Quebec’s recent amendment to Bill 15 is short sighted

An amendment to Quebec’s Bill 15 adopted last week rightly has prompted a response from the Quebec Association of Pharmacy Owners (AQPP) and the entire profession.The amendment, tabled by the provincial political party Québec solidaire, opens the door for a cap on fees paid by private insurers. However, these fees are not affected by the usual negotiations between AQPP and the provincial health ministry. By bypassing established rules and procedures, the government is interfering in a contractual relationship, one that falls under the purview of free market forces and bargaining—not legislative intervention.The fees the Régie de l’assurance maladie du Québec (RAMQ) pays for dispensing prescriptions have not been adjusted for inflation in more than a decade, eroding their real value.Fees paid by private insurers, on the other hand, have followed a curve closer to that of the market. This disparity should not surprise the government, which has benefited for years from fees that are lower than the actual value of services rendered.It is not surprising that private insurers criticize pharmacists' fees since their clients complain about them, as their companies profit from the volume of reimbursed services.However, the insurers' business model creates a structural bias: their profits increase as services increase, which makes their position on fees ambivalent. It is the insured groups who see their premiums increase and who feel they are footing the bill, even as the insurers maintain their profit margins. Recent articles have denounced the high fees charged by some specialty pharmacies. These situations have shocked the public, and the unease is understandable. However, it is important to put these cases into context: the average fee paid by private insurers is close to $18-19 per prescription—not thousands of dollars, as has been alleged. The AQPP is addressing this, as at least one insurer has filed a complaint with the federal Competition Bureau. This is the appropriate avenue for addressing excesses. Developing a general rule based on exceptional cases is not a wise policy.The old system of bundling services into a single dispensing fee is outdated. We need a new pay structure that reflects clinical complexity, patient value and teamwork across healthcare professions.Prescriptions and treatment plans are becoming more complex, and the government expects more and more from pharmacists. These expectations must be matched by fair pay that reflects the value of their work.Ongoing negotiations between the Ministère de la Santé et des Services Sociaux (MSSS) and the AQPP are likely focusing on fees tied to the new services introduced under Bill 67. These services bring real value to the healthcare system, which strengthens the profession’s negotiating position. Because they are meant to improve access to primary care, they should be fairly compensated, without caps, and adapted to patients’ needs.Pharmacists should not be swayed by ministerial rhetoric about pharmacy availability being used to offset broader access issues in the system. At the same time, pharmacists must define—or should have already long ago defined—the range of services they are prepared to provide to meet the needs of the healthcare system, government and public. The profession itself needs to take the lead in defining those services.The idea of directing patients to the most appropriate professional needs to be backed by real mechanisms for interprofessional collaboration, not just rhetoric. The government must establish these pathways to properly integrate all front-line professionals it relies on.If private insurers find existing agreements unfavourable, they have their own negotiation processes.This government appears to believe that pressuring the professionals who run its network will solve its access problems. That assumption is misguided.What the profession and the healthcare system need is a clear, comprehensive vision for pharmacist compensation—not a reactive approach developed under pressure and disconnected from clinical and on-the-ground realities.Referencehttps://spgq.qc.ca/2026/03/honoraires-des-pharmaciens-un-pas-dans-la-bonne-direction/https://ici.radio-canada.ca/nouvelle/2242114/quebec-limite-honoraires-medicaments-assureurs-prive-pharmaciens https://www.lapresse.ca/actualites/sante/medicaments-de-specialite/un-quasi-monopole-sur-de-couteuses-molecules/2025-12-11/la-mainmise-de-quelques-pharmaciens-sur-des-medicaments-de-specialite.phpMarc Parent is a pharmacist working in a family medicine clinic, with previous experience at the Centre hospitalier universitaire de Québec.This article was initially published on our sister site ProfessionSanté.ca and has been translated from its original French.

Quebec’s recent amendment to Bill 15 is short sighted

Register for free access or login.

Related Topics