves the best interest of patients across Canada.As we navigate these changes, let’s not lose sight of what makes Canadian healthcare unique— its ability to adapt and evolve, and above all, its commitment to providing accessible care for everyone. The Manulife-Loblaw deal is a significant setback, but it should not dictate the future of our healthcare system without a thorough examination of its impact from all angles.

Navigating the challenges of the Manulife-Loblaw PPN arrangement

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