Your questions answered about Ontario’s July 1 pharmacy scope expansion

Starting July 1, Ontario pharmacists will gain a major expansion of scope, with new prescribing authority, additional vaccines and updated reimbursement fees all arriving at once. But amongst all the announcements, we’ve heard that some pharmacies are still trying to understand what the rollout will actually look like operationally.Here’s a practical breakdown of what pharmacists need to know, with some help from Justin Bates, CEO of the Ontario Pharmacists Association. What will pharmacists actually be able to prescribe starting July 1?Beginning this summer, pharmacists in Ontario will be able to assess and prescribe for an additional nine minor ailments:calluses and corns;dandruff;dry eye;head lice;jock itch;mild headaches;nasal congestion;ringworm;warts.Ontario is also expanding pharmacies’ role in immunization by adding six publicly funded vaccines to the list of what can be administered in a pharmacy rather than only a doctor's office:tetanus;pertussis;diphtheria;pneumococcal disease;RSV;shingles.Wait—wasn’t the province originally talking about 14 new ailments? Not all of the originally proposed conditions are arriving in July.The province has said it is still considering another group of conditions that could potentially be added to pharmacists' scope of practice in early 2027, including swimmer’s ear, nail fungus, a shingles antiviral (as distinct from the vaccine) and certain minor sleep disorders. Why were those ailments delayed? Some of the expansions were delayed while the Ontario College of Pharmacists reviewed additional safeguards and continuing education requirements. Strep throat assessment may also eventually be added, but that expansion depends partly on regulation changes that would allow pharmacists to order and interpret certain lab tests.Speaking to the Canadian Healthcare Network, Bates said the government appeared “motivated” to have those final expansions added by October, in time for the fall respiratory illness season. How much will pharmacies actually be paid for these new vaccines?Bates said all of the newly added vaccines will carry a $10.50 administration fee.He also said the province will be increasing the existing flu shot administration fee from $8.50 to $10.50, making vaccine billing more consistent within pharmacies.How does that compare to COVID vaccine fees?Bates said COVID-19 vaccinations will continue to be funded separately at $13 per shot. When that fee was first established during the pandemic, it was meant to reflect the additional administrative work pharmacists faced entering information into Ontario’s COVaxON vaccine repository system.Though Bates said the OPA would have liked to see the new vaccine administration fee come in closer to the $13 pharmacies receive for COVID-19 shots, Bates said the increase still helps Ontario catch up with what pharmacies are being paid elsewhere in Canada.Speaking of reimbursement, does this scope expansion come with broader dispensing fee increases?It does not.Ontario’s dispensing fee has not increased in roughly 12 years. According to Bates, pharmacists in Ontario also continue to provide several services that remain largely unfunded, including prescription renewals and adaptations.“We need to make sure that these types of services are well funded so that the right resources can be hired,” Bates said.So when could pharmacists actually see a dispensing fee increase?Bates said discussions with the Ford government appear to be progressing, though he suggested any increase would likely be phased in gradually over several years rather than introduced all at once because of the cost to the government.

Your questions answered about Ontario’s July 1 pharmacy scope expansion

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