Ontario MedsCheck Pressure Grows

Table of Contents:

• Shoppers drug mart billing growth in Ontario MedsCheck program
• Ontario college of pharmacists tracking pressure on staff
• Proposed reforms to the MedsCheck program
• Ongoing review and next steps

Shoppers drug mart billing growth in Ontario MedsCheck program

Shoppers Drug Mart billed Ontario $81.2 million for MedsCheck services during the 2022 to 2023 and 2023 to 2024 fiscal years, a total that is $8 million higher than the amount invoiced over the previous six years combined. The figures were obtained by CBC News through a freedom of information request. Regulatory lawyer Aly Háji stated “Correlation is not causation, but the upswing in MedsChecks is remarkable given the downswing in revenues from things like COVID shots or other services that were allowed during COVID.”

Medication reviews are structured meetings that help ensure prescriptions are appropriate for eligible patients. Those taking at least three chronic medications, living in licenced long-term care homes, or receiving diabetes treatment qualify. Pharmacies can bill $60 for annual assessments, $75 for diabetes-related reviews and $25 for follow-up appointments.

Increased flexibility after 2020

In March 2020, the MedsCheck program allowed pharmacists to complete reviews over the phone. Since that fiscal year, Shoppers has billed more for medication reviews than in the previous seven years combined, with average revenue rising to $183,800 per pharmacy. This figure is more than double the average revenue recorded by the other seven corporate chains and up to sixteen times higher in certain comparisons.

Provincewide billing totals

Across eight corporations operating in Ontario, billings between 2013 and 2024 reached a combined $293.2 million. Shoppers Drug Mart accounted for 77 percent of that total, or $225.3 million across an average of 682 stores annually. These locations represented slightly more than half of all pharmacies included in the provincial tally.

Shoppers Drug Mart told CBC News that its scale enables it to deliver more MedsChecks and emphasized that “our scale and the nature of our operations … are specifically designed to give pharmacists more time for the one-on-one clinical care that patients require.” The company added that medication reviews constitute less than 20 percent of its professional services in Ontario.

Ontario college of pharmacists tracking pressure on staff

Survey results from the Ontario College of Pharmacists (OCP) show that pharmacists continue to report business pressures that interfere with their professional obligations, including pressure to perform MedsCheck reviews. By mid-September, the regulator had opened 111 investigation files related to workplace pressures, with nearly half referring specifically to MedsChecks.

OCP spokesperson Dave Bourne said outcomes of completed cases have ranged from taking no action to referrals to the discipline committee. In its June 2024 report “Under Stress and Duress,” the OCP wrote that pharmacists said “corporate influence on pharmacy professional autonomy is compromising the delivery of ethical, quality patient care and their wellbeing.”

The report also noted that 70 percent of surveyed pharmacists felt pressured to meet numeric or financial targets. The vast majority of those respondents worked at Shoppers Drug Mart.

Proposed reforms to the MedsCheck program

There is no rule preventing pharmacies from generating profit under the MedsCheck program. However, Háji argued that “The program really needs to be overhauled and corrected to prevent … the way it's being used.” He proposed raising eligibility criteria, improving documentation to verify adequate review time and strengthening communication between pharmacists and prescribers.

The Ontario Pharmacy Association (OPA) supported raising the eligibility threshold from three to five chronic medications. Justin Bates, the OPA’s CEO, said “We’re very much committed to maintaining medication reviews, we think there is value. But we also recognize that the current program needs to be improved.”

OPA representatives met with the province to discuss reforms. Bates said the government is committed to modernizing the MedsCheck program. The Ministry of Health told CBC News “We are improving the MedsCheck program to support health outcomes and reduce unnecessary service duplication and administrative red tape, while continuing to protect patient choice.” The ministry continues to assess feedback from the public consultation.

Ongoing review and next steps

Ontario is evaluating MedsCheck billing patterns, workplace pressures and proposed reforms to determine how the program should evolve. The OCP continues to investigate active complaints, and policy discussions remain underway at the provincial level. Further updates are expected as reviews by regulators and the government progress.

Source: CBC