Pharmacies lobby for mandatory $75 prescription consult to help curb opioid crisis

A group that represents the largest pharmacy chains in Canada is pushing Ontario to create a compulsory consultation for patients prescribed opioids for pain management.

Cost of consultations could be prohibitive for province, says health minister

The Neighbourhood Pharmacy Assocation of Canada represents some 6,500 individual stores belonging to the biggest pharmaceutical chains in the country. The group wants pharmacists to have more control over prescriptions. (Graeme Roy/Canadian Press)

A group that represents the largest pharmacy chains in Canada is pushing Ontario to implement a compulsory consultation program for patients prescribed opioids for pain management — a consultation that would initially cost the province $75 per patient. 

"It's about preventing new patients from becoming dependant to opioids by identifying the risks before they start taking them," said Justin Bates, chief executive of the Neighbourhood Pharmacy Association of Canada (NPAC).

NPAC lobbies on behalf of more than 6,500 individual stores, and counts Shoppers Drug Mart, Walmart and Pharmapix among its members.

The organization claims it can help contain the province's opioid abuse crisis if the ministry of health updates a program called MedsCheck, which helps some patients manage medication schedules and doses. Currently, only patients who live with diabetes; are on more than three medications or live in a long-term care facility qualify. 

Bates added that the group will also be pushing the federal government to allow pharmacists to renew, modify or reduce prescription doses at their own discretion without consulting the customer's physician.

Currently, each initial in-store consultation costs $60. The lobby group is asking Ontario to include opioid medications under an expanded MedsCheck program, meaning every person prescribed an opioid would be required to do an in-store consultation. Each follow-up consultation would cost the province $25. 

The program would apply retroactively, so even patients who are already on an opioid would need to do a consultation. Methadone therapies would not be covered under the proposed regime. 

'Taking this seriously'

Ontario Minister of Health Eric Hoskins told Radio-Canada that he will consider any proposals that may help limit the number of patients on prescription opioids. The most recent data collected by Health Quality Ontario shows more than two million people in the province were prescribed an opioid medication in 2016. 

"I am looking at anything that will help reduce the impact of the opioid crisis in this province, and that's why we are taking this seriously," said Hoskins. He admitted, however, the cost of implementing such a program would likely be prohibitive. 

The association has already made a presentation at Queen's Park, but Bates said he hopes a similar approach could be used country-wide.

Late last month, more than 700 Ontario health-care workers wrote an open letter about the "disturbing" increase in opioid-related overdose deaths in recent months. The next day the provincial government vowed to invest $222 million over three years to improve access to harm-reduction services and addiction treatment.

An April report by researchers at the Ontario Institute for Clinical Evaluative Sciences, St. Michael's Hospital and the Ontario Drug Policy Research Network found that about two Ontarians died of opioid-related causes each day in mid-2016, while an estimated 2,458 Canadians died of opioid-related causes that same year.

More precise data for Ontario will be published in the coming weeks, the ministry of health promised.

With files from Katherine Brulotte