Ontario regulator condemns exclusive deals between pharmacies, insurance companies

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Ontario College of Pharmacists says preferred pharmacy networks pose potential ‘risk of harm to patients’

A person walks past a Shoppers Drug Mart pharmacy in Bowmanville, Ont. Earlier this year, Manulife Financial reversed its decision to give Loblaw, owner of Shoppers Drug Mart, the exclusive right to fill prescriptions on certain specialty medications.

In an open or voluntary PPN, plan members can choose from an approved list of pharmacies for specialty drugs, or they may fill prescriptions at an out-of-network pharmacy that may be more expensive. In a closed or mandatory PPN, insurers restrict plan members to using only their approved pharmacies, forcing them to pay out of pocket if they go elsewhere.That deal caused regulators to take a closer look at PPN arrangements in Canada.

“It could have gone further,” Michael Nashat, a director of OnPharm-United, which is a network of more than 600 independent pharmacies, said in an interview. One example that falls under a closed network is the Ontario Teachers Insurance Plan. Last year, OTIP, with help from health care company Cubic Health, launched its own in-house pharmacy, MemberRx, to be the exclusive supplier of specialty-care drugs to its members.

“These small shifts are never obvious in their initial stages. They are not meant to be sold under the guise for convenience or saving money. But they are meant to infringe on a person’s right to choose what they believe is best for them.” The survey found that 85 per cent of the respondents are currently experiencing or have previously experienced workplace pressures, including to meet quotas to increase revenues, while 70 per cent were currently experiencing pressures. A few chains – Rexall, Walmart, and Loblaw-owned pharmacies including Shoppers Drug Mart – had more than 80 per cent of respondents report workplace pressures.

 

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