What's Ontario's funding model for minor ailment assessment?

Tick-tock, tick-tock. Pharmacists in the province are just a little more than two weeks away from being able to prescribe medications for minor ailments ranging from allergic rhinitis to urinary tract infections. But unless the province’s Ministry of Health does something soon, this new service—which Ontario pharmacists have been pushing to offer for years—will be rolled out on Jan. 1, 2023 with no arrangements for reimbursements from either public or private insurance and little guidance around how and if pharmacists should start billing. “There will be no formal or public announcement of a pharmacist minor ailments funding model prior to January 1, 2023,” Justin Bates, CEO of the Ontario Pharmacists Association, told Pharmacy Practice + Business. “The government plans an announcement in early January.” He added that the association has been engaged in discussions with the province on a publicly funded minor ailments program. “The goal is that any Ontario resident can use their health card to get an assessment and treatment of the 13 minor ailments,” Bates wrote in an email. Offering prescribing services for minor ailments isn’t just a matter of putting up a sign to let patients know about this expansion to scope of practice. Ontario pharmacists need to either upgrade their billing system or migrate to a new platform, such as MAPflow, that supports billing for minor ailments prescribing. Read: Ontario Pharmacists Association partners with MAPflow software for minor ailments While there’s no fee to take the Ontario College of Pharmacists’ mandatory orientation course for minor ailment prescribing, other courses that delve deeper into the various conditions will present additional costs for Ontario pharmacists that want to provide this new service to their patients. It’s déjà vu all over again for pharmacists in other parts of the country where scopes of practice have long included minor ailments prescribing. Margaret Wing, CEO of the Alberta Pharmacists’ Association, recalled that the province’s pharmacists—who were authorized in 2007 to prescribe any Schedule 1 drug within their clinical competency—worked without provincial funding for prescribing services for about five years. “Between 2007 and 2012, most pharmacists didn’t charge for the service although some did charge the patient directly,” Wing told Pharmacy Practice + Business in an email. Alberta started reimbursing its pharmacists in 2012 for patient assessments to lead to a prescription. Today Alberta pharmacists are paid $25 for initiating a new medication therapy, and $20 per patient assessment for a renewal, adaptation or discontinuation of a prescription. “Our model has been established for over 10 years now and the general sentiment is that it is better for both the patient and the pharmacist to be able to offer these services and meet their patients’ needs directly than to have to find another healthcare professional to prescribe the same medication that the pharmacist could be recommending,” said Wing. Read: PEI pharmacists gain minor ailment prescribing, ability to renew prescriptions In Prince Edward Island, it took eight years for pharmacists to be compensated by the province for minor ailments prescribing. Since 2014, most PEI pharmacists were charging customers a "consultation fee" of $20 or more to prescribe meds for minor conditions. But in October 2022 the government announced a $3-million program to pay for the service so patients will no longer have to. In Nova Scotia, pharmacists are still waiting for the province to step up with some dollars for most minor ailments prescribing. “We have had minor ailments prescribing in Nova Scotia since 2011 and still do not have funding for most of them,” said Alison Bodnar, executive director of the Pharmacy Association of Nova Scotia. “It’s all a private-pay service and some of our 31 minor ailments are more popular than others, in terms of patients willing to pay.” Nova Scotia pharmacists have managed to negotiate funding for prescription for herpes, Lyme disease and contraception management. “There has never been a real interest on behalf of government to fund most minor ailments, so we really look at them on an individual basis and whether they impact other primary care providers’ ability to see patients or volume in an emergency department,” said Bodnar. In British Columbia, where minor ailments prescribing by pharmacists is expected to be in place by spring 2023, a funding mechanism is among the list of matters the province expects to finalize over the coming months. Editor's note: The headline for this story has been edited from the original, which inferred that there was no funding in the works for minor ailment assessments in Ontario. Read: 'It's exciting': B.C. pharmacists' new prescription and injection powers begin

What's Ontario's funding model for minor ailment assessment?

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