Off to the Races INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - Neighbourhood Pharmacy Association of ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Gazette
S P R I N G 2 0 21
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
Off to the Races
What to expect as federal parties round the bend to election day
CONTENTS
MESSAGE FROM THE CEO
Spring 2021
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 Healthcare debate
a sure bet this election
Neighbourhood Pharmacy Gazette is
published four times a year by the
Neighbourhood Pharmacy Association
of Canada. 365 Bloor St. E. Suite 2003,
Toronto, ON M4W 3L4. 416-226-9100.
COV ER S TORY
4
info@neighbourhoodpharmacies.ca
Off to the races When sharing or reproducing content,
What to expect as federal parties please ensure it is sourced to
round the bend to election day Neighbourhood Pharmacy Gazette.
EXECUTIVE EDITOR
11
CONFERENCE: E X ECUTI V E SUMMIT
Jennifer Deschenes
Exploring Canada’s
road to recovery CONSULTING EDITOR
Courtney Secord
I N S I G H T S : H E A LT H C A R E F U N D I N G
13 Progress finally in sight MANAGING EDITOR
Karen Welds
for health funding?
ART DIRECTOR
Shawn Samson
A DVOC AC Y: PH A RM AC A RE
16 Raising conversation
about pharmacare
CONTRIBUTORS
Shelita Dattani, Jennifer Deschenes,
Jeff Mehltretter, Rosalind Stefanac,
Steve Vander Wal, Karen Welds, Rita Winn
I N S I G H T S : C O V I D -19
17 Community pharmacy
& COVID-19 vaccinations
ADVERTISING COORDINATOR
Lucy Montana
I N S I G H T S : VA C C I N E H E S I TA N C Y
18
Find us online
From vaccine hesitant neighbourhoodpharmacies.ca
to vaccine confident
We want to
MEMBER Q& A: BIOSCRIPT SOLUTIONS
21 Patients in the
driver’s seat 22 hear from you!
Send us your ideas, opinions and
questions to help guide the content
THE L A ST WORD of the Gazette. We also welcome
24 Time to integrate submissions for contributed articles.
INSIGHTS: CANNABIS
pharmacy into Cannabis use climbs Contact us
info@neighbourhoodpharmacies.ca
healthcare system to 1 in 5 Canadians
2 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
MESSAGE FROM THE CEO
Healthcare debate
a sure bet this election
Pandemic notwithstanding, we’ll The narrative of public-private
soon be able to sit back and enjoy a collaboration is especially important.
spectacle that typically occurs once On the manufacturing side, continued
every four years—and I’m not talking political rhetoric about “big bad pharma”
about the summer Olympic Games. would strike a sour note to say the least,
That’s right, we can probably look given that vaccines are getting us out of
forward to a federal election this fall. this crisis.
The timing is likely the best it will be For pharmacy, the pandemic has
for the minority Liberal government, shone a spotlight on our ability to pivot
given that it will want to campaign on in ways that are not feasible in the public
its performance during the pandemic system. We have proven ourselves
Sandra Hanna
CEO
while riding the wave (hopefully) of a to be a safeguard for continuity of Neighbourhood Pharmacy
successful vaccination rollout and the care. Equally important, Canadians Association of Canada
start of economic recovery. increasingly see us as a convenient, 416-226-9100
As Canadians tentatively emerge trusted point of access for information, info@neighbourhoodpharmacies.ca
@pharmacy_CAN
from the pall cast by the pandemic, this navigation of services and direct care.
election will be unlike any other. With As pollster Nik Nanos put it in our cover
healthcare as one of the top issues, it will story (page 5), community pharmacy “is
be especially informative for community basically a community health hub, and I
pharmacy and other healthcare can’t see that turning back.”
stakeholders. While medication management
Now that voters are more aware of will always be our raison d’être, our
‘‘
how the healthcare system works—and accessibility—both geographically and
doesn’t work—will the parties propose psychosocially—can and should be put
new and better ways to close long- to better use. Yes, barriers need to be For pharmacy,
standing gaps, harshly exposed by the addressed, in areas such as funding, the pandemic
SARS-CoV-2 virus? After experiencing gaps regulations and integration with primary has shone a
and delays in the supply chain—from care and public health systems. Yet the
personal protective equipment and drug way forward is clear.
spotlight on
supply to testing kits and vaccinations— Whatever the outcome of the federal our ability to
will we turn a corner in policies that election, and provincial elections after pivot in ways
affect access and domestic capacity? that, at Neighbourhood Pharmacies that are not
Pharmaceutical policies have generally we will build upon our hard-earned feasible in
been very price focussed. The pandemic experiences of the past year to continue
the public
’’
has demonstrated that we need to be to enable solutions that benefit
more value focussed to better leverage pharmacy, the public healthcare system system.
the strengths of innovation in this sector. and, most importantly, Canadians.
3 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
COVER STORY By Karen Welds
Off to the races
What to expect as A federal election this fall is pretty much a safe bet—and
regardless of which party crosses the finish line first,
federal parties round healthcare may turn out to be the biggest winner.
the bend to election day Or not.
As with all things political, one feels compelled to counter
any prediction with its opposite. And yet…COVID-19 changes
everything. The election will revolve around this black swan event.
4 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
COVER STORY
While healthcare is generally a default issue during although long-term care reform, economic
election campaigns, it could be a defining issue this resilience (including domestic manufacturing),
time around (even if edged out by economic recovery in debt repayment/taxation and the environment
the end). will certainly vie for attention.
The fact that healthcare is a provincial responsibility With that in mind, the federal government’s
will likely have no bearing: thanks to the pandemic, April budget caused a considerable amount of
Canadians are more attuned to the workings—and head-scratching. While its focus on continued
shortcomings—of our federalist system. They have efforts to support those hardest hit by COVID-19 is
new questions and concerns, which deserve new—and understandable, its relative silence on some of the
better—answers. bigger-picture issues could be described as a misfire.
