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Gazette
                                                                  WI N T E R 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

                                         Take
                                         Care
                                           WHAT YOU NEED TO
                                           KNOW ABOUT TODAY’S
                                           WELLNESS CONSUMER

                                            ALSO IN THIS ISSUE:

                                           Mental health
                                           road to recovery
Take Care - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - WHAT YOU NEED TO KNOW ABOUT TODAY'S WELLNESS CONSUMER - Neighbourhood Pharmacy ...
CONTENTS

           MESSAGE FROM THE CEO
                                         Winter 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     The deeper meaning
          of wellness in 2021
                                                                                             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

    5
                                                                                             info@neighbourhoodpharmacies.ca

          Take care                                                                         When sharing or reproducing content,
          Five traits you need to know about                                                    please ensure it is sourced to
          today’s wellness consumer                                                           Neighbourhood Pharmacy Gazette.

                                                                                                      EXECUTIVE EDITOR

10
           I N S I G H T S : M E N TA L W E L L N E S S
                                                                                                      Jennifer Deschenes
           Mental healthcare part
           of long road to recovery                                                                 CONSULTING EDITOR
                                                                                                        Courtney Secord

          A DVOC AC Y: 2020 Y E A R IN RE V IE W

12        How we made strides                                                                        MANAGING EDITOR
                                                                                                             Karen Welds

          in the year that was
                                                                                                          ART DIRECTOR
                                                                                                          Shawn Samson
           I N S I G H T S : C O V I D -19 VA C C I N AT I O N S

13         Canada’s maze for
           vaccine distribution
                                                                                                         CONTRIBUTORS
                                                                                               Anne Bokma, Matt Boudreau,
                                                                                            Jennifer Deschenes, Jeff Mehltretter,
                                                                                               Rosalind Stefanac, Karen Welds
           A D V O C A C Y : P O S I T I O N S TAT E M E N T S

16        Where we stand on
          current healthcare issues
                                                                                               ADVERTISING COORDINATOR
                                                                                                           Lucy Montana

           MEMBER Q& A : C A LG A RY CO - OP

18
                                                                                              Find us online
          All for one,                                                                         neighbourhoodpharmacies.ca

          one for all

                                                                                            We want to
          I N S I G H T S : N AT I O N A L P H A R M A C A R E          THE L A ST WORD

19        COVID-19 marks new
          path for pharmacare                                      22   A united
                                                                        voice is           hear from you!
                                                                        key to              Send us your ideas, opinions and
                                                                                           questions to help guide the content

                                                                        pharmacy’s          of the Gazette. We also welcome
                                                                                          submissions for contributed articles.

                                                                        future                              Contact us
                                                                                             info@neighbourhoodpharmacies.ca

2   // Neighbourhood Pharmacy Gazette // Winter 2021                                                                  neighbourhoodpharmacies.ca
Take Care - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - WHAT YOU NEED TO KNOW ABOUT TODAY'S WELLNESS CONSUMER - Neighbourhood Pharmacy ...
MESSAGE FROM THE CEO

The deeper meaning
of wellness in 2021
Before the pandemic, I regularly hit                   (page 13). Yet even so we are dogged by
the gym for my physical and mental                     the whisperings of doubt. Will enough
fitness. Not being able to continue to                 people get vaccinated in order to turn
do so was a huge adjustment, but I’ve                  this tide?
come to have a renewed appreciation                      Distrust is often a key factor
for slower paced activities that force me              underlying vaccine hesitancy: distrust in
to be more introspective and reflective,               the vaccine’s effectiveness and safety,
such as yoga and long walks.                           and for some a distrust in the healthcare
   Chances are we have all had to                      system. Public opinion polling by the
try something new, or try harder, to                   Canadian Pharmacists Association
                                                                                                   Sandra Hanna
maintain an even keel during this                      (CPhA) in December found that one in
                                                                                                   CEO
terribly unsettling time. As explored                  three Canadians plans to get the vaccine    Neighbourhood Pharmacy
in this issue’s cover story (page 5),                  as soon as possible and 48 per cent will    Association of Canada

personal wellness has taken on a much                  “wait a bit.”                                 416-226-9100

deeper meaning, particularly in the                      Healthcare providers are a vital bridge     info@neighbourhoodpharmacies.ca

