Healthcare in a Digital World - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - Neighbourhood Pharmacy ...
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Gazette
N OV E M B E R 2 0 2 0
IN S IGH T S . A DVOC AC Y. HE A LT HIE R C A N A DI A N S .
A publication of the Neighbourhood Pharmacy Association of Canada
Healthcare in a
Digital World
HOW PHARMACY IS EMBRACING TECHNOLOGIES TO DELIVER CARE
CONTENTS
MESSAGE FROM THE CEO
November 2020
Gazette I N S I G H T S . A D V O C A C Y. H E A LT H I E R C A N A D I A N S .
3 Putting patients first
with new technologies
Neighbourhood Pharmacy Gazette is
published four times a year (twice in 2020) by
the Neighbourhood Pharmacy Association
of Canada. 365 Bloor St. E. Suite 2003,
Toronto, ON M4W 3L4. 416-226-9100.
COV ER S TORY
5
info@neighbourhoodpharmacies.ca
Healthcare in When sharing or reproducing content,
a digital world please ensure it is sourced to
Neighbourhood Pharmacy Gazette.
Pharmacy at the forefront in the
use of technologies to deliver care EXECUTIVE EDITORS
Jennifer Deschenes
jdeschenes@neighbourhoodpharmacies.ca
10
A N A LY S I S : P H A R M A C Y V S A M A Z O N
Taking care to show care Jeff Mehltretter
in the face of competition
jmehltretter@neighbourhoodpharmacies.ca
CONSULTING EDITOR
C O N F E R E N C E TA K E A W AY S Courtney Secord
12 Future forward in
csecord@neighbourhoodpharmacies.ca
a pandemic world MANAGING EDITOR
Karen Welds
ART DIRECTOR
2020 AWA RDS
15 16
Shawn Samson
Honouring a Leading with CONTRIBUTORS
healthcare passion reaps Jeff Mehltretter, Rosalind Stefanac,
trailblazer rewards
Karen Welds
ADVERTISING COORDINATOR
Lucy Montana
A DVOC AC Y: CONTROLLED DRUGS
17
lmontana@neighbourhoodpharmacies.ca
New authorities advance role
as opioid stewards Find us online
neighbourhoodpharmacies.ca
B . C . F L U VA C C I N E R E P O R T
19 A closer look at flu
vaccine distribution
We want to
C O N F E R E N C E TA K E A W AY S THE L A ST WORD
hear from you!
20 Taking the pulse of
specialty pharmacy 23 Stronger
than before
Send us your ideas, opinions and
questions to help guide the content
of the Gazette. We also welcome
as we head submissions for contributed articles.
into 2021 Contact Jennifer Deschenes,
jdeschenes@neighbourhoodpharmacies.ca
2 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.ca
MESSAGE FROM THE CEO
Putting patients first
with new technologies
When I reimagine the delivery of Equally important, we are making
healthcare in a digital world, I don’t headway on the regulatory changes
think about mobile phones and virtual needed to securely and safely support
visits and seamless data integration these technologies—progress that has
between patients and healthcare been accelerated by COVID-19.
providers—although all of that is Not everything can be virtual, of
certainly part of the picture. Those are course. Technology is at our service as a
the tools that will help us perform the tool for triage, and certain services and
magic. The true “magic,” however, will be situations require person-to-person care.
the realization of patient-centred care. And in some cases, a lonely individual
Sandra Hanna
As put so well in our cover story this would simply like to get out of the house.
CEO
issue, leveraging and assimilating all Wherever the patient is at, whether Neighbourhood Pharmacy
of the new technologies is ultimately physically, temporally or psychologically, Association of Canada
about meeting the needs of the patient today’s technologies increase our 416-226-9100
wherever they are at, rather than where capacity to meet their needs. info@neighbourhoodpharmacies.ca
@pharmacy_CAN
the system is. We’ve talked about On the other hand, a proliferation of
patient centricity for many years, yet technologies for multiple services can
our healthcare system has operated be just as confusing as the traditional
in a way that’s very provider centric. bricks-and-mortar healthcare system.
Understandably so, given our resources, Navigation support is as essential in a
capabilities and regulatory environment digital world as it is in the physical world.
at the time. In the physical world, almost all
Today’s technologies finally enable Canadians are minutes away from their
us to realize the full potential of neighbourhood community pharmacy.
patient-centred care by facilitating The pandemic triggered a powerful
access like never before. A mother demonstration of community pharmacy’s
with an ailing child can have a virtual emerging role as a community healthcare
‘‘
consult in the middle of the night. hub. In the digital world, COVID-19
People with diabetes can share has also sped community pharmacy’s
their blood glucose monitoring with implementation of technologies. Navigation
their healthcare team with a simple Community pharmacy is uniquely support is as
tap on their smartphone. Patients situated to become a “virtual front door” essential in a
can check in with their providers, or omnichannel to help people easily
including allied health professionals navigate what’s available in both the
digital world
such as physiotherapists, using apps public healthcare system and the private as it is in
or secure, asynchronous texts or sector, whether virtually or in person. Our the physical
world.
’’
emails. E-prescribing is on its way, and primary objective: to offer our customers
automated refills are already here. and our patients the best of all worlds.
3 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.ca
My Glucose
GLUCOSE IN RANGE 1m ago
6.2 mmol/L
10:23pm
21
Ends in 13 days
6.2
18
15 mmol
L
12
mmol/L
21
Charlene§
9 15
6 9
3
3
2pm 6pm 10pm
3pm 6pm 9pm
ADD NOTE
The FreeStyle Libre
system gives patients
the freedom to test
anytime,† anywhere‡
Reduces A1C
A1C
Clinically proven to significantly reduce A1C
in type 2 diabetes1
Easy to Use2
With a painless3 1-second scan, patients see
their current glucose reading, trend arrow,
and 8-hour history
Easy to Wear
Serge§ A small, discreet sensor that is easy to apply
and wear2 for up to 14 days
Recommend the FreeStyle Libre system to your patients today.