At least, we can hope. “For its first budget in two years, there was a lack of
After interviewing political pundits and assessing vision, a lack of innovation and a lack of key Liberal
the odds based on the latest polling, Neighbourhood spending priorities to bring the country back from the
Pharmacy Gazette offers the following analysis of the brink,” notes Summa Strategies in its April blog. Adds
upcoming federal race, including a look at the potential Coletto: “This was not a budget that will win over a lot
gains for pharmacy. of voters, at least not in the
short term.”
‘‘
The timing The budget’s most visionary
Canadians want to hear a
All four of our experts agree item, at least according to
that a federal election will deeper conversation about our media coverage and public
probably happen this fall. health system now that they awareness, was a universal
“Minority governments tend realize how vulnerable, and system for early learning and
to take on a certain lifespan childcare. “While you can
perhaps weak, it can be when
’’
and we are past their average debate the merits of national
length of stay. All of the
put under intense pressure. childcare as a solution to
parties are getting ready,” says a real problem, I’m not
Don Guy, owner and Chief convinced it’s as politically
Strategist, Pollara Strategic Insights. powerful as other policies might have been,” observes
Until now, the pandemic has stayed all parties’ hands. Coletto.
Come the fall, the timing should be right for the Liberal An Abacus poll conducted shortly after the budget
government. “Once we get to a situation where many asked Canadians what issues they’d like the political
Canadians have been vaccinated and the economy will parties to discuss in an election that could happen this
likely be picking up, that would be a natural window for year. Out of 12 possible options, affordable childcare
an election,” notes Nik Nanos, founder and Chief Data was last, after relations with China. Healthcare, the
Scientist, Nanos Research. economy and fair taxes were the top three issues.
Recent polling by Abacus Data indicates that the Here’s what else our experts have to say about some
incumbent government would be wise not to wait until of the issues that will likely come up during election
2022. “While the numbers aren’t really bad for the federal campaigns:
government, they’re not incredibly positive either. And a Healthcare – COVID-19 may push healthcare
lot is assessed through the lens of the pandemic. What discussions beyond the usual partisan platitudes.
that suggests is that the top issues of the day are all “What Canadians learned through the pandemic is that,
potential pain points for the government, the further we although they are comfortable with their provinces
get away from the worst of the pandemic,” explains David and public health authorities making decisions on the
Coletto, founding partner and CEO, Abacus Data. ground, there needs to be a federal strategy. We want
to cooperate as a country as much as possible,” notes
The issues Nanos.
Economic recovery and better healthcare will likely “Canadians want to hear a deeper conversation
emerge as the top two issues on the election trail, about our health system now that they realize how
5 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
COVER STORY
vulnerable, and perhaps weak, it can be when put What Canadians want the parties
under intense pressure,” echoes Coletto. to discuss in a federal election
The party that successfully taps into that may capture
hearts and undecided voting minds. Improving healthcare 68%
Mental health in particular could be a litmus test. Growing economy; creating
good-paying jobs 68%
Canadians polled in November 2020 most often
cited mental health as a top healthcare priority for Fairer tax system; ensuring
rich/corporations pay fair share 64%
governments, second only to COVID-19 itself, reports
Pollara Strategic Insights. Reducing taxes for middle/
working-class Canadians 63%
“Early signals are that mental health will be a significant
Ensuring we are prepared for
commitment from all parties, including the Conservatives. future pandemics 61%
That’s noteworthy because historically the Conservatives
Improving self-sufficiency when
don’t make a lot of commitments in healthcare since 59%
it comes to drug manufacturing
they see that as a provincial responsibility,” says Michelle
More affordable housing 55%
McLean, General Manager, Hill+Knowlton Strategies
and National Health and Wellness Lead, Hill+Knowlton Reducing federal budget deficit 53%
Strategies. “Having said that the Conservatives did
Fighting climate change;
create the Mental Health Commission of Canada transition to cleaner economy 48%
in 2007, when very few governments were making
Improving agriculture/
significant investments in mental health.” 45%
food production
As for the provinces, their demands for more funding
How we deal with China 37%
from the Canada Health Transfer, no strings attached,
are as vocal as ever (see “Meaningful progress finally in More affordable childcare 33%
sight for health funding?”, page 13). Within the context
of a federal election that’s under a pandemic’s shadow, Source: Abacus Data, April 21-28
however, the usual debate over jurisdiction may be
muted. its poll asking Canadians to choose the most important
“It will all depend on where we sit come election healthcare priorities, Pollara found that a national
time. If vaccinations are rolling out and the economic universal pharmacare program ranked eighth.
trajectory is positive, the provinces will probably “The pandemic pressed a pause button, and
support the approach of ‘how do we work together we can use this time to educate Canadians,” says
for the future?’ Ontario and Québec especially will Sandra Hanna, CEO of Neighbourhood Pharmacies.
be watching closely because they will probably have “Considering the major financial investment required to
their own elections next year. They won’t want to say implement a single payor model, a more cost-effective
anything that may come back to bite them,” observes solution would be to build upon the current system,
Nanos. which works for the majority of Canadians.” (See
Pharmacare – Before the pandemic, the “Raising conversation on pharmacare,” page 16).
