Who will foot the bill?

Broadening pharmacists’ role to improve access to front-line health care services sounds like a great idea. However, billing these essential services seriously undermines the principles of accessibility and fairness with respect to health.

This was one of the more important issues raised by the CSQ as the government prepars to amend the Pharmacy Act. Its Bill no 31 aims to authorize pharmacists to engage in eight new professional activities in the practice of pharmacy, such as prescribing and administering vaccines or prescribing all non-prescription medications.

However, changing the role of these professionals without reviewing their compensation doesn’t make any sense. “The government can’t say it wants to improve access to health care while allowing new pharmaceutical services to be billed to public and private insurance plans,” says Sonia Ethier1.

When transferring services provided for in the public hospital network to private community pharmacies, initial and monthly professional fees may be charged. Even though these fees are covered by the RAMQ2, people who are not covered by the prescription drug insurance plan’s public component are not insured.

A worrisome privatization

As such, a broader role for pharmacists, combined with fewer services offered in the public sector as well as the deinsurance of pharmaceutical services for individuals covered by a private insurance, constitutes an insidious privatization of health care services. Such an approach is unfair and runs contrary to the spirit of the Canada Health Act.

“The government cannot ignore or contribute to these growing inequities in the health sector. The fair access to health care, and therefore the right to health as recognized by the World Health Organization, is at stake,” states Sonia Ethier.


As part of the consultation on Bill no 31, the CSQ submitted a brief wherein it recommended, among other things:

  • That necessary pharmaceutical services be officially recognized as insured essential health care services;
  • That universal and public coverage of prescription drugs and pharmaceutical services be provided.

1 Sonia Ethier is President of the CSQ.
2 Régie de l’assurance maladie du Québec.


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