Visit FreeStyleLibre.ca to learn more
The FreeStyle Libre flash glucose monitoring system is indicated for measuring interstitial fluid glucose levels in adults aged 18 years and older with
diabetes mellitus. Always read and follow the label/insert.
The FreeStyle LibreLink app and the FreeStyle Libre reader have similar but not identical features. A finger prick test using a blood glucose meter is required
during times of rapidly changing glucose levels when interstitial fluid glucose levels may not accurately reflect blood glucose levels or if hypoglycemia or impending
hypoglycemia is reported by the FreeStyle LibreLink app or when symptoms do not match the app readings. The FreeStyle Libre sensor communicates with the
FreeStyle Libre reader that started it or the FreeStyle LibreLink app that started it. A sensor started by the FreeStyle Libre reader will also communicate with the
FreeStyle LibreLink app. The FreeStyle LibreLink app is only compatible with certain mobile devices and operating systems. Please check the website for more
information about device compatibility before using the app. Use of FreeStyle LibreLink requires registration with LibreView.
* Scanning the sensor does not require lancets.
† 60-minute warm-up required when applying the sensor.
‡ Sensor is water-resistant in up to 1 metre (3 feet) of water. Do not immerse longer than 30 minutes. Not to be used above 10,000 feet.
§ Real FreeStyle Libre user.
References: 1. Kröger J, Fasching P, Hanaire H. Three European retrospective real-world chart review studies to determine the effectiveness of flash
glucose monitoring on HbA1c in adults with type 2 diabetes. Diabetes Ther. 2020;11(1):279-291. 2. Data on file, Abbott Diabetes Care Inc. 3. Haak T,
Hanaire H, Ajjan R, Hermanns N, Riveline JP, Rayman G. Flash glucose-sensing technology as a replacement for blood glucose monitoring for the
management of insulin-treated type 2 diabetes: a multicenter, open-label randomized controlled trial. Diabetes Ther. 2017;8(1):55-73.
© 2020 Abbott. FreeStyle, Libre, and related brand marks are marks of Abbott. Product images are for illustrative purposes only. Other trademarks are
the property of their respective owners.
Géraldine§ ADC-30821
COVER STORY By Karen Welds
Reimagining healthcare
in a digital world
Pharmacy at the forefront in the use
of technologies to deliver care
Before COVID-19, community pharmacies in Canada It’s been almost 20 years and more than $2 billion
were already exploring and implementing new in funding since the federal government established
technologies to improve patients’ experiences and Canada Health Infoway, tasked with helping the
interactions with pharmacists. The pandemic has provinces and territories implement electronic health
undeniably accelerated their efforts. Here’s a review of the records, electronic medical records and e-prescribing.
important strides made this year, and what the future holds. In 2017 Infoway launched PrescribeIT and set out
to build a pipeline of pharmacists and prescribers
E-prescribing, a cornerstone who would be ready to implement e-prescribing as
Illustration ©Eric Chow, i2iart.com
When it comes to new technologies, most attention agreements with provinces are put in place.
to date has understandably focused on virtual care, London Drugs helped pilot PrescribeIT in 2018. “The
given the immediate urgencies surrounding access interactions between physicians and pharmacists
and continuity of care. E-prescribing is worthy of equal improved greatly, there was no misreading of
attention, as it will flow through and optimize many prescriptions and it saved patients and pharmacists a
other healthcare technologies, as well as be part of lot of time. Pharmacists could focus their conversation
an important bridge for data integration. on clinical matters,” says Chris Chiew, General Manager,
5 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.ca
COVER STORY Pharmacy, for London Drugs, adding that London pharmacy is helping with physician uptake. Drugs’ 23 pharmacies in Alberta will be fully set up “Momentum feeds momentum,” says Lording. to use the platform in January 2021. By the end of this year, 12 of the 13 provinces The pandemic has led London Drugs and Canada and territories will have signed memorandums of Health Infoway to redouble efforts to get local understanding to implement PrescribeIT. Five are physicians on board, in part to offset the jump in faxed already live: Alberta, Saskatchewan, Ontario, New prescriptions from physicians working from home. “This Brunswick and Newfoundland and Labrador. “We is definitely a priority. When we are able to convert are starting to see entire communities now where them over in Alberta, where PrescribeIT is live, they’re all pharmacies and physicians are using PrescribeIT. thrilled by how easy and seamless it is,” says Chiew. We are well on our way,” says Lording. Before the pandemic, close to a third of Canada’s community pharmacies, across all pharmacy formats, Virtual care here to stay had enrolled or were in the process, reports Ian For patients, virtual healthcare services are likely Lording, a pharmacist and Senior Director, Relationship the most visible evidence of new technologies Management, at PrescribeIT. Since January 2020, implemented since COVID-19. The pandemic served as enrollment has climbed by 91 per cent, propelled by a burning platform: physicians, pharmacists and other agreements with large pharmacy operators including providers had no choice but to turn to the telephone, Loblaw Companies Ltd./Shoppers Drug Mart and videoconferencing and electronic communications McKesson/Rexall. Once all of these locations are (texts and emails) to maintain continuity of care. enrolled, more than 6,500 pharmacies, or 60 per cent Nearly seven out of 10 Canadians who sought of the market outlet share, will be set up. “Interest healthcare assistance during the pandemic had a virtual and enthusiasm from pharmacy was always strong. visit, according to A Healthy Dialogue, a report released Now it’s rapidly accelerating,” says Lording. by Canada Health Infoway in November. Among them, Enrollment by physicians has doubled since January 91 per cent were satisfied with the experience and 2020, and transaction volume has tripled. While it will 76 per cent are willing to keep using it after the pandemic. take more time to reach critical mass among physicians, In February, the Canadian Medical Association, the queries are steady and Lording doesn’t doubt that College of Family Physicians of Canada and the Royal Special needs of specialty patients Technology tools can be especially helpful for the “We are working with insurers and regulators unique, complex needs of patients taking specialty to accommodate today’s innovative technologies. medications—and specialty pharmacies are leading Many of the rules and regulations haven’t been the charge. modified over the years, and there was certainly “We are all looking to use technology so that no thinking about digital solutions,” says St-Jean. the touchpoints with patients are meaningful and Meanwhile, specialty pharmacies pursue other digital complementary to our specialty pharmacy services. aids. For example, Innomar Strategies acquired the We are looking at the patient journey and using Chronically Simple app in June 2019. The app figuratively technology to optimize communication and quality and literally takes a weight off. “Patients no longer have patient care,” says Renée St-Jean, Senior Director, to lug around huge binders. They describe it as a game- Pharmacy Services, at Innomar Strategies. changer,” says Jason Zabransky, Vice-President, Specialty Innomar is looking to offer a solution where Operations, at Innomar Strategies. patients would use a single point of entry from The company is now adding custom functionality to which to manage administration of the medication, the app, with a focus on integrating with its specialty reimbursement and ongoing care. Paper-based, pharmacy. “The future features will be very tightly tied repetitive documentation would be a thing of the to services provided by Innomar pharmacies, such as past. However, hurdles regarding the collection booking your own delivery time for the drug and having and exchange of information need to be overcome. virtual conversations with pharmacists,” says Zabransky. 6 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.ca
COVER STORY
College of Physicians and Surgeons of Canada released that they simply click for a video consultation.
