Today, community pharmacies in Canada are so much more than dispensaries. They are healthcare hubs offering both traditional dispensing services and Medication Management services which help improve patient outcomes and relieve downstream pressures on the healthcare system.
To help realize the optimization of community pharmacy, CACDS, the Canadian Pharmacists Association (CPhA) and provincial pharmacy associations jointly developed the Canadian Pharmacy Services Framework (Framework).
The Framework’s purpose is to help transition the pharmacy business model from a transactional approach based on dispensing to a patient-focused approach centred on pharmacy services.
The Framework is an implementation project of the Blueprint for Pharmacy.
To learn more about the Canadian Pharmacy Services Framework and its signficance to the future of community pharmacy in Canada, click through the tabs below.
Community Pharmacy in Canada can do more.
As highly trained healthcare professionals and recognized experts in the delivery of Medication Management services, pharmacists can help realize this change. In order to do so however, governments and regulators must continue on their path towards the optimal utilization of the unique expertise and knowledge of pharmacists.
Doing so will result in:
- Better health outcomes
- Improved access and equity in healthcare
- Enhanced cost controls
- Better decision making
To help realize the optimization of community pharmacy, CACDS, the Canadian Pharmacists Association (CPhA) and provincial pharmacy associations jointly developed the Canadian Pharmacy Services Framework which describes a new pan-Canadian service model by:
- Clearly defining services
- Communicating the value of services in a way that is easily understood by public and private payors
- Addressing operating procedures and workflows
- Managing transition issues
- Establishing training standards
Pressure on both public and private healthcare payors to maximize return on investment and shift to reimbursement models based on demonstrable outcomes and quantifiable data is necessitating this change.
It is imperative that governments and regulators in every jurisdiction act now to improve patient outcomes by maximizing the role played by pharmacy in the healthcare system.
What is 'The Framework'?
- The Framework creates a common approach to describing and understanding professional pharmacy services
- The Framework recognizes the value of professional pharmacy services while ensuring a financially viable and sustainable pharmacy business model
- The Framework outlines a roadmap to deliver increased patient-centred care – pharmacy services that are cost-effective, and based on the needs of Canadians and value to the healthcare system
- The Framework supports the development of financially-viable services that are scalable across jurisdictions
Guiding Principles of The Framework
- Pharmacy services are patient-centred, cost-effective, and are based on the needs of patients and value to the healthcare system
- Therapeutic outcomes are optimized through enhanced interprofessional collaboration and communication
- The Framework aligns with existing pharmacists’ standards of practice and with emerging scope of practice activities
- Provinces can adapt and implement the Framework in alignment with jurisdictional scopes of practice, healthcare priorities and available resources
- Pharmacists will practice in accordance with jurisdictional legislation and policy, and recognized standards and scope of practice
- The Framework creates a common, unified and strong voice for pharmacy across Canada
|Adapting a Prescription||Changing the dosage, formulation, duration or regimen with a patient’s consent and an appropriate follow-up to the prescriber|
|Therapeutic Substitution||Substituting another drug within a defined therapeutic class that is expected to have an equivalent effect with the goal of meeting the patient’s therapeutic goal|
|Prescribing in an Emergency||In the absence of an existing prescription and when there is an immediate need for drug therapy (in an emergency), a community pharmacist can prescribe and dispense a Schedule 1 drug|
|Refusal to Fill||Refusing to fill a prescription when it is not in the best interest of the patient – examples could include but are not limited to identifying drug interactions, a prior adverse reaction to a medication or a dangerously high dose, etc.|
|Administration of a Medication by Injection and Immunization||Consistent with jurisdictional and regulatory restrictions, a qualified pharmacist may administer medications or immunizations with or without a prescription but in the latter case, with an appropriate update to the physician|
|Comprehensive Medication Management||
A patient centred systematic approach of assessment, problem identification and resolution, care plan development and implementation, monitoring and follow-up
|Interpreting and Ordering Laboratory Tests||As part of the comprehensive medication management process, pharmacist collects and interprets laboratory tests, and takes appropriate actions based on the results|
|Minor Ailments Assessment and Management||Pharmacists can assess symptoms and prescribe for the treatment of certain minor, and self-diagnosed ailments, as determined by applicable legislation/regulations|
|Medication Reconciliation||A systematic and comprehensive review of all medications a patient is taking to ensure all medications added, changed or discontinued are carefully evaluated and are appropriate|
|Chronic Disease Management||Preventing undue delays in filling a prescription that a patient has been taking regularly when a prescriber cannot be reached|
Pharmacy Services offer many benefits to patients, payors and the healthcare system.
These benefits include:
Safer and more effective utilization of medications
Decreased instances of adverse drug reactions
- Decreased instances of adverse drug reactions
Reduced downstream costs and pressures on the healthcare system
- Physicians and other health-care providers can focus on patients who are more seriously ill or require their specific expertise
- A decrease in absenteeism from work, resulting in increased productivity
For a comprehensive overview of the benefits of pharmacy services, click here.
When determining fair compensation for pharmacy services, public and private payors should consider the following:
- Pharmacy services add unique value to patient care and improving outcomes
- The pharmacist’s time to provide service and follow-up
- Accountability of the pharmacist in providing patient care
- What other costs each service saves the healthcare system
- The evolving funding models of other healthcare professionals
The Evolving Pharmacy Economic Model
Enhanced Medication Related Services:
- Adapting a prescription
- Therapeutic substitution
- Renewing prescription for continuity of care for chronic medications
- Providing a pharmaceutical opinion (i.e. refusal to fill)
- Emergency prescribing
- Adherence monitoring and compliance programs
- Medication reconciliation
- Administering a medication by injection
Expanded Patient Care Services:
- Comprehensive medication management
- Management of minor ailments
- Health promotion and disease prevention