Quebec proposes regulations on clinical pharmacy services

Quebec Premier François Legault's government tabled a draft regulation on Wednesday to implement certain provisions related to pharmacists' clinical activities and their coverage by health insurance.This draft regulation will be subject to a 20-day consultation period, and does not change anything in practice for the time being.Since the adoption of Bill 67, Quebec has intended to allow pharmacists to intervene more broadly in common health problems without a prior medical consultation. The draft regulation would expand their ability to prescribe medications for conditions such as urinary tract infections, erectile dysfunction, certain dermatological conditions, and pre-exposure prophylaxis (PrEP) for HIV prevention. It would also facilitate the renewal of prescriptions, without the current time restrictions, and authorize the administration of certain medications.Behind the counter, they will also be able to perform tests and then prescribe treatment if the result is positive, for example, an antibiotic following a throat swab confirming the presence of group A streptococcus. The stated objective is clear: to offer faster access to local care and shift some of the demand away from family medicine groups (GMFs) and emergency rooms.According to projections from the Ministry of Health, coverage of these services through health insurance would provide approximately 360,000 additional pharmaceutical services during its first full year of implementation. Within five years, this volume could reach nearly 1.1 million services, as these new activities are gradually integrated into practice.“Quebecers must be able to access the care they need, when they need it. This is our health priority,” emphasized Health Minister Christian Dubé in a press release issued by his office. He adds that being able to assess and treat more situations in pharmacies, free of charge, upon presentation of the health insurance card, would improve access to care for the entire population.From a legal standpoint, this draft regulation follows the Act to amend the Professional Code for the modernization of the professional system, better known as Bill 67. The new regulation would amend both the Regulation respecting the application of the Health Insurance Act and the Regulation respecting the general prescription drug insurance plan. It would also replace the Regulation respecting the initiation and modification of drug therapy, the administration of medication and the prescription of tests by a pharmacist, which is slated for repeal.Yet to be implementedDespite the gradual tabling of various regulations related to clinical services, the Quebec Association of Pharmacy Owners (AQPP) continues to lament the gap between the legal framework for these new activities and the operational reality of their implementation. Earlier on Wednesday, its president, Benoit Morin, emphasized the slow pace of negotiations surrounding the concrete implementation of the new powers provided for by Bill 67. He says these expanded acts will remain difficult to deploy without a comprehensive agreement governing their remuneration, the previous one having expired on March 31, 2025. Discussions with the government have been ongoing for several months, but progress is slow.For the AQPP, the issue goes beyond simple regulatory recognition. The expansion of clinical acts requires organizational adjustments, additional professional time, and investments in teams and infrastructure. However, without an adequate remuneration framework, these new responsibilities risk remaining purely theoretical. “We need a different approach so that we can truly utilize the network’s 1,900 pharmacies to their full potential and invest in clinical services to provide these services to the public,” Benoit Morin told the Canadian Press, noting that the initial objective of Bill 67 was to alleviate pressure on primary care and better distribute the workload among healthcare professionals.Notably, the Quebec Order of Pharmacists unveiled its training program a few days ago, designed to prepare pharmacists to perform these new responsibilities.This article has been translated from its original French and appeared originally on our sister site Profession Santé.

Quebec proposes regulations on clinical pharmacy services

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