their task force report with recommendations for virtual “Virtual care has really bolstered our reach and
care in the public system. In May, the federal government ability to connect with patients,” says Sonal Ejner,
announced $240.5 million in funding for virtual care and Pharmacy Professional Services Manager at Calgary
mental health tools. And in October, Competition Bureau Co-op. “While COVID-19 immediately elevated us to
Canada wrapped up consultations for a market study move more to the telephone, you cannot do every
that will “examine how to support digital healthcare in service by phone. The video platform is really handy to
Canada through pro-competitive strategies.” review inhaler technique for COPD and asthma patients.”
Against this backdrop, community pharmacy is London Drugs is in the process of launching a virtual
matching or exceeding the pace of change. Provincial care platform for its pharmacists who are certified
and national associations are lobbying to make diabetes educators. “Diabetes patients are at high risk
permanent the temporary regulations put in place during for COVID-19 complications and video consults are an
the pandemic to enable virtual consultations. Equally important option for their regular follow-ups,” says Chiew.
important, they are working to ensure virtual services are Across Neighbourhood Pharmacies’ members,
billable. “Not all provinces have enabled pharmacies to regional or head office staff are working with interested
bill yet,” says Jeff Mehltretter, Vice-President, Pharmacy pharmacy owners or managers to vet and implement
and Business Development, at Neighbourhood virtual care platforms. These providers already power
Pharmacies. “We’re working with provincial drug plans virtual care in the private sector, and will undoubtedly
and associations to make sure that takes place.” be providers for the public system. Pharmacies can
In September, Calgary Co-op launched virtual services serve as a bridge, and source of learning, for both sides.
using a platform that’s well established in the private In March, Shoppers Drug Mart launched virtual
sector for employers with health benefit plans. Patients primary care in partnership with Maple, a provider that
can book their appointment online, and receive a link has implemented telehealth systems for governments.
Proudly dispensing quality products!
Patients are at the heart of all we do!
Apotex is proud to have roots in Canada with a strong focus on
the Canadian market:
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4 state-of-the-art manufacturing sites in Canada
5,000 employees across Canada
45-year footprint in Canada
95.3% of APOTEX products sold in Canada are made in Canada
Our leadership team is focused on growing and sustaining
Canadian business and maintaining high-quality,
highly skilled jobs in our country.
7 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.ca
COVER STORY
When access to physicians was severely limited during who used health technology in the past year reported
the pandemic, Shoppers Drug Mart promoted online they were better able to manage their health.
physician consults at no cost. Where public coverage was The Sanofi Canada Healthcare Survey, conducted
not available, Shoppers Drug Mart funded the virtual in January 2020, found that 53 per cent of employed
visits for a period of time. The initiative led to almost Canadians used at least one digital device or mobile
20,000 virtual visits in less than a month. The Maple app to help achieve personal health or fitness goals in
platform is now permanently available in more than the past year, up from 32 per cent in 2015.
160 Shoppers Drug Mart locations in B.C., with possible When you marry these findings with the expanding
expansion in other provinces. scope of practice for community pharmacists, their
In September, Shoppers Drug Mart announced a $75 growing role in public health, a retail infrastructure
million investment in Maple as part of its overall strategy, of 11,000 locations, most with extended hours, their
with parent company Loblaw Companies Ltd., to help capability to adopt new technologies quickly and the
drive a digitally connected healthcare network. “The goal sheer frequency of interactions with Canadians of all
is to structure the program so it is easy for patients to ages, it’s no wonder that community pharmacy sees
really utilize pharmacy as the front door for whatever they itself as a integral part of the future of healthcare.
need, whether that ‘door’ is a brick-and-mortar pharmacy “A high priority for us is what we call an omnichannel
or a virtual platform,” says Theresa Firestone, Senior Vice- experience for healthcare. It’s really about meeting the
President, Health and Wellness, at Shoppers Drug Mart. needs where the patient is, as opposed to where the
system is,” says Firestone.
Pharmacy, the omnichannel “When we view the role of community pharmacy,
Canada Health Infoway’s survey of Canadians found that we want to fill the gaps and reduce the burden on the
92 per cent want technology that makes healthcare as healthcare system. All of the new technologies, the virtual
convenient as other aspects of their lives. Eight out of 10 services, are a means to that end goal,” adds Ejner.
