Since August 1, 2008, dispensing fees paid by the Ontario government to community pharmacies for compliance packaging such as pill packs, blister packs and Dosetts, for seniors and patients covered under the Ontario Drug Benefit program, have been limited to a maximum of twice a month, with some exceptions.
Under the new regulations, monthly dispensing is the standard, with some allowance for biweekly dispensing.
The Ontario Pharmacists’ Association believes these changes will have a negative impact on some of the province’s most vulnerable and disadvantaged patients, by making it harder for them to follow their complex medication schedules and threatening their ability to live independently.
Dispensing medications in compliance packaging enables many patients – including seniors and others with physical, cognitive and sensory impairments -- to live safely in their own homes by reducing the threat of medication errors and improving adherence rates.
In addition to long-term care homes, which are exempted from the regulations, compliance packaging is also important in other residential facilities, such as group and retirement homes, where staff and caregivers must manage complex medication regimens for several residents.
Reducing access to these packages will limit pharmacists’ ability to provide the best care for some of our most at-risk patients, resulting in poorer health, increased emergency room visits and wait times, more hospitalizations and higher health care costs.
Ontario pharmacists share the Ministry of Health and Long-Term Care’s commitment to providing the best patient care possible, and to spending health care dollars efficiently. For some very specific medications, daily dispensing may be necessary, but weekly dispensing is more prevalent.
We believe the Ministry needs to continue to enable pharmacists to provide more frequent pill packs, blister packs, Dosetts and similar compliance packaging for patients who really need it.
Among other changes, we have asked that the government expand the exemptions to enable patients receiving one or more exempted medications to be eligible for multiple dispensing for all of their medications; to include those ODB patients who need this service and are living in any kind of group,
nursing or retirement home; and to expand and/or reclassify the list of exemptions to meet patient specific needs and diagnoses.
Compliance dispensing is both a specialized and an individualized service that requires the professional judgment and expertise of pharmacists working in close collaboration with prescribers, caregivers and patients to ensure the safe and effective use of medication.
Exempted homes for Special Care - Updated Dec 1, 2008
Drug Exemption List - Effective Nov 1, 2008
Additional Clarification on Dispensing Fee Conditions - Oct 30, 2008
letter from the Executive Officer - Oct 7
FCH Communication to Providers - Oct 06
NIHB Letter - Sept 19
ORCA Letter on Dispensing Fees
CMHA Ont letter to MOHLTC re dispensing concerns
Ontario College of Family Physicians Letter
OPA Requests to MoHLTC on Compliance Dispensing
MPP Contact Information
Template for Compliance Packaging Letter from Pharmacist to MPP
Template for Compliance Packaging Letter from Caregiver to MPP
Compliance Packaging Dispensing Fees Regulations Q&A - July 29, 2008
Conditions for Payment of Dispensing Fees for Compliance Packaging
OPA Submission on Proposed Regulatory Changes ? May 30, 2008