Changes Affecting Ontario

The Government of Ontario has made changes to the Ontario Drug Benefit (ODB) Program in an effort to reduce the risk of drug shortages in the province during the COVID-19 outbreak. Effective immediately, ODB eligible drugs are subject to the following changes to rules on dispensing and fees:

  • The dispensing of medication is limited to no more than a 30-days' supply. Dispensers may use professional judgment to provide a longer supply in exceptional cases, but should not exceed the patient's usual supply
  • Prescriptions should not be refilled more than 10 days in advance of a patient depleting their current supply. In exceptional cases where there is a clinical reason to refill a prescription early, the dispenser may provide a refill and document the reason.
  • Previously, dispensing fees would only be paid for 100-days' supply of medication or the total quantity of the prescription. Now, all medicines on the ODB Formulary and accessible through the Exceptional Access Program (EAP) are eligible for a dispensing fee based on a 30-days' supply even if dispensed quantity is less than prescribed or less than the 100-days supply payable under the ODB program.
  • The list of chronic medications subject to a limit of 5 dispensing fees per 365 days is temporarily removed.

Additionally, pharmacists may be reimbursed for MedsChecks performed virtually, or over the phone. Proper documentation is required and subject to audit and inspection.

Finally, the EAP is authorising the automatic extension of all EAP approvals that have expired or are expiring between February 1, 2020 to May 31, 2020 by an additional 90 days from the expiry date listed on the original approval letter.

Separately, Ontario has declared the drug supply chain to be an essential service during the outbreak, including "manufacturers, wholesalers, distributors and retailers of pharmaceutical products and medical supplies, including medications, medical isotopes, vaccines and antivirals; medical devices and medical supplies".

Changes Affecting Quebec

Quebec's Bill 31 An Act to amend mainly the Pharmacy Act to facilitate access to certain services received Royal Assent on March 17, 2020. The bill specifies that pharmacists may, in certain cases or in accordance with the conditions and procedure determined by regulation:

  1. prescribe and administer vaccines and, in emergency situations, certain other medications;
  2. prescribe all non-prescription medications;
  3. administer a medication by intranasal route;
  4. adjust or renew prescriptions of all prescribers, not only those of physicians;
  5. stop medication therapy according to a prescription or following a consultation conducted at the request of a prescriber;
  6. substitute, for a prescribed medication, another medication even if it does not belong to the same therapeutic subclass; and
  7. prescribe and interpret not only laboratory analyses but also any other test, for the purpose of monitoring medication therapy.

Similar to Ontario, Quebec has also listed the drug supply chain as an essential service, including pharmacies and wholesalers and manufacturers of medication accredited by the Minister of Health and Social Services.

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