OPQ president hails Bill 67 ‘an extraordinary step forward’

To no one's surprise, Jean-François Desgagné, president of the Order of Pharmacists of Quebec (OPQ), was full of praise for Bill 67's expanded scope of practice at recent parliamentary hearings for the bill. By removing the administrative constraints and obstacles that currently limit pharmacists' interventions, as well as opening up the possibility of making mental health diagnoses to more professionals, “This bill represents an extraordinary step forward for the field of pharmacy and for patients,” reads the OPQ’s brief.During the hearings, Desgagné mentioned several statistics: the more than five million new prescriptions issued by pharmacists in 2022 (17.6% of the total), as well as the 424% increase in the number of treatments for minor conditions initiated in pharmacies, and the 1080% increase in changes to drug therapies since the adoption of the previous Pharmacy Act. Specialist title to ensure equitable access to careDesgagné then quickly moved on to the organization’s main, if not only, complaint regarding the bill: the non-recognition of the specialization of pharmacists holding a master's degree in advanced pharmacotherapy. “Creating a specialist title would make it possible to grant similar practice rights (including prescribing) to all holders of the master’s degree (MPA) in advanced pharmacotherapy, thus ensuring equitable access to care across Quebec,” he said.Desgagné used the example of England, where pharmacists have acquired the right to prescribe since the beginning of the year: They now treat 4% of hospital emergency consultations. “In Quebec, this would correspond to 150,000 consultations a year.”Most of the questions raised by Treasury Board President Sonia LeBel and the opposition MPs concerned advanced pharmacotherapy practice agreements (EPAP), which already allow pharmacists to prescribe via a signed agreement with other medical teams. It’s a superb pilot project that is now showing its limitations, argued Patrick Boudreault, senior director of the OPQ’s Direction de la qualité de l'exercice et des relations partenaires. “An oncology pharmacist won't be able to offer the same care if his patient goes to emergency and falls outside the EPAP framework. He'll have to submit suggestions to the emergency doctor and will be less effective.”In addition, the 900 EPAPs in Quebec today generate a great deal of paperwork, ultimately making the service corridor inequitable and less efficient, according to OPQ representatives.To remedy this situation, the OPQ would like to give the 1,500 pharmacists holding an MPA the right to prescribe for all patients, not just stable patients, as currently stipulated in Bill 67. Opening up servicesIn addition to facilitating access by better-identifying service corridors and supporting community pharmacists, this specialist title would enable the OPQ to maintain control over the relevance of training and recognize equivalencies for foreign pharmacists.“These pharmacists [holding an MPA] are in all healthcare establishments and FMGs,” added Desgagné. “The Université de Montréal is developing a master's degree in advanced ambulatory pharmacotherapy, so there's going to be more and more of them.” While the idea seemed to catch on with opposition MPs, LeBel appeared more dubious, proposing that this increased prescribing power be passed by regulation. “I'm more in favour of opening up professional services rather than creating another title that would have a straitjacket effect.” Several other recommendations were made by the OPQ in its brief: amend section 27 of the Pharmacy Act to add the concepts of director, founder and member, to provide a better framework for not-for-profit legal entitiessimplify the pilot project approval processrepeal section 21 of the Pharmacy Act concerning drug substitution, already enshrined in section 17 and the regulationsSurprisingly, one of the OPQ’s recommendations was immediately approved by the President of the Treasury Board: the addition of a section to the Pharmacy Act prohibiting obstruction of investigations carried out within healthcare institutions.

OPQ president hails Bill 67 ‘an extraordinary step forward’

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