Lupin 2023

More expansive role for pharmacy eyed in Canada

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TORONTO — “In transition,” “crisis,” “opportunity,” “danger,” “a new paradigm”: Those were the words and phrases that were liberally sprinkled through the remarks of 10 speakers who, in an intense six-hour session, addressed the delegates to the 2009 Innovation In Pharmacy conference here earlier this month.

Organized by the Canadian Association of Chain Drug Stores (CACDS) and the Canadian Foundation for Pharmacy, the event attracted delegates from both the retail and supply sides of the pharmacy sector.

Summing up at the end of the day, Mark Sarner, president of Manifest Communications, a consulting firm, said it was clear that the thought leaders at the conference saw retail pharmacy in Canada as well on its way to being a deliverer of health care rather than filling its historic role of simply being a drug provider.

Pharmacy was now focusing on ends rather than means. Pharmacists were concentrating on outcomes more than output. Patient health was displacing drugs as the center of the pharmacist’s priorities. The pharmacy was evolving from being a distribution point for drugs to being a knowledge center — part of the front line of patient care delivery.

The challenge — as Sarner saw it, reflecting the views of many of the speakers — was to convince governments and other third-party payers that pharmacists should be appropriately recompensed for their new, enlarged role. That challenge is especially daunting at a time when all governments are struggling to balance budgets and are primarily interested in driving health costs down.

The pharmacy sector is fully conscious that the current period is critical for the future of the profession and the industry, noted Janet Cooper, senior director of professional affairs at the Canadian Pharmacists Association (CPhA), as she reported on the progress to date on the Blueprint for Pharmacy.

Representatives from all the participants in the pharmacy sector have been collaborating since 2005 on the blueprint, which she described as “a long-term, collaborative initiative for managing the changes required to strategically align pharmacy practice with the health care needs of Canadians.”

Status quo for the profession is not an option, Cooper told her audience. The gap between what pharmacists could bring to the Canadian health care system and the role to which they have historically been limited is too large to ignore.

In June 2008 the five working groups that were formed to develop the initiative produced “The Vision for Pharmacy,” a document that describes a landscape where pharmacists and pharmacy technicians practice to the full extent of their skills and knowledge and identifies areas where change is needed.

Remarkably, 78 organizations — including all of the national and provincial professional pharmacy groups, 11 of the 13 provincial and territorial regulatory authorities, all of the 10 faculties of pharmacy, and 18 chain pharmacy companies — committed themselves to helping implement the vision.

Putting the plan in place involves 53 strategic actions that should produce 130 deliverables. Key actions include:

• Promoting and increasing interprofessional and intraprofessional approaches to education and training, to ensure optimal patient-centered care in an integrated health care environment.

• Implementing accessible programs to upgrade knowledge, skills and values, to support current practice and services as well as the emergence of new professional pharmacy services, specialty practices or new practice models.

• Developing bridge programs to assist nonregulated pharmacy personnel, to achieve the competencies required for pharmacy technician status.

• Identifying, defining, piloting and evaluating emerging and innovative professional pharmacy services, to determine their feasibility, impact on the quality of care and cost-effectiveness.

• Developing a framework for professional pharmacy services, to provide a method and a rationale for establishing fees for different categories of services and at varying levels of service.

CPhA is acting as the secretariat for the initiative, which (although it has received a substantial grant from the federal government’s Health Canada department) is slated to be funded from contributions from the pharmacy community.

Mark Dickson, national pharmacy director at Pharmasave Drugs and in this context speaking for CACDS, indicated that the association, like its individual members, was supportive of, and intimately involved in, the project.

He noted that CACDS is participating in all of the discussions and is playing a lead role in the financial analysis of proposed outcomes.

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