Liberals and New Democratic Party It will be interesting to see the direction
(NDP) were grooming national of conversations should
pharmacare to be a major pharmacare come up during
issue come the next federal campaigning. “I expect
federal election. Today, pharmacare to come back with
not so much. While still a twist, as part of talks about
on the agenda for both the resiliency of our healthcare
parties, it’s expected system,” says Nanos. “The
to cede way to more pandemic should be a great big
urgent matters based wake-up call that governments
on public opinion. In need to work in partnership with all
6 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
COVER STORY
stakeholders that provide medicines, medical devices, for how much longer? These are some of the key
vaccinations and other therapeutics. Otherwise, you questions to be debated,” notes Guy.
have a system that is not working the way it should.” Funding, taxation and budget management will
Long-term care – In her budget speech, Deputy Prime be intertwined within the discussion about economic
Minister and Minister of Finance Chrystia Freeland recovery. “The push and pull of all of this will be a
apologized to residents of long-term care (LTC) facilities. challenge for all the political parties. It will be a very
“We have failed so many,” she said. politically difficult conservation to have with prospective
As with mental health, all parties are expected voters,” notes Coletto.
to present an approach for long-term care reform. Closely tied to economic recovery is the new topic
The Liberal government’s budget commitment of $3 of economic resilience, as most Canadians
billion for national LTC standards, “to help ensure that experienced disruptions in the supply chain during
provinces and territories provide a high standard of the pandemic. “The pandemic has sensitized
care,” could also be a harbinger of its approach in other Canadians to the need to have secure local capacity in
areas of healthcare. critical therapies like vaccines, in manufacturing and
Economic recovery & resilience – Given the timing, distribution,” says Guy.
economic recovery will likely dominate political debates. The environment – Where does all of this leave the
The Liberal government has previewed some of its environment? Before the pandemic, all indicators
details in the budget, which the Conservatives will pointed to climate change as a defining issue for the
castigate while explaining their own plan. next election. However, the April Abacus poll placed it
“What is the role of government in the economic ninth out of 12 possible election issues that Canadians
recovery? Where should future stimulus be applied and want discussed.
Working Together
to Put Canadians First
We are committed to maintain inventory
levels above the industry average.
We have one of the largest
product portfolios in Canada.
We are a leader in product
launches in Canada*.
Your partner in building
a healthier Canada
*Number of new notices of compliance, from January 1st, 2020 to December 31st, 2020. (Public information available on Health Canada’s website.)
7 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
COVER STORY
“Personal health and economic health have knocked the Liberals and Conservatives,” says McLean.
environmental health off the top perch. But if those two “Québec is so seat-rich that all parties will be
factors start to stabilize by the time of the election, the focused on Québec.”
environment could be the sleeper issue,” says Nanos. “It The Liberals will also be hard-pressed to pick up
could come roaring back.” votes from the NDP. “The leader of the NDP has strong
approval ratings and the NDP and Liberals will mirror
The results? each other more often on a policy front,” says McLean.
It’s impossible to predict results of course. Polling by “The best-case scenario for the NDP is another minority
Nanos and Abacus for early May—when provinces were parliament in which they have the balance of power
in extended lockdowns and vaccine supplies were still and they’re building a narrative—that they are looking
stuttering for momentum—suggested this could be out for working-class Canadians—to achieve that.”
an election for the Liberals to lose. However, public What about the Conservatives? The election will be
opinion will likely turn around as jabs finally get into many Canadians’ introduction to their new leader and
arms and restrictions lift. the party is not a natural second choice for waffling
Whether Parliament Hill is red or blue come election Liberal or NDP votes. “They will have to make some
day, the quest for a majority government is an uphill pledges outside of the economy—on climate change, on
battle unless major changes happen in Québec. At this healthcare—to build their base,” notes McLean.
point, that’s not likely. “Right now the Bloc Québécois Conservative leader Erin O’Toole has promised
is still polling pretty strongly and if they run a strong more progressive policy commitments, but in doing so
campaign they will cause no end of problems for has ruffled feathers within the party. “There is a very
Wixela Inhub (fluticasone propionate and Large dose
100 mcg / 50 mcg salmeterol inhalation powder, USP)
counter window
Wixela Inhub (fluticasone propionate and Device lockout
100 mcg / 50 mcg 250 mcg / 50 mcg 500 mcg / 50 mcg 250 mcg / 50 mcg salmeterol inhalation powder, USP) after final dose
Generic alternative to Wixela Inhub Similar steps as
ADVAIR® DISKUS®
(fluticasone propionate and
500 mcg / 50 mcg salmeterol inhalation powder, USP) ADVAIR DISKUS
View the instructional How-To-Use video at WIXELA.CA
Wixela® Inhub® (fluticasone propionate/salmeterol) is a combination of an inhaled corticosteroid (ICS) and a long-acting beta2-adrenergic agonist (LABA) indicated for the maintenance treatment of asthma,
in patients with reversible obstructive airways disease. Wixela Inhub should be prescribed for patients not adequately controlled on a long-term asthma control medication, such as an ICS, or whose disease severity clearly warrants treatment
with both an ICS and a LABA.
Wixela Inhub 250 mcg/50 mcg and Wixela Inhub 500 mcg/50 mcg are indicated for the maintenance treatment of COPD, including emphysema and chronic bronchitis, in patients where the use of a combination product is considered
appropriate.
Consult the Product Monograph at https://health-products.canada.ca/dpd-bdpp/index- eng.jsp for more information about:
• Contraindications regarding IgE mediated allergic reactions to lactose or milk, patients with cardiac tachyarrhythmias, patients with untreated fungal, bacterial or tuberculous infections of the respiratory tract and in the primary treatment of
status asthmaticus or other acute episodes of asthma
• Other relevant warnings and precautions regarding serious asthma-related events (hospitalizations, intubations, death), treating acute symptoms of asthma or COPD, excessive use and use with other LABA products, abrupt stop of
treatment, caution in patients with cardiovascular disorders, central nervous system effects, symptoms of laryngeal spasm, irritation, or swelling, caution in patients who are transferred from systemically active corticosteroids to inhaled
corticosteroids, systemic endocrine effects, reversible metabolic changes, eosinophilic conditions, enhanced effect of corticosteroids on patients with cirrhosis, immediate hypersensitivity reactions, candidiasis, masking some signs of
infection and new infections, serious course of chickenpox and measles,glaucoma, cataracts, central serous chorioretinopathy, paradoxical bronchospasm, pneumonia (COPD Patients) and active monitoring during long term therapy
• Conditions of clinical use, adverse reactions, drug interactions and dosing instructions
The Product Monograph is also available by calling 1-844-596-9526.