                                                                                                     @pharmacy_CAN
area of mental health (page 10), yet                   for building trust and overcoming
it can be more challenging due to the                  vaccine hesitancy. The CPhA poll also
restrictions imposed by public health                  reinforced Canadians’ high level of
safety measures. We’ve had to refocus
our efforts. On the other hand, perhaps
this was long overdue in a world that
was so fast-paced that we may have put
                                                       trust in pharmacists as immunizers.
                                                       Speaking on behalf of the members of
                                                       Neighbourhood Pharmacies, I can add
                                                       that huge efforts are underway to help
                                                                                                   ‘‘
                                                                                                   The coming
                                                                                                   months
our needs last, especially for mental                  community pharmacists leverage that         will see a
wellbeing.                                             trust in order to instill confidence in     vaccination
   The definition of preventative care has             Canadians.                                  campaign
additionally evolved now that “infectious                March is Pharmacy Appreciation
                                                                                                   the likes of
disease” is part of our daily lexicon.                 Month, formerly known as Pharmacy
Hand hygiene and physical distancing                   Awareness Month. The new name
                                                                                                   which we’ve
will likely continue long after the                    reflects all that pharmacists have          never seen
pandemic is finally over.                              done—and continue to do—to adapt            before, and
   Vaccination against COVID-19 is a vital             to the changing healthcare needs of         pharmacy
part of that broader understanding of                  Canadians during a pandemic. Our
                                                                                                   will be
preventative care. The coming months                   wellness journey during this time is far
                                                                                                   integral to

                                                                                                                           ’’
will see a vaccination campaign the likes              from over, and I hope you agree that we
of which we’ve never seen before, and                  appreciate that pharmacists are with us     its success.
pharmacy will be integral to its success               every step of the way.

3   // Neighbourhood Pharmacy Gazette // Winter 2021                                                  neighbourhoodpharmacies.ca
Take Care - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - WHAT YOU NEED TO KNOW ABOUT TODAY'S WELLNESS CONSUMER - Neighbourhood Pharmacy ...
Welcome to the
               Neighbourhood
                          neighbourhoodpharmacies.ca

     Check out our new online home, renovated
        and refreshed to serve you better.
     It’s easier to locate our informative publications, including:
• Neighbourhood Pharmacy Gazette                          • “The Big Business of WELL” research report
• 2020 Year in Review: Stepping Up Together               • “A Primer on the Value of Specialty Pharmacy Services
• Our Position Statements (on public health capacity,       for Patients and Healthcare Systems in Canada”
  pharmacare and scope of practice, to name just a few)   • And more!
Take Care - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - WHAT YOU NEED TO KNOW ABOUT TODAY'S WELLNESS CONSUMER - Neighbourhood Pharmacy ...
Take
        COVER STORY              By Anne Bokma

Care

       5              traits you need to know about today’s wellness consumer

The stress, uncertainty and fear caused by COVID-19        and anxiety. The pandemic has reignited—and for
over the past year have dramatically affected              some, newly ignited—consumers’ quest for health and
consumer behaviour. Witness the bunker-style               wellbeing, for themselves and their loved ones.
mentality of stockpiling essential goods such as toilet      “Given the nature of COVID-19, one of the elements of
paper, the massive shift to online shopping and            restoring a sense of control and safety is managing your
the plethora of ways explored to combat isolation          health, especially when you are dealing with a disease
and loneliness, from virtual gaming with friends to        that preys on co-morbidities,” says Doug Stephens,
skyrocketing sales of outdoor gear.                        founder of the Hamilton-based retail consulting firm,
  A single driving force is behind all of these            Retail Prophet, and author of the forthcoming book,
behaviours: a renewed appreciation of the importance       Resurrecting Retail: The future of business in a post-
and fragility of health. A June 2020 survey by New York-   pandemic world.
based WSL Strategic Retail revealed that 73 per cent         “Combine this with the fact that we are already
of consumers worry they will get sick. Multiple other      dealing with a rapidly aging population and a large
surveys show skyrocketing rates of sadness, depression     group of baby boomers who don’t want to age the way

5   // Neighbourhood Pharmacy Gazette // Winter 2021                                           neighbourhoodpharmacies.ca
Take Care - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - WHAT YOU NEED TO KNOW ABOUT TODAY'S WELLNESS CONSUMER - Neighbourhood Pharmacy ...
COVER STORY

their parents aged—when you underpin this with the             “This is one of the biggest shifts we’ve seen
threat of COVID-19 and what it represents, that’s why       during COVID-19,” says Gretkowski. Even essential
we are seeing such a big focus on the idea of actively      retailers have seen dramatic changes. WSL’s
pursuing wellness.”                                         research found that 54 per cent of shoppers ordered
  That focus bodes well for the pharmacy sector if it       groceries and health products online for pick-up and
can understand how best to respond to the factors           delivery during the pandemic and half of them did so
contributing to consumer                                                                    for the first time. Home
behaviour in the age of                                                                     deliveries for prescriptions