8 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.ca
COVER STORY
And the key piece of the puzzle, perhaps somewhat provider in the private health benefits space,
ironically, is the flesh-and-blood pharmacist. “The PC Health gives users free access to registered
Amazons of the world can only go so far. The new nurses and dietitians and incentivizes behaviour
normal may require e-commerce and delivery and change through goal-setting and rewards. Users can
artificial intelligence, but our point of differentiation also connect with care navigators to source services in
is that when patients are ready to get those services the public system or through private-sector providers.
where they need to go there in person, community The app is now available in B.C., Alberta, Ontario and
pharmacists are ready for that,” says Chiew. the Atlantic provinces and will expand to the remaining
In other words, technology can be used to augment the provinces in early 2021.
patient-pharmacist relationship, rather than replace it. Over time the PC Health app will expand to include
pharmacists and other healthcare providers. “It could
Opening the front door be a consultation with a dietitian, a diabetes medication
The coming year will see more community pharmacies review with the pharmacist or virtual physician care,”
launching or upgrading mobile apps that can come says Firestone. “We really see ourselves as a broader
to serve as a gateway to a range of services from healthcare organization, which goes beyond the
pharmacists and possibly other healthcare providers. pharmacy offering. Our overall purpose is to help
A number of members of Neighbourhood Pharmacies Canadians live life well.”
already offer an app that enables patients to access
their medication profiles and those of family members,
and to set up automatic refills. Karen Welds writes for healthcare provider
Loblaw Companies’ PC Health app provides a first look publications, with more than 25 years of
at the omnichannel experience. Launched in October experience covering community pharmacy.
2020 in partnership with League, a digital health platform info@neighbourhoodpharmacies.ca
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9 2020-10-004_P2H_HalfPgAd_FNL.indd
// Neighbourhood Pharmacy Gazette1 // November 2020 2020-10-23 10:44 AM
www.neighbourhoodpharmacies.ca
ANALYSIS: PHARMACY VS AMAZON By Jeff Mehltretter
Taking care to show care
in the face of competition
Canadian consumers are more interested in products Canadian Shoppers’ Caring Caring Score
and services that promote wellness, according to Scores for Retailers with
Pharmacies Compared Drugstore Store-
recent research commissioned by Neighbourhood to Amazon Pharmacy in-Store Amazon
Pharmacies—and they give pharmacy retailers higher
1. This retailer cares about helping
scores on that front than they give to Amazon. me keep my family healthy.
38 30 23
WSL Strategic Retail surveyed Canadian shoppers on
2. This retailer cares enough to
behalf of Neighbourhood Pharmacies in March. Results offer healthier choices I can 34 34 26
afford.
were presented at the Association’s Virtual Fall Conference,
and additional results are available on its website. 3. This retailer displays healthier
choices to encourage me to 33 33 22
One aspect of the research study incorporated buy them.
“caring scores.” WSL has used these scores as part of 4. This retailer demonstrates that
38 33 21
they care about our community.
their U.S. surveys for many years to enable retailers to
benchmark themselves against other retailers. Survey 5. Most of the prices in this store
34 42 45
are fair.
participants indicate their level of agreement with nine
6. I feel I get good value for the
standardized statements on the topics of wellness, price 35 45 51
money I spend here.
and service. For our Canadian survey, we compared 7. This retailer has services that
39 40 58
shoppers’ caring scores for retailers with pharmacies make my shopping easier.
against their scores for Amazon. We also differentiated 8. The sales associates in this
50 43 31
store respect the customers.
between the traditional drugstore format and the store-
9. I don’t usually get stressed
in-store format (for example, a pharmacy in a grocery shopping here.
52 49 63
store). The results, shown in the table, reveal some
Overall Composite Caring Score 39 39 38
interesting perceptions among consumers.
What Science Can Do
At AstraZeneca, we believe in the power of what science can do to transform
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Each and everyone of us is bold in the belief that science should be at the
centre of everything we do. It compels us to push the boundaries of what is
possible. To trust in the potential of ideas and pursue them, alone and with
others, until we have transformed the treatment of disease.
Together we can develop creative solutions to help tackle the challenges of
effectively preventing and treating disease. AstraZeneca Canada Inc. is proud
of our commitment to support Canada’s healthcare community.
The AstraZeneca logo is a registered trade-mark of AstraZeneca AB.
AZ_CorpAd-Science_2019-8.5x3.25.indd 1 4/4/2019 3:58:57 PM
10 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.caANALYSIS: PHARMACY VS AMAZON
The overall scores for pharmacy retailers and Amazon Doug Stephens, Founder of Retail Prophet in
are almost identical. However, significant differences Canada, also presented at the Fall Conference. He
emerge within the caring-score statements. Amazon predicted the expansion of today’s online retailers
receives lower scores for the four wellness statements into areas such as financial services and healthcare.
(one to four) and higher scores for price and value. These “apex predators” will dominate the retail landscape
Amazon also receives a higher score for stress-free and have no “natural competitors.” To survive, he advises
shopping. The greatest spread occurs with statements other retailers to have strategies that allow them to thrive
seven and eight: Amazon gets higher marks for ease of in the niches where such giants do not perform well.
shopping, while pharmacy retailers come out well ahead The caring scores from the WSL help illustrate that
in terms of the helpfulness of sales staff. These results the natural strengths of pharmacy retailers include
confirm that shopping in a pharmacy can be a much a more personal, empathetic approach to customer
more personal experience. service—to meet needs that can’t be fully sussed out by
This survey took place just prior to the first lockdown online algorithms, no matter how artificially intelligent.
in Canada and, as we all know, online shopping has These fundamental findings can help pharmacy
exploded since then. Many consumers have become retailers develop successful strategies for competing in
habituated to the ease and convenience of online an increasingly digital and online world.
shopping and will continue to choose online for some
of their shopping needs, even after the pandemic.
