You have the right to choose your pharmacist!

Since the 2000s, increasing numbers of patients have been prescribed so-called specialty drugs. But what are they, exactly? Specialty drugs may be prescribed for complex and chronic diseases and illnesses, including some rare conditions. Most of these treatments are very expensive, and some can require specific types of care or management, including ensuring that the drugs are properly administered (e.g., if they must be injected).

For many of these prescription medications, manufacturers have established patient support programs (PSPs) to make it easier for patients to obtain refunds or financial assistance when they need it, or to provide therapeutic follow-up services.

It is important to know, however, that some prohibited practices, which violate patients’ rights and are contrary to their interests, have emerged in recent years.

What happens is this: a patient, when they are prescribed their medication, is often in a highly vulnerable state, and is referred to a so-called speciality pharmacy by the PSP, which has preferential relationships with a select number of pharmacies and other third parties, despite the fact that this is prohibited under current laws and regulations. No manufacturer, wholesaler, infusion clinic, health professional, insurer or employer can compel a patient to choose a particular pharmacist or pressure them in any way.[1]

Every patient has the right to choose their pharmacist and must be able to make an informed decision.

All Québec pharmacists have the necessary knowledge and are entitled, by their right of practice, to assess the full range of a patient’s drug therapy and ensure that it is properly monitored and managed.

Therapies are constantly evolving, and always have been, and pharmacists take continuous training to respond and adapt to these changes (indeed, this falls under their professional responsibility).

In other words, no one involved in a patient’s care can claim that their usual pharmacist is not capable of providing the same level of care as a pharmacy designated by a PSP.

Preventing fragmentation of care 

If you are receiving a specialty drug from another pharmacy, tell your pharmacist about it. This is especially important to make sure that your file is analyzed safely and comprehensively, which includes checking for drug interactions, as well as to ensure appropriate and personalized support and guidance throughout your treatment.

The advantage of community pharmacists is that they know their patients and their complete health status.

It is in every patient’s interest for their drug therapy to be fully managed by their usual pharmacy, if that is their choice.

“With my regular pharmacist I get much more personalized service, because they are familiar with my overall health situation and my entire history. My pharmacist is the one I can consult if I need antibiotics because of my immunosuppressed condition, or when my blood pressure is too high. People like me who have to live with a chronic disease and are in a highly vulnerable state can maintain control over their therapy and their lives, regardless of what some groups or individuals may say. And that starts with making our own choice of the pharmacy where we want to get your medication.” – Isabelle, who is living with two autoimmune disorders, including Crohn’s disease

« “The fragmentation of patient care is totally illogical. Québec’s 7,000 pharmacists and their teams also have the capability and the skills to properly serve their patients. They have a strong presence in all regions and are easily accessible, right in people’s neighbourhoods. We help patients every single day, and we are the ones who are there to meet their every need, large or small.”
Judith Choquette, owner-pharmacist, Longueuil

If you would like more information about patient support programs or financial assistance, an explanatory brochure is available here.

Did you know that a small group of individuals, alongside certain pharmaceutical industry players (certain manufacturers and their patient support programs), are engaged in non-compliant strategies that are contrary to the Act Respecting Prescription Drug Insurance and the Code of Ethics of Pharmacists and that allow them to control the majority of the specialty drug market?

That’s right: there are six so-called specialty pharmacies currently sharing 40%* of the specialty drug market in Québec. This situation is jeopardizing the survival of Québec’s pharmacy network, making the patient care pathway more complex and funnelling the resulting profits to a handful of pharmacists. And yet those profits could be of benefit to the overall community pharmacy network, helping to maintain or improve frontline services provided to patients.

With the Government of Québec preparing to further expand pharmacists’ scope of practice in frontline care through Bill 67, it is important to safeguard the vitality of the local pharmacy network as we know it today, as it has a presence in all of the province’s regions and communities.

*Patients covered by the RAMQ for the year 2023–2024

Class action 

In response to the unlawful and wrongful commercial practices being perpetrated by certain groups and individuals, the Association québécoise des pharmaciens propriétaires (AQPP) has filed an application for authorization to institute a class action against 10 of its pharmacist members and the pharmacist owners of six pharmacies, three patient support program (PSP) managers and three private infusion networks. To learn more, go here.

Anyone wishing to report a situation where laws and regulations are not being upheld and they are pressured into obtaining a service from a pharmacy they have not chosen may reach out to their pharmacist or the RAMQ using the following contact information:

WEBSITE

Report wrongdoing (a person or situation) | Régie de l’assurance maladie du Québec (RAMQ) (gouv.qc.ca)

Visit the “Reporting Wrongdoing” section of the RAMQ website, accessible at the bottom of any page of the site, under “Your rights.”

TELEPHONE

1 877 858-2242

Régie de l’assurance maladie du Québec – Dénonciation

C.P. 6600, succ. Terminus

Québec (Québec) G1K 7T3


[1]. Such actions are contrary to the Code of Ethics of Pharmacists (Chapter P-10, R. 7) and the Code of Ethics of Physicians (Chapter M-9, R. 17, Sec. 27), and also violate the Health Insurance Act (Chapter A-29, Sec. 2).