ADVAIR and DISKUS are registered trademarks of Glaxo Group Limited.
WIXELA and INHUB are registered trademarks of Mylan Pharmaceuticals ULC, a Viatris company.
VIATRIS and VIATRIS & Design are trademarks of Mylan Inc., used under permission by Mylan Pharmaceuticals ULC, a Viatris company.
©2021 Viatris Inc. All rights reserved.
WIX-2020-0076B – AL2021
8 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
COVER STORY
strong social conservative element of the party that Because pharmacy is demonstrating its value and
is uncomfortable with some of the positions he has providing tangible solutions in all the right areas.”
taken, specifically on climate change. This is a problem “The role of pharmacy and pharmacists
because if the party has to spend a lot of energy on will be very much top of mind as it’s been primed
keeping the party united then they can’t spend that by pharmacists stepping up during the pandemic,
energy on the campaign trail,” says McLean. especially now for vaccinations,” agrees Guy. “Trust
Uncertainty is also anathema in today’s environment. that was already high has been deepened, leaving
“In 2015, the change agenda came through really Canadians open to pharmacists providing a wider range
strongly. But that change agenda doesn’t exist during a of services than ever.”
pandemic. People are looking for security and stability Adds Nanos: “Pharmacy has solidified its position
and certainly the Liberals are positioning themselves as part of the frontline of delivering healthcare. You
to ‘build back better’ on that premise,” summarizes need to continue to say, ‘What can we do to support
McLean. better healthcare outcomes? To support our healthcare
On the other hand, unlike death and taxes, nothing partners as part of the system? We’re ready to help.’
is certain in politics. “Campaigns really do matter. All The pharmacy is basically a community health hub, and
parties must ensure there are no unforced errors. I can’t see that turning back.”
Anything can happen between now and then,” she
concludes.
Where pharmacy fits Tools for grassroots advocacy
Whatever the outcome, community pharmacy is Neighbourhood Pharmacies’ Healthcare Advocates
poised to benefit from the heightened, more nuanced Program provides members with resources to support
conversation around healthcare, which will feed pharmacists who wish to educate and lobby political
advocacy efforts at national and provincial levels. candidates at the grassroots level. The program
“Canadians have become more sensitive to the public includes advocacy and media training, leave-behind
system and the need to better coordinate its strengths. documents and templated communication pieces.
Policy makers and health system partners now have For more information, contact Jennifer Deschenes,
many proof points to show how this must include the Director, Communications & Stakeholder Relations,
integration of pharmacy,” says Hanna. “Regardless of info@neighbourhoodpharmacies.ca.
who wins we won’t really need to change our advocacy.
SAVE
THE
DATES OCTOBER 4 – 8 NOVEMBER 9 – 10
9 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
Content supplied by the Health Products Stewardship Association
Let’s talk about safe disposal
As part of the fight against the
Courtesy of Seasons Pharmacy and Culinaria, Sudbury, Ontario
opioid crisis, remind patients to
return unused medications
O
pioid stewardship has become increasingly important
during the COVID-19 pandemic. Reminding your
patients that they can bring back unused or expired
medications is a simple step to help fulfill that role.
“I pay special attention when someone is undergoing
treatment for cancer or receiving end-of-life care at home,”
says Rachelle Rocha, pharmacist and co-owner of Seasons
Pharmacy and Culinaria, part of the Whole Health Pharmacy
Partners group, in Sudbury, Ontario. “First and foremost, this
is an opportunity to extend compassion and support. And
when the time is right, I gently remind them or their caregivers
to bring back any unused medications. In most of these bags
Pharmacies on board
there are narcotics and other controlled drugs.”
Recent data from the Government of Canada confirm
90%+ Pharmacies registered in
HPSA’s programs in the provinces where
that hospitalizations and deaths due to opioid poisoning have available (B.C., Manitoba, Ontario, P.E.I.)
increased since the start of the pandemic.1 A 2018 study found
that one in three opioid-related deaths involved people with
active opioid prescriptions.2 all forms and promotional materials are on HPSA’s website
Prescribers (including veterinarians) can refer patients (healthsteward.ca). “The program is super easy,” says Rocha.
to a pharmacy for the safe disposal of all unused or expired “We are global leaders in this space, especially with our
medications, including topical and liquid medications, sharps program,” says Terri Drover, Director-General of the
nonprescription drugs, vitamins and supplements. Some also HPSA. “Our program will expand as more provinces enact
accept used sharps. However, it’s important for patients to EPR regulations. Manufacturers welcome the framework this
confirm their drop-off pharmacy before leaving their home puts in place to encourage consumers to safely dispose of
with bags full of medications. consumer health products.”
The likelihood of multiple potential drop-off sites is In Rocha’s pharmacy, consumers empty their bags in a smaller
highest in B.C., Manitoba, Ontario and P.E.I. Their respective bin at the pharmacy counter and then a staff member transfers
provincial governments have legislated Extended Producer the contents to the program’s large bin in the dispensary, where
Responsibility (EPR) programs that require manufacturers of it’s not accessible to the public. If people just drop off a bag,
consumer health products to be responsible for and fund the staff wear gloves and use a tong when checking the contents to
safe disposal of their products. Manitoba, Ontario and P.E.I. lessen the risk of accidental punctures or cuts.
also have EPR programs for medical sharps disposal. Opioids can be placed in the collection bin with all other
The Health Products Stewardship Association (HPSA) medications. Or the pharmacy can separate them out and use
executes these programs on behalf of manufacturers. There their usual commercial provider for disposal. “We decided to
is no cost for pharmacies to become a collection site, and take that extra step because we did not want the large bin to
be a source of temptation for anyone,” says Rocha.
She adds that while people readily understand the importance
Weighty matters of proper disposal, they need to be nudged. “We just posted
a reminder on our social media and dozens of people came in
with bags. Reminders are definitely worthwhile.”