As WSL’s Elizabeth Gretkowski noted during her Jeff Mehltretter is Vice-President, Pharmacy
presentation at the Fall Conference, this begs the and Business Development, at Neighbourhood
question: “What should pharmacies do to compete Pharmacy Association of Canada.
against giant online retailers like Amazon?” jmehltretter@neighbourhoodpharmacies.ca
PARTNER SPOTLIGHT
Supporting pharmacists as
SUPPLIED CONTENT,
BROUGHT TO YOU BY
immunization leaders
Pfizer is recognized as a global leader in How Pfizer is supporting pharmacy We recognized early
helping prevent disease, with a focus on on that pharmacists were becoming the hub for patient
immunization. Fabien Paquette, Vaccines information. We also knew immunization programs across the
Canada Lead, Pfizer Canada, weighs in on country had been impacted by the pandemic and wanted to
the growing importance of pharmacists in provide as much information as possible. We worked with
the immunization space, and how Pfizer is pharmacists and other healthcare providers to put together
supporting this cause. online educational events to address their questions and
Role of pharmacists in immunizations during COVID-19 concerns. We have run more than 50 events for healthcare
With the pandemic, access to a variety of healthcare providers providers since the pandemic started.
was reduced significantly and the role of retail pharmacists in Future initiatives The most frequent feedback we get from
optimizing immunizations took on much greater importance. pharmacists is their desire to be more equipped to set up and
COVID-19 has been an eye-opener for other healthcare lead immunization programs. We will continue to expand our
providers in seeing the retail pharmacist as a partner in offerings of educational resources in multiple formats (e.g.,
supporting the well-being of Canadians. It has also been an interactive workshops, peer-to-peer sessions, etc.) to ensure
opportunity for government to see the value of retail pharmacy they feel supported and confident in their abilities. We also
as a partner in achieving public health goals and in some want to raise awareness of the essential role pharmacists play
provinces, their role in immunizations has expanded and in promoting vaccine awareness and helping achieve public
hopefully that will remain moving forward. health goals for vaccine-preventable diseases.
11 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.caCONFERENCE TAKEAWAYS
Future forward in
a pandemic world
COVID-19 has put a spotlight on the valuable by WSL for Neighbourhood Pharmacies, showed that
role of pharmacies and pharmacists in reaching more shoppers have a holistic view of wellness crossing
Canadians, both as shoppers and as patients. multiple categories, from over-the-counter drugs to
Industry leaders and other stakeholders gathered from beauty and home care. At least half view wellness as
October 26 to 30 for Neighbourhood Pharmacies’ first being financially responsible, having mental wellbeing
Virtual Fall Conference to discuss emerging shopper and looking better.
behaviours and new focal points for government. Consumers are seeking alternative treatments, with
46 per cent taking a multivitamin every day and 21 per
The WELL movement cent saying they would consider genetic testing. Food
“We are living a very dynamic, rapidly changing well is also playing a bigger role, with 47 per cent eating
movement…moving from sick care to well care to whole less sugar.
care,” said Elizabeth Gretkowski, Senior Consultant for While people have cut back on spending during the
WSL Strategic Retail, based in New York. pandemic, there is also “a whole slew of people who
The survey of Canadian shoppers, conducted in March want to buy purposeful products…and they’re willing
PARTNER SPOTLIGHT
Building healthcare resiliency
SUPPLIED CONTENT,
BROUGHT TO YOU BY
in a pandemic economy
As COVID-19 disrupted approaches and improved patient outcomes. In a word,
Canadian healthcare systems, Canada needs to build more resilient healthcare systems.
leaders across the country were With its focus on outcomes over inputs, Amgen believes
forced to confront numerous that Value-Based Healthcare (VBHC) offers system leaders
interconnected challenges: the best approach to predicting and preventing disease by
protecting the vulnerable and intervening early, and by investing in accelerated access to
treating the sick, modifying and critically important treatments and technologies. We believe
reconfiguring institutions, systems and technologies, as well as that Neighbourhood Pharmacy Association of Canada
designing and implementing new public health protocols. (Neighbourhood Pharmacies) and the pharmacies it supports
Although they performed admirably under enormous pressure, have a critical role to play in resilient healthcare systems by
the pandemic exposed and exacerbated important long-standing supporting positive patient outcomes and providing accessible
gaps and weaknesses in long-term care, immunization, digital treatments and therapies.
health, scope of practice and access to innovation. That’s why we’re committed to working with Neighbourhood
With the worst days of the pandemic hopefully behind Pharmacies and a wide range of other experts to launch a new
us, Canada has a unique opportunity to rethink, redesign conversation inspired by the lessons learned from COVID-19. By
and rework its healthcare systems. A once-in-a-century crisis leveraging perspectives from the public, private and not-for-profit
should be met with a once-in-a-century response – one that sectors, this conversation can help build healthcare systems across
relentlessly pushes for new models of care, more innovative Canada that are stronger, more adaptable and more resilient.
12 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.caCONFERENCE TAKEAWAYS
to pay more for it,” said Gretkowski. Those wanting Rather than looking to compete on price,
to entice these shoppers have to look at their entire convenience and selection, which will be
business through a wellness lens to determine how to dominated by “apex predators” such as Amazon,
be more relevant. Stephens urged retailers to think about their purpose in
the lives of consumers. “What precise question are you
Finding purpose the answer to?”
In the shadow of giant conglomerates like Amazon, From a pharmacy perspective, the treatment of
Walmart and Asia’s Alibaba, smaller retailers can still illness is a narrow position from which to compete,
shine, said Doug Stephens, Founder of Retail Prophet. observed Stephens. Instead, the support of wellness
The pandemic is pulling retailers from the industrial opens up a slew of opportunities. “Prescriptions and
era to a digital one, with new opportunities to give vaccinations are still part of the bargain, but now we
customers a better experience in-store and online via the can start conversations about nutrition…overall fitness
use of chatbots, live streaming and artificial intelligence. and mental wellbeing.”
CONFERENCE SPEAKERS
Dr. Bob Bell Dr. Yves Bolduc Elizabeth Dr. Perry Mark Nafekh Doug Stephens Brendan Christine
Former Ontario Former Quebec Gretkowski Kendall Public Health Retail Prophet Dunlop Sinclair
Deputy Minister Minister of Health WSL Strategic Retail BC Centre on Agency of Canada Sportscaster Professional
of Health Substance Use soccer player
With a focus on best in-class supply chain
management, Mint has averted 15 national drug
shortages in Canada on 10 different molecules since
2014. Most recently, we ensured Canadians had
continued access to Hydroxychloroquine during the
COVID-19 pandemic despite unprecedented demand
and global shortages of the product. Pharmacies
accross Canada rely on Mint everyday.
13 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.caCONFERENCE TAKEAWAYS
Plus, consumers are willing to spend more
on wellness than ever before, said Stephens.