                                               ‘‘
COVID-19.                                                                                   jumped from 21 per cent
                                           This is an opportune time
  While pharmacy may                                                                        to 37 per cent.
never be able to “out-app”                  to build equity with the                           “Online shopping is
purely digital spaces like                 consumer     and  strengthen                     definitely here to stay,”
Amazon, it can provide what
can’t be ordered online:
human connection. “This is
                                          the emotional relationship.

an opportune time to build equity with the consumer
                                                                              ’’            says Gretkowski. “Once
                                                                                            consumers try it and see
                                                                                            how easy it is, they stick
                                                            to it.” Her firm predicts 75 per cent of shoppers will
and strengthen the emotional relationship,” says Tony       continue to shop online post-COVID-19.
Chapman, a Toronto-based retail consultant and host of         COVID-19 has also stoked readiness and demand
radio show Chatter that Matters.                            for virtual healthcare services. Seventy per cent of
  Neighbourhood Pharmacy Gazette gathered insights          Canadians agree that virtual healthcare represents the
from Stephens, Chapman and Liz Gretkowski, a senior         future of healthcare and an overwhelming majority of
consultant with WSL, to describe five key consumer          working Canadians (82 per cent) agree their employer
behaviours that are shaping wellness trends.                should provide access to virtual healthcare, according
                                                            to the 2020 report by Environics Research, Canadian

    1  Home sweet home (or trying to be)
       Statistics Canada reports that five million
                                                            Attitudes on Healthcare and Telemedicine.
                                                               Virtual care represents “a call to action for pharmacies,”
Canadians started working from home during the              says Gretkowski. “Pharmacies don’t want to lose their
pandemic and, according to the Vancouver-based              customers because they aren’t offering telehealth. It’s
polling firm Research Co., 73 per cent believe the work-    important to meet your customers where they are at in
from-home trend will continue after the pandemic            their life. And right now, they are at home.”
because of persistent safety concerns.
  The home is now a workspace, classroom,
entertainment centre, remote gathering place and               2    Driven by convenience
                                                                    Time management competes with price, as 53
(sometimes cramped) fitness area. The-do-it-at-home         per cent of consumers say they plan to shop in ways
mindset has boosted renovations: a TD Bank survey           that save time even if it means they have to pay higher
conducted in September 2020 found that 37 per cent          prices, according to WSL.
of Canadians have done or plan to do significant home          Consumers are also more comfortable with time-
renovations to accommodate their new lifestyle. The         saving digital tools such as self-checkout and digital
early days of lockdown also saw massive spikes in the       coupons. Twenty-two per cent of shoppers use digital
online sales of products such as bread machines (up         coupons, of whom 55 per cent started using them
652 per cent in the U.S. in March 2020) and weight          during COVID-19. “It saves time and makes the check-
training equipment (up 307 per cent), according to retail   out experience much faster,” says Gretkowski.
technology company Stackline.                                  She adds that pharmacies also need to be thinking of
  Most significantly for retailers, the home has become     expanding their delivery methods to ensure consumers
a place of e-commerce with online purchasing and            get their products quickly. “Curbside pick-up is a given.
direct-to-home delivery—not just because physical           Everyone should be doing that.”
shops are closed or less convenient, but also because          She notes that even quick trips are moving online.
consumers want to limit contacts with strangers.            “It’s not worth it for shoppers to run into the store

6   // Neighbourhood Pharmacy Gazette // Winter 2021                                                neighbourhoodpharmacies.ca
Take Care - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - WHAT YOU NEED TO KNOW ABOUT TODAY'S WELLNESS CONSUMER - Neighbourhood Pharmacy ...
COVER STORY

