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Study: Empower Ontario pharmacists to do more

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Ontario's health system could save at least $143 million over the next five years by making better use of pharmacist capabilities in five key practice areas, an Accenture study commissioned by the Ontario Pharmacists' Association found.

OPA said the savings could come from fully implementing and funding pharmacists' authority in counseling and prescribing for smoking cessation, administering flu shots, adapting patient drug therapy, renewing scripts and prescribing for minor ailments.

TORONTO — Ontario’s health system could save at least $143 million (Canadian) over the next five years by making better use of pharmacist capabilities in five key practice areas, a study commissioned by the Ontario Pharmacists’ Association (OPA) found.

OPA said Wednesday that the economic analysis, conducted by global management consultancy Accenture, showed that Ontario could realize the savings by fully implementing and funding pharmacists’ authority in counseling and prescribing for smoking cessation, administering flu vaccinations, adapting patient drug therapy, renewing prescriptions for stable chronic conditions, and prescribing for minor ailments.

In October, the Ontario government approved regulations allowing pharmacists to provide a wider range of pharmacy and health services, including some of the practice areas identified in the Accenture study. Later that month, pharmacists in the province started administering flu shots.

For the OPA study, Accenture reviewed pharmacy professional services currently offered and those under consideration in Ontario.

The analysis revealed that between 2013 and 2017, expanding the current Pharmaceutical Opinion Program to include prescriptions adapted independently by pharmacists could produce savings of over $75.4 million, mainly as a result of avoided adverse drug events, according to OPA. In addition, it was estimated that services for prescribing smoking cessation drugs and advising patients on strategies to quit smoking could yield savings of up to $49.1 million.

Other key findings of the study included the following:

• Pharmacist renewal of prescriptions for patients with stable chronic conditions could save the government more than $5.6 million.

• The introduction of a pharmacy-based program that addresses nine common minor ailments could save the province more than $12.3 million.

• Further integration of pharmacists into the annual flu vaccination program could save the Ontario’s government about $500,000 plus boost overall immunization rates in the province. 

Expanding pharmacy-based services could also help ensure the sustainability of Ontario’s publicly funded health system, the study showed.

"Ontario’s health care system is facing some unprecedented challenges, not the least of which is the rapidly escalating cost of providing primary care to patients," OPA chief executive officer Dennis Darby said in a statement. "Our research shows that utilizing pharmacists to the full extent of their scope will not only reduce health care costs in the short term, but will also increase system capacity and access to primary health care services."

Drug store operators in Ontario have sharpened their focus on broadening the range of pharmacist-provided services amid increased pressure on prescription reimbursement.

In recent years, Ontario and other provincial governments have slashed payments for generic prescriptions as well as professional allowances. And as of April 1, provinces and territories in Canada are slated to set price points for six popular generic drugs at 18% of the branded equivalent, compared with 25% to 40% currently.

Accenture’s analysis, however, illustrates that a bigger realm of practice for pharmacists would benefit patients by improving quality of care and shifting to lower-cost providers for certain practice areas.

"The findings show that by expanding pharmacists’ scope of services in the five authority areas examined, it is anticipated that further benefits may be realized for all stakeholders," stated Sanjay Cherian, Accenture’s health industry lead in Canada.

For example, OPA noted that the study shows that expansion of the Pharmaceutical Opinion Program alone could have an immediate impact on the number of patients using health care services following an adverse drug event.

Pharmaceutical opinions are offered to identify and resolve drug-related problems such as duplication in medication therapy, an incorrect dosage, potential drug interactions or the need for additional drug therapies. In the first year of the program (2011-12), pharmacists provided nearly 250,000 pharmaceutical opinions, about 75% of which led to a change of dose, regimen or method of delivery or in a refusal-to-fill.

Other expanded services support increased system capacity by diverting noncritical patients away from doctors’ offices and hospital emergency rooms and by shortening wait times for more critical patients, according to the study.

OPA pointed out that patients already have embraced a larger role for pharmacists, as shown by the fact that more than 240,000 Ontarians got a flu shot from a pharmacist during the 2012-13 flu season, the first year the service was available in a pharmacy.

"Ontario’s pharmacists already play a vital role on the health care team, and we are willing and eager to further support the provincial government in its goal of providing the right care to the right patient at the right place and at the right time," commented OPA chairman Billy Cheung. "This report clearly demonstrates that expanded pharmacy professional services stand to have a significant impact on the health care system, and we look forward to collaborating with government and other health care providers to ensure Ontarians have access to the best possible care."


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