He suggested that pharmacies create alliances in
the community, such as with yoga studios and massage
therapists, so they can offer a much more “expansive
Working Together
conversation” when it comes to wellness solutions.
Wins and woes during COVID-19
to Put Canadians The pandemic put the performance of Canada’s entire
healthcare system under a microscope, revealing some
First major wins as well as huge gaps, agreed participants in
a panel discussion.
“We haven’t seen the kind of situation [here] that has
We are a Canadian company been so tragically on display in other countries where
with global headquarters in healthcare systems have been overwhelmed,” said Dr.
the Montreal area. Bob Bell, Ontario’s former Deputy Minister of Health.
However, what happened in long-term care facilities
Our decisions always has sadly put attention on Canada. “Statistics suggest
prioritize Canadian needs. that in terms of the proportion of people who have died
from COVID-19, we have the world’s largest proportion
We have one of the largest in long-term care homes.”
product portfolio in Canada. Panelists agreed that many wins to date have come
from community pharmacies and pharmacists who
We are the leader in product stepped up to carry out critical activities (e.g., patient
launches in Canada. education, renewal/delivery of medications, patient
consultations, screenings, vaccine distribution, etc.).
Most of our volume sold in “It shows they are important and effective community
Canada is also manufactured partners operating on the frontline of Canada’s health
in Canada. system, and that role will continue to be relevant,” said
Mark Nafekh, Director General, Centre for Chronic
We are committed to maintain Disease Prevention and Health Equity, Public Health
inventory levels above the Agency of Canada.
industry average. Some of the biggest gaps are in prevention (including
affordable access to options) and better use of health
We are your local partner data systems. “The infrastructure is there but we need
to enhance Canadians' to collect information to be able to gear our services to
well-being. those who need it most,” said Nafekh.
“We could manage chronic diseases much better
than we do now,” added Dr. Perry Kendall, co-interim
Executive Director at the British Columbia Centre on
Substance Use. He emphasized the need to bring in
multiple healthcare practitioners to work together, along
with more health education and access to virtual care.
Dr. Yves Bolduc, former Minister of Health in Quebec,
agreed that virtual care will play a much bigger role. “What
jamppharma.ca
we see at this moment is that we can give very good care
seeing patients 30 per cent of the time in person, and
70 per cent of the time by phone or computer.”
14 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.ca2020 AWARDS
Honouring a
healthcare trailblazer
Len Marks Pharmacy Advancement Award: Domenic Pilla
Anyone who crosses paths with Domenic Pilla Drug Mart and a Director of Loblaw Companies. An
knows he has strong beliefs when it comes to engineer by profession, he enjoyed an 18-year tenure at
Canada’s healthcare system and what it needs to Petro Canada before switching gears into healthcare.
survive. “Unfortunately, in its current incarnation it Although retired now, Pilla has no intention of giving
is not sustainable and our legacy is at risk…and I think up his healthcare advocacy work. Attendees at the
pharmacy has to be at the centre of re-egineering it,” virtual awards ceremony expressed their appreciation
said Pilla at the virtual awards ceremony for his continued commitment.
to honour his win of the Len Marks “I view you as great visionary leader,”
Pharmacy Advancement Award from said Dan Chiasson, President and CEO,
Neighbourhood Pharmacies. Canadian Association for Pharmacy
A pharmacy advocate throughout his 20 Distribution Management. “I’m grateful
years in the healthcare industry, it’s fitting that you’re putting up your hand and
that Pilla is the recipient of this particular continuing to do advocacy work.”
award. “This award fits my beliefs,” he Mona Sabharwal, Rexall’s Senior Vice-
said. “Pharmacy is at the centre of our President, Pharmacy Services, said she’d
future and I will continue to support it.” heard of Pilla’s leadership and passion
Pilla, who was Chief Executive for healthcare before she’d ever met
Officer of McKesson Canada before him. “Your reputation precedes you,”
DOMENIC PILLA
retiring in August, oversaw the she said. “You’ve inspired many of us to
company’s pharmaceutical distribution, specialty think really big and boldly about how we should lead to
health, independent pharmacy and retail pharmacy implement long-term success.”
businesses. He also worked at McKesson earlier in his Rita Winn, Director, Lovell Drugs, recalled the
career, when he helped grow the company into new leadership Pilla showed during the creation of
areas, including pharmacy technology, with a focus on Neighbourhood Pharmacies’ 9000 Points of Care:
meeting the changing needs of pharmacy customers Improving Access to Affordable Healthcare report in
and healthcare partners. 2013. “That’s a pivotal piece of work that is still relevant
Pilla also served as CEO of Shoppers Drug Mart today,” she said. “I agree that we need to do more for
Corporation until its sale to Loblaw Companies Ltd. in our healthcare system, and I hope people like you will
2014, at which point he became President of Shoppers continue to stay involved to push it forward.”
ABOUT THE AWARD
The Len Marks Pharmacy Advancement Award was established in memory of pharmacist
Len Marks, who was an advocate for community pharmacy. This award recognizes someone
whose passion for the advancement of pharmacy helps lead change in the areas of education,
pharmacy practice, advocacy and collaboration.
15 // Neighbourhood Pharmacy Gazette www.neighbourhoodpharmacies.ca2020 AWARDS
Leading with passion
reaps rewards
Distinguished Associate of the Year Award: Martin Arès
With a reputation for being a strategic thinker greater opportunities to come.” He also stressed that
and passionate leader, Martin Arès has the it would be difficult to find anyone in the industry “who
magic touch to engage with people to tackle works harder and is more committed to the cause; for
challenging and ambitious goals, connect with Martin it’s not just a program or a number, it’s about
customers and shape industry trends. Under making a positive difference in peoples’ lives.”
his watch, Sandoz Canada was named best generics Tanya Moore, Vice-President, Pharmaceutical
company and partner three years Partnerships, Shoppers Drug Mart, said
running. He was instrumental in evolving Arès exemplifies all the qualities that
Sandoz Canada into a unique bio- this award represents. “He is dedicated
generic entity with one of the largest to supporting retail pharmacy and
product portfolios in the industry— the advancement of pharmacists as
and his vocal support of the role of the core to his day-to-day approach in
pharmacists never wavered. managing the business and supporting
In accepting his award for his pharmacy customers,” she said.