3.5 million
Collected and
safely disposed 1. Opioid- and Stimulant-related Harms
in Canada. Government of Canada.
kilograms of medications of by the Public Health Infobased. 2020 Dec.
Health Products https://health-infobase.canada.ca/sub-
stance-related-harms/opioids-stimulants
Stewardship
2 million
2. Gomes T, Khuu W, Martins D, et al. Contri-
Association since butions of prescribed and non-prescribed
it was established opioids to opioid related deaths: popu-
kilograms of sharps in 1999
lation based cohort study in Ontario,
Canada. BMJ 2018;362:k3207.CONFERENCE: EXECUTIVE SUMMIT
Exploring Canada’s
road to recovery
Economically speaking, Canada should do
“extremely well” in the second half of the year
and into the new year, said Benjamin Tal, Managing
Director, Deputy Chief Economist, CIBC World
Markets Inc., at Neighbourhood Pharmacies’ virtual
Executive Summit on May 11. He was joined by several
other thought leaders who shared their insights on what
could (or should) happen in the economy, the healthcare
system and the white-collar workplace.
Tal expects a strong economic rebound for three
reasons:
1. The damage caused by the pandemic-induced
recession was “very deep but also very narrow.” In
other words, the relatively low number of industries
impacted predicts a rapid pace of recovery relative to
previous recessions.
2. All of the damage was in the services sector, which
Neighbourhood Pharmacies’ virtual Executive Summit 2021:
can bounce back more easily than the goods sector. Top photo: Panelists Terry Lake, BC Care Providers Association;
3. Pent-up demand is high among middle- and high- Lindsay Finneran-Gingras, Hill+Knowlton Strategies; Goldy Hyder,
Business Council of Canada; and moderator Michelle McLean,
income households. “We are sitting on a mountain of Hill+Knowlton Strategies; Bottom left: Benjamin Tal, CIBC World
cash,” noted Tal. “Most of it will go to services, which Markets; Bottom right: Richard Florida, urbanist
is exactly where you want it.”
Who will pay for the extra $100 billion-plus in Government spending as a percentage of GDP, which
spending by government? “The short answer is soared to 35 per cent compared to the usual level of
nobody,” said Tal. “The reality is that governments really about 15 per cent, will eventually stabilize at about
never pay down debt. They roll it over and refinance it.” 18 per cent, predicted Tal. This reflects the likelihood
Having said that, today’s extremely low interest rates that changes initiated or accelerated by the pandemic
are not likely to last. “The trick is not to raise interest will continue (for example, revamped unemployment
rates too quickly…or wait too long, because inflation is insurance). “We are putting together the infrastructure
a lagging indicator.” for tomorrow’s social assistance program,” noted Tal.
Consumer spending will be closely monitored in the “This permanent increase in government spending will
coming months. “The minute they start spending, you eventually lead to an increase in taxes.”
have to remove liquidity from the system….The issue
is to what extent the Bank of Canada and the federal Stronger on the other side?
government will be able to remove all this stimulus A panel discussion moderated by Michelle McLean,
from the market to avoid a significant increase in General Manager of Hill+Knowlton, Ottawa, explored
inflation,” noted Tal, who expects an inflation rate some of the healthcare-related lessons that need to be
of three to three-and-a-half per cent by the end of learned from the past year—and what needs to happen
the year. to aid Canada’s recovery.
11 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.caCONFERENCE: EXECUTIVE SUMMIT Panelists spoke of a disjointed healthcare system Improving healthcare also means harnessing and a lack of consistent government messaging that the best of what happened during COVID-19 have negatively impacted public trust. “The fact the (e.g., virtual care) and building upon it. “It’s not city of Toronto had to partner with a Twitter account that every interaction with a pharmacist or physician to communicate how Ontarians can get vaccines is has to be done virtually, but we have to be able to use astonishing,” said Lindsay Finneran-Gingras, Vice- technology better,” said Lake, who added that there’s a President, Social and Digital, Hill+Knowlton Strategies. need to “empower pharmacists” even more in providing “It speaks to our lack of communication and digital essential public services such as vaccines. infrastructure.” “When you think about what we can enact quickly in While other countries found creative ways to thwart times of crisis…pharmacies were already there,” said virus spread (i.e., contact tracing), Canada’s lack of Finneran-Gingras. “That trust has already been built.” innovation caused it to lag behind. Goldy Hyder, And even as access to digitized healthcare grows, President and CEO of the Business Council of Canada, the value of community-based, brick-and-mortar pointed to lost opportunities by not looking to the pharmacies will also grow, she added. private sector for ideas or not learning from past experiences with epidemics such as SARs. “We will want The post-pandemic city an autopsy on the pandemic...then the key is execution “We’re going to see a shift from what is now a central and what we do with it,” he said. “In order to build back business district to a central social or networking better, we need to be better and do better.” district,” noted urbanist Richard Florida in speaking Part of rebuilding means taking a serious look at about work life post-COVID-19. “The office is no longer senior care, which has been grossly neglected, noted just a place to work…it’s a place for social interaction, Terry Lake, CEO of the BC Care Providers Association. context and collaboration.” “We spend 30 per cent less than other OECD countries Florida, researcher and professor at the University in seniors’ care and that led to a tremendous health of Toronto and co-founder of CityLab, a publication human resource challenge across Canada,” he said. devoted to cities and urbanism, said that the With most healthcare costs happening at the end skyscrapers and office parks of pre-pandemic times of life, Hyder said it’s essential to engage the public may be revamped into communities with unique in “adult conversations” about what they need from eateries, wellness centres and other amenities in order their healthcare system as they age and how they to entice employees to leave their work-from-home can work with governments to make it happen, rather setups. Transformation may also occur in suburbs, rural than making them feel that money is going to solve areas and even parking lots as employers seek to create all their problems. collaborative work spaces closer to home. 12 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
INSIGHTS: HEALTHCARE FUNDING By Steve Vander Wal
Meaningful
progress
finally in sight
for health
funding?
