Alberta pharmacies expand services framework

Alberta’s pharmacies are now able to provide seven health services, with compensation.

Alberta’s pharmacies are now able to provide seven health services, with compensation.

“It’s nice to see that the Alberta government recognizes services that were already being done for Albertans,” said Jamil Rawji, owner of Ponoka Professional Pharmacy. He considers Alberta to be the last province to be reimbursed for expanded services although they were one of the first to introduce the services.

Some of the seven services are new to the authority of pharmacies, some were already provided, just without compensation. In the past pharmacists could renew a prescription short-term, but they weren’t being compensated for the product or service.

A press release names comprehensive annual care plan, standard medication management assessment, assessment and adaptation of a prescription, patient assessment for prescription renewal, assessment and administration of medications by injection, patient assessment for initiating medication therapy, and patient assessment in a medication-related emergent as the seven new services.

According to the Alberta College of Pharmacists a comprehensive annual care plan, standard medication management assessment, administration of drugs by injection, adaptation of a prescription, and patient assessment for prescribing in an emergency, for initiating medication therapy, and for prescription renewal have been services of pharmacists since 2007.

“What the press release doesn’t state is that a pharmacist can renew it (a prescription) on a short-term basis. It’s not indefinite,” said Rawji. This service expansion does not replace the need for a doctor, it allows patients extra time to get in and see their doctor.”

“Once a pharmacist puts their name on it they must get in to see a doctor after that,” said Rawji.

As of July 1, pharmacists can now administer medication through injections and initiate medication therapy, two services they couldn’t provide before. Initiation of medication therapy means that for a medical condition or situation a pharmacist can start a prescription and the patient must follow up with a doctor. However, for initiation, a pharmacist must have additional prescribing authority.

“I believe the number will go up,” said Russell Cohen, executive vice-president of industry and government affairs, referring to the number of pharmacists who have additional prescribing authority.

The news release says Alberta will save $85 million by reducing what it pays for generic drugs from 45 per cent to 35 per cent. According to Cohen a large portion of that savings will be reinvested into the services.

However, the $85 million will come out of community pharmacies. “This is a concern that remote pharmacies could be at impact for potential closure,” said Neil Cameron, president of the Alberta Pharmacists Association.

Because of this concern, $15.9 million was put into a fund for remote pharmacies. This remote pharmacy plan will take place over three years. According to Cameron the details and agreement are not final.

Another $20 million, outside the saved $85 million, will be used for renewals. A concern of Rawji’s is that pharmacists will need extra time to provide the services. Although they were already providing some, now that they’re being reimbursed they will have to “document more diligently and a little more carefully, as required.”

“The whole idea behind offering additional services is to save some health care dollars and free up physician and nursing time,” said Rawji. Corporate pharmacies have been preparing for this since the announcement of the expansion was made by Alberta Health Minister Fred Horne.

Cohen is passionate about the positive benefits the services will have on patients. Physicians and pharmacists will be able to work together to build patient profiles as well as collaborate on patient compliance.

It’s been found through reviews that due to factors such as language barriers and miscommunication, some patients are not taking medication properly.

With the expanded services pharmacists will be able to make sure medication is taken according to the prescription. The reviews are finding patients are being plagued by reoccurring symptoms because of miscommunication.

“Within the pharmacy world there is concern and apprehension because there is a change in funding,” said Cameron. But he says there’s also a sigh of relief.

Alberta has been working on the service expansions for about five years. The provinces plan so comprehensive because it’s seen the pitfalls of other provinces says Cameron.