Distinguished Associate of the Year “There is a true understanding
from Neighbourhood Pharmacies, Arès and appreciation of the value that
was quick to acknowledge his entire pharmacists offer to the sustainability
team. “This award reflects the efforts of healthcare in Canada.”
MARTIN ARÈS
that we as a company have made to As further proof of his passion for
become trusted partners, and everything we’re doing the profession, Arès told attendees at the virtual
to increase the role of pharmacists in Canada,” he said. ceremony that pharmacists and pharmacy owners
“You can’t do things by yourself and I’m really proud to “are all heroes” in his eyes. “Without them Sandoz
recognize that I have a great team surrounding me.” Canada wouldn’t be able to fulfill its purpose to get
Tim Smith, Senior Vice-President, Business patients access to their medications.”
Development, McKesson Canada, noted that the work With more than 25 years of global pharmaceutical
Arès and his team have done in advancing biosimilars experience under his belt, Arès started his career in
has been “foundational and has set the stage for sales and quickly advanced into senior leadership
positions and global roles in Europe. Upon his return
to Montreal in 2012, he held commercial leadership
ABOUT THE AWARD
roles at Bristol Myers Squibb and Sanofi until he joined
The Distinguished Associate of the Sandoz Canada in 2016.
Year Award honours a Neighbourhood As a member of the Sandoz Canada Executive
Pharmacies Associate in good standing who Committee since 2016, Arès was Vice-President, Bio-
displays extraordinary commitment to the Generic, Pharmacies & Wholesalers Channel, Head of
Association’s initiatives and/or committees, Generics, before being promoted to the Sandoz U.S.
while helping advance community pharmacy. organization in November 2020 as Business Head,
Solid Oral Generics. He is still based out of Montreal.
16 // Neighbourhood Pharmacy Gazette www.neighbourhoodpharmacies.caADVOCACY: CONTROLLED DRUGS
New authorities advance
role as opioid stewards
The COVID-19 pandemic Section 56 of the Controlled Drugs and Substances
opened the door for Act (CDSA). For regulated drugs such as opioids,
pharmacists to play a pharmacists became temporarily authorized to:
more direct role in pain •a ccept verbal prescriptions;
management for patients • t ransfer prescriptions;
taking controlled drugs. •e xtend and renew prescriptions; and
Neighbourhood Pharmacies •p ermit pharmacy employees to deliver prescriptions.
and other pharmacy advocacy bodies These exemptions are subject to the laws and
are making the case to open that door regulations of the province or territory—an important
wide, and permanently, as an important component of clarification given the range in scopes of pharmacy
opioid harm reduction strategies. practice in Canada. Having said that, most provinces
On March 19, 2020, just days after the World Health and territories were able to apply most or all of the
Organization had declared COVID-19 a global pandemic exemptions. (For more details, consult the chart
on March 11, Health Canada issued exemptions under compiled by the Canadian Pharmacists Association.)
17 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.caADVOCACY: CONTROLLED DRUGS
Health Canada had originally stated these temporary prescribe controlled substances. Neighbourhood
authorities for pharmacists would expire on September Pharmacies is opting for the latter route.
30, 2020; it has since extended the deadline for another “Exemptions under Section 56 are meant to
year, until September 30, 2021, unless the exemptions be short-term and narrowly targeted. An update to
are replaced or revoked before then. the list of prescribers recognizes how expansions to
“We will have almost two years of experience pharmacists’ scope of practice over the past years
to consider the impact of this expanded role for have set the profession up to be more proactive in this
pharmacists in terms of outcomes for patients and important area of care,” says Mehltretter.
the healthcare system,” says Jeff Mehltretter, Vice- An updated list of practitioners is also a simpler
President, Pharmacy and Business Development, at approach to address provincial and territorial scopes of
Neighbourhood Pharmacies. “We will also use that time practice. “In practical terms this is a more clear-cut way
to advocate for making these authorities permanent.” for regulators to be able to continue to provide guidance
Anecdotally, members of the Association report at the provincial level,” summarizes Mehltretter.
high levels of patient satisfaction, he notes. “Patients “We’re looking forward to seeing whether or not
appreciate that the pharmacist can ensure that the exemptions issued by Health Canada become
continuity of care, which is so important for those permanent changes to the legislation,” says Anu
suffering from chronic pain. Long-term care facilities Sharma, Senior Policy & Legislation Analyst, B.C. College
have also said this is very helpful, especially when of Pharmacists. “As we move forward, the College is
moving patients between facilities.” modernizing its requirements to be principle-based,
Two routes exist to make these authorities allowing greater flexibility in how pharmacy services
permanent: extend the exemptions indefinitely or add are provided while ensuring they still achieve their
pharmacists to the CDSA’s list of practitioners who can intended public safety outcome.”
Patients rely on you. You can rely on us.
Rely on our unified Bio-Generic sales team, our leadership position in Canada, our strong
Sandoz-Novartis supply network, our large portfolio of high-quality generics and biosimilars,
and our patient support programs designed to ease access to treatments.
We take care of your needs so you can take care of your patients.
As your partners in this rapidly evolving world, we help you anticipate and harness market
changes, capitalize on new product launches and ensure a reliable supply of medicines
to your patients, for a more robust and sustainable healthcare system.
When we work together, the future looks better than ever.
www.sandoz.ca
18 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.caB.C. FLU VACCINE REPORT
A closer look
at flu vaccine
distribution
B.C.’s current distribution system for
influenza vaccines to pharmacies and
physicians requires major resources
from Public Health. Switching to the
pharmaceutical distribution system could
result in substantial gains, especially now with
resources stretched to capacity due to COVID-19.