Provincial premiers demanding more money for the usual dynamic of provincial resistance to federal
healthcare is a tale as old as time itself. But as interference. When the dust settled, first ministers had
the third wave of the COVID-19 pandemic tested the an agreement for new healthcare funding with a six
limits of our health systems, the need has never been per cent increase each year. But instead of ironclad
greater for our federal and provincial leaders to finally commitments for change from the provinces, the
figure out how to make meaningful progress. Will the federal government had to settle for monitoring and
pandemic help create a time of blissful agreement publicly reporting on provincial compliance.
among our leaders? History tells us the hill ahead is After becoming prime minister in 2006, Stephen
steep, but a crisis often creates the momentum needed Harper implemented exactly half of Paul Martin’s plan.
to break logjams in politics. He continued to increase health transfers by six per
When Medicare became a national program in 1957, cent a year and even tacked on two extra years for
the federal government agreed to cover half the cost good measure. However, he did not monitor provincial
of hospital care on the condition that there were no compliance, arguing provinces knew best how to run
user fees, and that access was universal. Physician fees their healthcare systems. He also refused to discuss
were added in 1965 with the same conditions. health funding with premiers, recognizing this was likely
This funding formula evolved through the years a no-win situation.
along with changes to the health system and new Even with this new money, provincial finance
elements such as prescription drugs and seniors’ care. ministers watched as health budgets steadily gobbled
The federal government eventually agreed to lump up a growing ratio of their budgets due to higher rates
all health and social funding into one line item, which of chronic disease and other factors. Many argued that,
premiers liked as it gave them maximum flexibility. without drastic action, health would eventually squeeze
out other priorities.
The perpetual tug-of-war As provinces fretted about cost pressures to their
Paul Martin was elected prime minister in 2004 after health budgets, the federal government continued to
committing to fix healthcare for a generation. His dream of ways to improve and standardize healthcare
strategy offered increased health transfers only if for Canadians. Justin Trudeau has in recent years been
premiers agreed to make specific changes in their advocating for the creation of a national pharmacare
healthcare systems. This plan soon derailed given program, arguing it will expand access to critical drug
13 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.caINSIGHTS: HEALTHCARE FUNDING
therapies and help fill gaps in provincial drug coverage. should agree to add another $4 billion per year
He likely knows this strategy will allow Ottawa to get to maintain this ratio. When first ministers met
more credit from voters for the new dollars it would in December, Trudeau promised to increase the
be contributing. As well, national standards for seniors’ federal share of funding for healthcare but only after
care were always part of the the immediate crisis of the
conversation but has now pandemic.
taken on more urgency given
the gaps exposed by COVID-19.
Coming to a increase
‘‘
When first ministers met in
December, Trudeau promised to
the federal share of funding
On March 21, the federal
government came through
with legislation to provide an
additional $4 billion through
crossroads? for healthcare but only after the the Canada Health Transfer.
Last year premiers went on the
offensive again, arguing that
the federal funding share had
immediate crisis of the pandemic.
continued to slip. They said they were now spending
’’ The federal budget tabled
on April 19 confirmed the
government’s intent to move
forward on this. While this is a single-year increase,
$185 billion collectively on healthcare while the total Trudeau has since gone on record stating that his
Canada Health Transfer was only $42 billion, or 22 government will increase transfers for the long term,
per cent. Their joint position was that Ottawa should but decisions on the details will have to wait until the
increase its funding to a more equitable 35 per cent worst of the pandemic is over.
of provincial health spending, which would increase A federal election before the end of the year seems
federal funding to $70 billion. They also argued the feds like a strong possibility. The federal government’s
14 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.caINSIGHTS: HEALTHCARE FUNDING
overall response to COVID-19 will likely B.C. would chart its own course
be the ballot box question if the Liberal and urge others to follow. Alberta
government has its way. However, would likely set its own agenda
voters will more likely want to focus and not care if anyone follows. Québec
on the different parties’ economic would simply ask for the money and
recovery plans. A stronger healthcare ignore any direction from Ottawa.
system, ready for whatever the future Or, has COVID-19 created the crisis
holds, will also be a big part of the that will change history and finally start
election narrative. a new chapter on federal-provincial
The Liberal federal government is relations when it comes to health
prepared to contribute more money funding? Regardless of which party wins
to the Health Transfer but will want national standards the coming federal election, will the gaps exposed in
and public acknowledgment from the provinces so our healthcare system in the past year finally bring
voters know where the funding comes from. Provinces our leaders together to consider solutions in a new
want more cash to help meet existing budget pressures light? Time will tell—and for a change, that may happen
but will resist federal interference and new conditions. sooner than later.
If new federal cash for healthcare is on the table in
the future, how will provinces react to any conditions?
With history as our guide, Atlantic provinces would be Steve Vander Wal is Vice-President at
the first to agree to new funding and any strings that Hill+Knowlton Strategies. Prior to that he was
come attached. Ontario would likely use its sheer size to a political advisor to three British Columbia
help steer the national agenda to suit its interests, while Ministers of Health.
The most
heart-warming video
you’ll see today
Caregivers go to amazing lengths, embracing
their changing role to bring care and joyous
moments to a loved one as their health changes.
To watch the video and see the inspiration behind
our caregiver commitment scan the QR code or visit
TevaCanada.com/Caregivers. Watch Video
15 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.caADVOCACY: PHARMACARE
Raising conversation
about pharmacare
Neighbourhood Pharmacies’ position statement on a national pharmacare
program outlines the top priorities and benefits of our position for
governments, Canadians and other stakeholders. Below is a summary, including
recommended actions, with the full statement available on our website.