and pick up something when they can shop 24/7 from              they realize they need downtime, that they
their mobile phone and get delivery in an hour or a             have to take care of themselves and find ways
day. There’s a big call to the pharmacy to think about          not to be so stressed,” says Gretkowski. “The
convenience in a new way because getting out of the car,        opportunity for pharmacy is to address it, to bring it to
putting on a mask, getting the kids out of the car, finding     light, whether that’s providing sleep aids or vitamins
a product and waiting in line—this is not the future.”          for mental health. What are the products that can help
   Having said that, as an essential service provider that      people relax?”
will always be open regardless of lockdowns, the bricks-           Mental health conversations were already entering
and-mortar pharmacy has come to represent an oasis for          the mainstream before 2020; now, it’s almost part of
consumers who need to talk about, see or get immediate          daily communications from political leaders and public
access to products or services related to health.               health experts as we cautiously navigate the uncharted
   The trick, then, is to make the in-store experience as       territory of a pandemic.
convenient and time-efficient as possible. For example,            Pharmacies have an opportunity to be part of that
use shelf tags to identify specific types of products, such     conversation beyond the pharmacy counter. They
as organic, vegan or sugar-free, and merchandise by             can engage stressed-out consumers by offering
solution, rather than by category. Pull together displays       compelling content adjacent to products and services,
that offer multiple products for a single need, be it to        such as a video recordings, articles, podcasts or virtual
reduce stress, boost immunity or manage diabetes. “If           sessions with experts, including their own pharmacists.
it’s a customer with sleep issues, rather than having           Pharmacists can also recommend or “prescribe” vetted
melatonin, vitamins, lavender essential oil and chamomile       mental health apps, such as those curated by Therappx,
tea in separate aisles, you can group them and say, ‘Here       a Canadian firm founded by pharmacists.
are your solutions for better sleep’,” says Gretkowski.            “There is a hunger for information and a sense of
   Equally important, increase the visibility and promote       connection and community. If the local pharmacy is
the availability of pharmacists. “Pharmacies have               not just the place I go to when I am not feeling well
respected, highly trained healthcare professionals to           but is also a beacon for great information, that gives
bring their brand ‘personality’ to life. This too is a highly   me added value,” says Stephens. “The differentiator
valued form of convenience, for consumers who need              between pharmacies that truly succeed and those that
to speak with a real person, sooner than later,” says           struggle will be the fact that they are not solely reliant
Chapman. He adds that pharmacists can be proactive              on product and prices but find valuable and creative
by making themselves available for regularly scheduled          ways to engage customers.”
virtual chats, with content that addresses frequently              For example, pharmacies can partner with local
asked questions.                                                practitioners to offer or promote free mindfulness
                                                                clinics or yoga sessions. They can help reduce stress

    3    Troubled in mind
        The isolation and loneliness caused by COVID-19
                                                                due to misinformation or the lack of information by
                                                                posting weekly briefings or bulletins on COVID-19,
and the unprecedented decline in social activity have
taken a toll on mental health. In 2019, two-thirds of

                                                                  The Big Business of WELL
Canadians said their mental health was good or very
good; in 2020, only 53 per cent could say the same,
according to an October 2020 report by Angus Reid. The
                                                                  In early March 2020, WSL Strategic Retail surveyed
percentage of Canadians categorized as “The Desolate,”
                                                                  Canadians on behalf of Neighbourhood Pharmacies
who suffer from both loneliness and social isolation,
                                                                  to gain a better understanding of their perceptions
increased from 23 per cent to 33 per cent. One in five
                                                                  of pharmacy and shopping behaviours, particularly
now say their mental health is poor or very poor.
  Forty-one per cent of Canadians say stress is their             in the areas of health and wellness. The resulting
number one obstacle to good health, followed by lack              report, The Big Business of Well, is available on
of sleep (35 per cent). “Forty-nine per cent of consumers         Neighbourhood Pharmacies’ website.
say it’s important to attend to their mental health—

7   // Neighbourhood Pharmacy Gazette // Winter 2021                                                 neighbourhoodpharmacies.ca
Take Care - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - WHAT YOU NEED TO KNOW ABOUT TODAY'S WELLNESS CONSUMER - Neighbourhood Pharmacy ...
COVER STORY

including vaccination details, suggests Chapman.             bulletproof to infection and disease spread,”
  (For more on mental health, focussing on depression        adds Stephens. While all retailers need to take
and anxiety, see page 10.)                                   ownership of making sure their stores are
                                                             clean, well-organized and disinfected, pharmacies