Here are highlights from Neighbourhood
Pharmacies’ August 2020 report on the benefits
of shifting influenza vaccine distribution in B.C. The report examined two B.C. pilot projects conducted
to the private-sector distribution model. by Shoppers Drug Mart (with the Interior Health
Authority) and McKesson (with the Island Health
Authority). These pilots found that a pharmaceutical
distribution system resulted in:
Lead immunizer • Significantly less or no vaccine wastage due to cold
chain breaks or distribution waste.
n Pharmacists • Fewer or no patients turned away due to lack of inventory.
n Public Health 6% • Increased vaccination rates.
• A better use of pharmacists’ time as they could focus
n Physicians 14%
on patient care rather than pick up orders.
n Other • Easier end-of-season reporting as results are
consolidated by the distributor.
Pharmacists in B.C.
are anticipated to 20% 60% Given the benefits, the report recommended an
administer more than immediate transition to the pharmaceutical distribution
half of the 1.5 million system for pharmacies. While that is now too late for
vaccine doses ordered the 2020/21 flu season, recent communications with
for the 2020/21 season. decision makers in B.C. indicate the recommendation
is getting serious consideration for the 2021/22 season.
Neighbourhood Pharmacies has offered to be part of a
working group to map out a plan.
Less waste
A pharmaceutical distribution
model is predicted to reduce
wasted doses by at least half, Get the full Cost Comparisons of
Vaccine Distribution
resulting in savings as well as more vaccinations. report here Options in British Columbia
19 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.caCONFERENCE TAKEAWAYS
Taking the pulse of
specialty pharmacy
The complexities of specialty pharmaceuticals “Specialty pharmaceuticals are at the forefront of
have led to the emergence of a specialty pharmacy discussions around a national pharmacare, a rare
sector within community pharmacy. Neighbourhood disease drug strategy and pricing reform,” said Karl
Pharmacies’ first Specialty Pharmacy Summit, held Frank, Divisional Director, Bayshore Specialty Rx and
virtually and attended by more than 200 on September Board Chair of Neighbourhood Pharmacies. “Specialty
22 and 23, explores what lies ahead for this rapidly pharmacies need to be part of the discussion because
evolving market. we are ideally positioned as critical solution providers
for governments and decision makers.”
Changes and challenges Past decisions or the lack thereof—such as capped
Specialty pharmaceuticals account for approximately mark-ups and the absence of professional service
30 per cent of spending by public and private drug fees specific to specialty pharmacy—have put
plans, for less than two per cent of Canadians.1 Their strain on the sector’s economic viability. Regulatory
growing share of revenue leads payors and healthcare changes are required, as well as improved integration
providers to wrestle even more with how to affordably between specialty and traditional community
provide access to these potentially life-changing drugs. pharmacies.
20 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.caCONFERENCE TAKEAWAYS
“We need to consolidate a pathway to enable each Pilot projects and social impact bonds can
other to provide a better model of care for patients, kickstart innovative models of practice and an
with measurable results for both health outcomes appropriate reimbursement framework, agreed
and system costs,” said Karen Chuk, Vice-President, panelists at the Specialty Pharmacy Summit.
Specialty Pharmacy Services, McKesson Canada.
As well, specialty pharmacies are at the forefront Patient support programs
of technological innovation in order to manage the Manufacturers are updating their patient support
sector’s unique complexities, optimize efficiencies and programs (PSPs) in response to cost pressures as well
relieve cost pressures. Increasingly, “we are using the as patients’ needs. “They are using technology to drive
data to generate real-world evidence that will shift the operational efficiency and connectivity with patients,”
focus away from cost to investment, to truly show the said Allison Wills, Partner and Consultant, 20Sense
tremendous benefits of these medications and specialty Specialty Pharmaceutical Consulting.
pharmacy services,” said Chris Dalseg, Vice-President, New emerging models include broad-spectrum
Strategic Growth and Marketing, BioScript Solutions. PSPs for multiple drugs from multiple manufacturers
CONFERENCE SPEAKERS
Andrew Karen Chuk Chris Jane Karl Frank Nadia Karine Renée Drew Taylor Allison Wills
Bhakit McKesson Dalseg Farnham Bayshore Khassassi Matteau St-Jean Acorn Biolabs 20Sense Specialty
Bayshore Canada BioScript Canadian HealthCare ACCESSA Biosimilars Innomar Pharmaceutical
Specialty Rx Solutions Organization for Canada Strategies Consulting
Rare Disorders
PARTNER SPOTLIGHT
Technology helps pharmacists SUPPLIED CONTENT,
empower patients
BROUGHT TO YOU BY
At his London Drugs Pharmacy in coming in once every three months, I don’t know where the
Lethbridge, Alberta, pharmacist and peaks and valleys are so we can specifically work on that.”
diabetes educator Rick Siemens was used Siemens notes that in helping empower patients to use tools
to having a busy diabetes practice. But like these, they can dramatically improve their blood sugar levels.
when COVID-19 hit, the demand for his “It’s a great teaching tool for them, and for pharmacists it’s a
expertise exploded. “With physicians so safety net of information in making clinical recommendations,”
backed up, there is more opportunity for he says. “Another great thing is that I’m able to easily share* the
pharmacists to help manage patients with diabetes,” he says. results of my interventions with physicians, so they see value too.”
“Some patients haven’t had an A1C test in six months so it’s The reality is that physicians can’t be experts in everything
crucial that pharmacists are involved in monitoring.” and don’t have the time and resources, says Siemens. “This
To keep up with demand, especially now that patients aren’t is a real opportunity for pharmacists to step up and use
coming into the pharmacy as often, Siemens looks to flash technologies to help patients—and the physicians who want
glucose monitoring and cloud-based diabetes management their patients to do well.”
systems such as LibreView,* where patients can upload† their * The LibreView website is compatible with certain operating systems and
glucose data to share with providers. “Platforms like these browsers only. Please check www.libreview.com for additional information.
† Use of FreeStyle LibreLink requires registration with LibreView. Automatic
are so impactful because they give me the chance to see a upload requires a wireless internet connection or mobile data connection.
patient’s day-to-day struggles,” he says. “When they’re only ADC-30497 v2.0
21 // Neighbourhood Pharmacy Gazette // November 2020 www.neighbourhoodpharmacies.caYou can also read