All Canadians deserve access to the medications
they need without financial barriers. Opportunities New awareness campaign
exist to improve access for the minority of Canadians
Neighbourhood Pharmacies has partnered with
with no coverage or insufficient coverage. This is
the Canadian Life and Health Insurance Association
best achieved through federal-provincial-territorial
and the Conference for Advanced Life Underwriting
collaboration that builds upon current public and
to launch KeepMyPlan.ca, a grassroots advocacy
private plans, rather than a new, single-payor national
campaign that encourages Canadians to express
pharmacare model that would disrupt the majority of
their concerns about the federal government’s
Canadians who already have drug coverage.
proposed single-payor pharmacare plan and the
Canada’s pharmacies serve millions of patients across
risk it proposes to existing benefits.
the country, and the sector has a deep understanding
of the current landscape of public and private programs
for drug coverage, including its gaps. While complex, the national pharmacare, the level of support drops to just
current system works well and is reliable. 25 per cent when the model is a program that would
Canadians agree. Among the 86 per cent who replace all existing government and private plans.
report having coverage, 80 per cent are satisfied with Rather than pursue single-payor national
their current primary plan, according to a survey pharmacare, the federal government can show
commissioned by Neighbourhood Pharmacies and leadership by establishing guiding principles for the
conducted by Pollara Strategic Insights in November provinces and territories. The overarching objective
2020. On the other hand, 72 per cent are concerned of these principles is to ensure basic coverage for
about the potential impact of national pharmacare on all Canadians regardless of where they live, their
their current coverage. Furthermore, while 82 per cent employment status or income level.
of Canadians are generally supportive of the concept of
RECOMMENDATIONS FOR GOVERNMENT
• Prioritize coverage for the uninsured and
“National pharmacare is so complex that it’s underinsured, particularly for those needing
largely misunderstood or misrepresented medications to treat rare diseases.
when conversation goes beyond the concept • Build upon current federal-provincial-territorial
of ‘drug-coverage-for-all.’ We are working to efforts to work together to close gaps in coverage,
educate Canadians and decision-makers on while ensuring continuity of coverage for those who
the advantages of an approach that builds already have it.
on existing public and private plans.” • Develop national principles to ensure an equitable
—Sandra Hanna, RPh., CEO, Neighbourhood Pharmacies approach, while maintaining the integrity of existing
provincial and private plans.
16 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.caINSIGHTS: COVID-19
Role of community pharmacy
in COVID-19 vaccinations
Information current as of June 1, 2021
# (%) Pharmacy doses
Vaccines (by Eligibility by age Provincial fee for
Start date pharmacies as % of total
manufacturer) (dose one) administration
registered (estimate)
667 • AstraZeneca
British Columbia Mar. 31 • 30+ $18 Not available
(48%) (second doses only)*
• AstraZeneca
• AZ: 40+
1,400 (second doses only)*
Alberta Feb. 24 • M: 18+ $25 41%
(93%) • Moderna
• P: 12+
• Pfizer
368 • Moderna • M: 18+
Saskatchewan Apr. 29 $20 13%
(92%) • Pfizer • P: 12+
• AstraZeneca • AZ: 40+; 30+ with health
315
Manitoba Mar. 15 (second doses only)* conditions $20 1%
(73%)
• Moderna • M: pilot phase
• AstraZeneca
• AZ: 40+
2,490 (second doses only)*
Ontario Mar. 12 • M: 18+ $13 12%
(53%) • Moderna
• P: 12+
• Pfizer
• AstraZeneca
1,500 • AZ: 45+
Quebec Mar. 22 (second doses only)* $17.10 Not available
(78%) • M: 18+
• Moderna
• AstraZeneca
• AZ: 55+
218 (second doses only)*
New Brunswick Mar. 11 • M: 18+ $15 39%
(94%) • Moderna
• P: 12+
• Pfizer
• AstraZeneca
• AZ: 40+
295 (second doses only)*
Nova Scotia Mar. 9 • M: 18+ $16 50%
(95%) • Moderna
• P: 12+
• Pfizer
• AstraZeneca
Prince Edward 19 • AZ: 55+
Mar. 11 (second doses only)* $15 Not available
Island (38%) • M: 18+
• Moderna
Newfoundland 160
June 1 • Moderna • 18+ $13 Not available
& Labrador (81%)
AZ = AstraZeneca; M = Moderna; P = Pfizer
* Administration of first doses of AstraZeneca vaccine paused due to
supply issues and/or out of an abundance of caution
Sources: Neighbourhood Pharmacies, COVID-19 Vaccine Distribution Tracking;
provincial pharmacy associations; National Association of Pharmacy Regulatory
Authorities (pharmacy counts)
17 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.caINSIGHTS: VACCINE HESITANCY By Shelita Dattani, PharmD., RPh. From vaccine hesitant to vaccine confident History shows that vaccination greatly reduces the burden of infectious diseases. Only clean water, considered to be a basic human right, performs better.1 Despite the evidence supporting vaccination, Canadians have become much more familiar with the concept of “vaccine hesitancy” in the past year. The term has moved to the forefront for healthcare providers, the media and the public because the pandemic clearly demonstrates that attitudes and behaviours toward vaccination are not binary (i.e., you are either for or against vaccination). Vaccine hesitancy describes a spectrum of attitudes, beliefs and uncertainties, and our efforts to “move the middle” reports that vaccine safety consistently gets more are paramount to get out of the COVID-19 pandemic public attention than vaccine effectiveness as a reason and return to some semblance of normalcy. for vaccine hesitancy. We have reason to be hopeful. Over 80 per cent of In March, vaccine hesitancy took a sharp turn. Canadians surveyed by Leger and the Association for Reports on the Oxford-AstraZeneca vaccine indicated Canadian Studies in April say they have been vaccinated a rare but potentially fatal link to blood clots, or intend to get vaccinated against COVID-19, a number known as vaccine-induced prothrombotic immune that has been rising consistently for several months as thrombocytopenia (VIPIT). The National Advisory vaccines have been rolling out in Canada and across Committee on Immunization (NACI) recommended that the world. An Angus Reid poll in May similarly states the AstraZeneca vaccine be limited to those 55 and that 82 per cent of Canadians have had their first dose older to allow time to review the potential link between or would like to be vaccinated as soon as possible. As the vaccine and VIPIT. of May 29, the Public Health Agency of Canada reports We saw the new phenomenon of “vaccine shopping” that 68 per cent of Canadians aged 18 and older have emerge. An Angus Reid poll in April found that among received at least one dose of a COVID-19 vaccine. unvaccinated by willing Canadians, 52 per cent were Yet as the past few months have shown, vaccine uncomfortable with the AstraZeneca vaccine. And among hesitancy can vacillate in response to new events and them, 40 per cent would reject the vaccine if offered. new information—or misinformation. The main initial In mid-April, Health Canada attempted to reaffirm concerns behind vaccine hesitancy include the belief confidence in the AstraZeneca vaccine by stating that that the vaccines were approved too quickly, wariness the benefits of the vaccine greatly outweighed the risks about the mRNA technology and general concerns of COVID-19 in adults over the age of 18. Shortly after, about adverse effects and safety. Although vaccines are several provinces lowered their age eligibility criteria safer than medications, the World Health Organization for the vaccine to 40 years. Upon further review, NACI 18 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.ca
INSIGHTS: VACCINE HESITANCY
lowered its recommended age limit to 30 and
older in late April.
