Specialty pharmaceuticals: Quebec RPMSQ members join the NPAC

The announcement from members of the decried Regroupement des pharmacies de médicaments de spécialité du Québec (RPMSQ) that they were joining the Canadian Neighbourhood Pharmacy Association (NPAC), has resulted in swift criticism and concern.The announcement was made in a press release issued on December 3.This national collaboration should take effect at the beginning of 2025, while the RPMSQ remains extremely isolated on the provincial scene. Six of its members are the subject of a class action launched in June by the Association québécoise des pharmaciens propriétaires (AQPP) for anti-competitive practices and agreements with patient support programs.In an open letter published on the Profession Santé website (affiliated with Pharmacy Practice+ Business and Canadianhealthcarenetwork.ca), the Ordre des pharmaciens (OPQ) questioned, “the model whereby care is divided according to medication, and in which the patient seems to be integrated into a system.”Pharmacy practice has evolved over the years and will continue to evolve, she told Profession Santé. “Online pharmacies, supermarkets, local pharmacies, dedicated practice pharmacies . . . . All these services are complementary and must benefit patients. Hence this idea of working together, collegially, to improve the offering.”It’s a collaborative vision also supported by the NPAC. “RPMSQ members have joined our association as members. This is not a one-off collaboration with the RPMSQ or its members,” said executive director Sandra Hanna, contacted by Profession Santé, adding that she wants to, “represent the interests of the entire pharmacy sector in providing care to their communities.”The AQPP strongly disagrees. “The Canadian Neighbourhood Pharmacy Association’s decision to include among its members a group comprising pharmacies that act to the detriment of the entire Quebec community pharmacy network demonstrates once again that this association is totally out of touch with the reality of pharmacy in Quebec, both in terms of its laws and regulations and its issues,” the association wrote to Profession Santé, once again denouncing, “illegal practices” leading to “an outrageous concentration of specialty drugs in Quebec” and undermining “patients’ right to choose their pharmacist.”Read: Specialty pharmacy a rapidly-emerging area of practiceOn these accusations, the NPAC sidestepped the issue. “We are aware of this but will not comment on it. We respect and rely on the role of the regulator to protect the public. Our role as an association is to represent the business interests of pharmacies of all models,” said Hanna. “The criteria for membership are clearly defined—in our policy manual and on our website—and it's an objective process, provided the applicant meets the criteria.”These include compliance with federal, provincial and local laws, and a requirement for “transparency” and “trust with customers and other stakeholders in order to maintain a positive and sustainable reputation in the pharmacy sector.”“Result of a need”Are specialty drugstores just another neighbourhood pharmacy after all? For the AQPP, this is out of the question. “The business model we advocate in community pharmacy is the opposite of the one proposed in these so-called specialty pharmacies: It's complete patient care,” AQPP president Benoit Morin emphasized to Profession Santé a few months ago.“Our pharmacists didn't wake up one day and decide to develop this offer,” retorted Viel, insisting that specialty pharmacies are the result of a need on the part of a public requiring more complex care. “If patients prefer to continue going to their community pharmacy, that's fine. But for now, we're not seeing a drop in demand, quite the opposite.” The RPMSQ says it represents 60,000 patients today.This is borne out by the figures, according to data shared by NPAC, which released a report last year, Value of Specialty Pharmacy Services to the Healthcare System. “Specialty drugs are driving growth in pharmaceuticals, with year-on-year growth of over 12%,” said Hanna. "Our work in this area is focused on ensuring the viability of all pharmacies by continuing to provide care for patients who require specialty medications, based on an inclusive, patient-centric model.”If this early relationship brings extra-provincial support to the RPMSQ, Viel is open to dialogue. “Everyone has a role to play, depending on each patient's needs,” she said. “We're ready to work with everyone. We have this spirit of openness, and we like other stakeholders to have it too.”On July 24, its president Jean-François Desgagné, wrote: “From the perspective of taking care of the patient as a whole, it is preferable for them to obtain pharmaceutical care and services from a single location. Several members of the group have been sanctioned by the order for ethical breaches.”The complementary pharmacy ecosystemRPMSQ members seem to have found allies in the NPAC. On its website, NPAC—a not-for-profit trade association representing over 12,000 pharmacies across the country—defines itself as “the voice of pharmacy in Canada.”The RPMSQ press release further states: “Neighbourhood pharmacies represent Canada's leading pharmacy organizations, including chains, banners, long-term care and specialty pharmacies, grocery chains and mass merchandisers with pharmacies.” Its members include numerous chains and banners: Brunet, Jean Coutu, Costco Pharmacy, McKesson Canada, Uniprix, Rexall, as well as patient service providers and specialty drug distributors such as Sentrex, Bayshore Specialty Rx, BioScript Solutions and Cencora Innomar Strategies. It was at the Specialty Pharmacy Summit, held in Toronto on November 28 and 29, and attended by members of the RPMSQ, that this collaboration took shape. RPMSQ executive director, Brigitte Viel welcomes NPAC's “very inclusive” vision of pharmacy practice and said she sees the association's members as part of the “pharmacy ecosystem.”This article was originally published on our sister website, ProfessionSanté.ca.

Specialty pharmaceuticals: Quebec RPMSQ members join the NPAC

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