Three moves the OCP is making around preferred provider networks

The Ontario College of Pharmacists (OCP) has announced it will make three moves around preferred provider networks (PPNs), also known as preferred pharmacy networks. It committed to the three steps at a board meeting late last month. The most immediate one was for it to create a formal position statement about PPNs. The statement will cover the impacts of PPNs on ethical and equity issues, including continuity of care, quality of care, and patient safety. The OCP expects to approve it in June. The college also promised two steps that would lead to regulatory changes. First, it said it would link PPNs to other strategic goals around “addressing business practices that impede the delivery of quality and effective pharmacy care.” It also said it would propose regulatory changes to Professional Misconduct and Conflict of Interest regulations. To start those changes, it would ask the Ministry of Health for advice about proposing relevant regulatory amendments. Read: Alarming growth in ‘patient steering’: CPhA calls on Canada to regulate PPN arrangementsThose would have to go through the regular process of the college drafting the amendments, consultation with the public, and then approval from the college and the provincial government. In a briefing note created for the meeting, Katya Masnyk, director of policy engagement and strategy implementation for the college, wrote that offering direction and guidance on PPNs is aligned with the college’s goal to ensure that, “Regardless of pharmacy setting, management and business exigencies do not compromise the health and well-being of pharmacy professionals or impede their ability to adhere to the Standards of Practice and Code of Ethics.” It also said that closed PPNs—where insurance companies set terms privately with a small group of pharmacies—limit patient choice much more than open ones, where more pharmacies can join the PPN and the conditions are more transparent. For that reason, it said, closed PPNs are more likely to result in patient harm, it said. Read: ‘An exceptionally important conversation’: Debating preferred pharmacy networks in wake of Manulife backlash The OCP discussed this issue five years ago at a board meeting and concluded that PPNs could reduce freedom of choice, continuity of care and access to care. The newer note added a more recent analysis that found two additional risks. The first was that PPNs could affect patient autonomy and equity by removing the right to choose their pharmacist (unless people can pay the uninsured cost of their medications). The second was that PPNs affect patients' ability to receive comprehensive care from pharmacists, which is especially important as pharmacists now provide more primary care services. A 2024 scan also found three provinces have judicial or regulatory oversight on PPNs. Quebec has a law that states, “No group insurance contract or employee benefit plan may restrict a beneficiary’s freedom to choose a pharmacist.”On the pharmacist side, Nova Scotia’s code of ethics includes that “registrants only enter into or engage in any arrangements, agreements or businesses that protect a patient’s right to safe, accessible and professional health care services.” Ontario’s Pharmacy Act also says that “entering into any agreement that restricts a person’s choice of a pharmacist without the consent of the person” is an act of professional misconduct. The briefing note said that one could argue that patients in Ontario are providing consent by joining the insurance company’s PPN legally. However, it said, “From an ethical and equity perspective, this is not true consent. Patients with financial limitations have no real option of opting out of the PPN.” Read: Why are Manulife patients still being sent to Bayshore HealthCare and Loblaw-owned pharmacies?

Three moves the OCP is making around preferred provider networks

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