Social media exploded and, interestingly,
vaccine-confident generation-Xers across the country
flooded pharmacies, their booking sites and phone
lines to get vaccinated, a stark contrast in behaviour
compared to the hesitant over-55 crowd. While this
particular narrative is far from over—as evidenced by
some provinces’ recent decisions to stop vaccinating
with the AstraZeneca vaccine altogether until more
analysis is done, and the possibility that second doses
of the vaccine will be replaced with one of the mRNA
vaccines—it illustrates the twists and turns that can
stymie vaccine acceptance.
How healthcare providers engage the public is key.
Everyone’s life circumstances, health situations and
Nous sommes plus qu’une entreprise drivers of decision-making are different. Behavioural
pharmaceutique. Nous sommes des hommes et science tells us that responding to those drivers is a
des femmes d’ici, fiers de nos racines québécoises, more effective strategy to build vaccine confidence than
qui travaillent sans relâche pour le bien-être “telling” people what they should do.
des patients et des communautés chez nous
‘‘
et à travers le monde.
How healthcare providers engage the
public is key. Everyone’s life circumstances,
health situations and drivers of
’’
We are more than just a pharmaceutical company.
We are men and women proud of our Quebec roots, decision-making are different.
who work tirelessly for the well-being of patients
and communities here and around the world. Pharmacists and other healthcare providers can
consider the following approaches as they leverage
opportunities to influence the “moveable middle” from
vaccine hesitant to confident.
RACINES LOCALES. PORTÉE MONDIALE. 1. Weigh the risks. With the hesitancy conversation
TOUCHE HUMAINE. having shifted so much towards safety it’s important
to help the public weigh the risks of getting vaccinated
against the risks of COVID-19. The risk of dying or
LOCALE ROOTS. GLOBAL REACH.
being hospitalized due to COVID-19 is much greater,
HUMAN TOUCH. and it becomes astronomically greater in times of high
community transmission.
2. Appeal to social motives or other drivers. Evidence
demonstrates that appealing to the social responsibility
of protecting others can be a driver for vaccination.
Another driver might be to identify what the individual
is missing since the pandemic began, such as gathering
with relatives or attending social events. Help people
understand that the quickest way to get back to
normalcy is for 70 to 80 per cent of the population to
be vaccinated.
19 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.caINSIGHTS: VACCINE HESITANCY
3. Consider the influencer. Healthcare providers are and trust is very personal. Key influencers that
key influencers for vaccine uptake because of their build confidence may include community elders,
trusted relationships with patients. However, other faith-based leaders, family members or public
variables that may play into vaccine hesitancy include figures.
race, gender, age, socioeconomic status and political 4. Ensure it’s easy. Accessibility can play a tremendous
beliefs. Trust is the cornerstone to build confidence, role in nudging people to get vaccinated. Pharmacies
are an ideal location to increase uptake, with
convenient access to a healthcare provider who can
Resources to help educate, build confidence and help identify trusted
healthcare providers influencers in their communities.
support vaccine At the time of writing this we are slowly emerging
from a third wave in some provinces and people
acceptance and uptake: continue to die from COVID-19 at alarming rates across
• 19tozero (a coalition of multi-disciplinary experts) the country. Combating vaccine hesitancy needs to be a
full-time job, right now. Together, we have a lot of work
• CANVax (from Canadian Public Health Association)
to do. And together, we “have a shot” at getting it done.
• Centre for Effective Practice
1. Andre FE, Booy R, Bock HL, et al. Vaccination greatly reduces disease, disability, death and
• Health Canada inequity worldwide. Bulletin of the World Health Organization. 2008 Feb. 86(2):81-160. https://
www.who.int/bulletin/volumes/86/2/07-040089/en/ (Accessed May 2021)
CUE THE SPOTLIGHT!
Let’s generate some good news and applaud the
achievements of two individuals who go above and
beyond for the profession of community pharmacy.
Nominate a deserving recipient for the:
ABOUT THE AWARDS
• Len Marks Pharmacy Advancement Award
The Len Marks Pharmacy • Distinguished Associate of the Year Award
Advancement Award recognizes an
individual whose passion for the advancement
of pharmacy helps lead change in the areas of DEADLINE OF JULY 30, 2021
education, pharmacy practice, advocacy or collaboration.
The award was established in memory of pharmacist Len
Marks, who was an advocate for community pharmacy.
The Distinguished Associate of the Year Award honours an
associate partner who displays extraordinary commitment to
Neighbourhood Pharmacies’ initiatives and/or committees,
while helping advance community pharmacy.
20 // Neighbourhood Pharmacy Gazette // Spring 2021 neighbourhoodpharmacies.caYou can also read
