Why are Manulife patients still being sent to Bayshore HealthCare and Loblaw-owned pharmacies?

In early February, Manulife announced that it would reverse its decision to have members of its Specialty Drug Care program fill their prescriptions through Shoppers Drug Mart and other Loblaw-owned pharmacies. That change would have reduced its preferred provider network from including Bayshore HealthCare and Loblaw-owned pharmacies to just Loblaw-owned pharmacies. But after public backlash, the insurer decided against it. “With this decision, 100% of the Canadians we support will be able to receive their medications at a pharmacy of their choosing,” the company said in an online statement. It said it would implement the change “swiftly.” However, more than a month later, pharmacists report that they still hear of patients being sent to Bayshore and Loblaw-owned pharmacies, leaving some to wonder what’s happening with the change.Read: Manulife to cover specialty drugs at any pharmacy following backlashOn March 10, the Globe and Mail reported on the issue. Michael Nashat, a director of the OnPharm-United network of independent pharmacies, said his members have reported about 100 specialty drug claims that Manulife has denied, some of which are from patients trying to switch from Bayshore HealthCare and Shoppers Drug Mart. Nashat said he’s hearing of pharmacies having reimbursement requests denied every day and being told through pop-up alerts that patients should be sent to Shoppers Drug Mart and Bayshore HealthCare.Manulife has responded that it’s simply taking time to make the change. “The technological requirements to automate this process are expected to be fully operational by the end of April,” it said in an email to Pharmacy Practice + Business. Read: ‘An exceptionally important conversation’: Debating preferred pharmacy networks in wake of Manulife backlashUntil then, Group Benefits members must call 1-800-565-4710 to request to change their pharmacy if they use a pharmacy other than Bayshore or Shoppers Drug Mart. (Pharmacists cannot call on their behalf.) The Globe spoke to a patient who described a frustrating and complex process that included upwards of three and a half hours on the phone and a two-week delay in the change that required him to receive his first dose through Bayshore before being able to switch pharmacies. Naveed Irshad, CEO and president of Manulife Canada told the Globe that the company now has an open, or voluntary, preferred provider network instead of a closed one. According to the Ontario Pharmacy Association, in an open network, any pharmacy that agrees to specific terms—such as set dispensing fees or markups—is in the preferred group. In a closed network, such as the one that caused the backlash against Manulife, members can only fill their prescriptions at approved pharmacies, usually under a limited group of pharmacies.Irshad told the Globe that Manulife is still confirming which pharmacy providers will be in the open PPN for its Specialty Drug Care program. Read: Alarming growth in ‘patient steering’: CPhA calls on Canada to regulate PPN arrangementsEditor’s note: The first sentence in this article was updated to reflect the fact that the Manulife decision was reversed in February.

Why are Manulife patients still being sent to Bayshore HealthCare and Loblaw-owned pharmacies?

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