    4     Infection rejection
       Heightened cleaning protocols and contactless
                                                             are especially well positioned to take the extra step
                                                             of helping consumers with best practices for both
experiences are the new norms, as 64 per cent of             personal preventative care and the home.
consumers say they are trying to avoid germs, says              “Home is no longer just where the heart is, it is
Gretkowski.                                                  literally where the health is. What is pharmacy doing to
  Boosting immunity is a primary objective. The global       help customers protect themselves and their families?
vitamins, minerals and supplements market was on             Pharmacies can become real thought leaders on how
track to grow by more than 25 per cent in 2020, and that     consumers can build their immune systems,” says
trajectory is expected to continue into 2021, according to   Chapman.
Bolst Global’s Health and Wellness Trends report.
  “People are much more focussed on their immunity,
taking vitamins and also keeping their house clean,”
                                                              5    Conscious consumerism
                                                                    Consumers are reasserting a sense of community
says Gretkowski. “When we talk about solution                to counteract the isolation forced upon them by
merchandising, these are the solutions people are            COVID-19. The ability to do good, to help others, is a
looking for—how do I keep my hands clean, my house           powerful way to do that—including efforts to support
clean, the air in my house clean, and how do I build         local businesses hit hard by the pandemic.
immunity, so my health is stronger?”                           A November 2020 survey by the Retail Council of
  “The emphasis is on trying to make yourself more           Canada found that 90 per cent of Canadians intended

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8    // Neighbourhood Pharmacy Gazette // Winter 2021                                             neighbourhoodpharmacies.ca
Take Care - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - WHAT YOU NEED TO KNOW ABOUT TODAY'S WELLNESS CONSUMER - Neighbourhood Pharmacy ...
COVER STORY

to shop locally during the holiday season. “Those of                     10 would pay a premium of 35 per cent, on
us who remain employed are more focussed on putting                      average, for brands that are sustainable and
our paychecks to good use, including by bolstering                       environmentally responsible.
local businesses and helping neighbours in need,”                          Conscious consumerism extends to the type of food
writes Marian Salzman in ZoomsDay Predictions:                           people eat. In 2018, 17 per cent of Canadians reported
Trends for 2021.                                                         they are vegan, vegetarian, pescatarian or flexitarian,
   “The pandemic crisis has very real implications for                   according to a study by Dalhousie University. The
sustainability and social responsibility,” says Stephens.                majority are under 35 and are likely to raise their
“It has shown us the degree to which we are truly                        families with the same eating habits.
interconnected on a global level. It has brought home                      The pandemic is accelerating changes in consumer
just how small this world really is.”                                    behaviour that were already underway. What the surreal
   “To give is the new reward,” summarizes Chapman,                      reality of the virus has added for many, however, is a
adding: “In pharmacy, loyalty points could be used to                    greater sense of purpose, one that circles around health
help the community, to provide goods for people who                      and wellbeing at all levels—physical, mental and social.
can’t afford them.”                                                      As healthcare providers in the retail space, pharmacies
   Before the pandemic, consumers were already                           are uniquely situated to help achieve this higher purpose.
embracing social causes and environmental concerns.
A June 2020 study of almost 20,000 in 28 countries by
Research Insights found that 57 per cent are willing                                    Anne Bokma is an award-winning journalist
to change their purchasing habits to help reduce the                                    in Hamilton, Ontario, and former editor of
negative impact to the environment. Of those who                                        Pharmacy Practice.
say this is very or extremely important, seven out of

                                                                                                                        PARTNER SPOTLIGHT

    Building resiliency in                                                                                                 SUPPLIED CONTENT,
                                                                                                                          BROUGHT TO YOU BY

    Canada’s healthcare system
     By Brian Heath, Vice-President and General Manager at Amgen Canada Inc.
                                   A year has passed since the           have come together to discuss how best to achieve health system
                                   COVID-19 pandemic began in            resilience. Four overarching policy pillars are needed:
                                   Canada. The first wave dramatically   1) View health spending as an investment, not a cost;
                                   impacted healthcare systems across    2) Break down the siloes impeding the delivery of seamless,
                                   the country, exposing gaps and           integrated and coordinated care;
                                   fragilities previously overlooked.    3) Leverage data, tools and technologies to measure health
                                      Efforts to protect the most           outcomes and maximize value; and
     vulnerable, leverage digital health tools and technologies, and     4) Increase collaboration across public, private and non-profit
     establish new public health protocols have had modest success          sectors.
     in slowing the spread of COVID-19. However, the second                 Fueled by such early discussions, Amgen is increasing
     wave of infections has exacerbated weaknesses in our health         its engagement with prospective partners committed to
     systems—from delays in treatments and surgeries, to hidden          addressing health system issues. The goals are to better
     crises in long-term care and immunization frameworks.               integrate and analyze data, accelerate and expand access to
        That’s why it’s so important for Canada to focus immediate       innovative diagnostics and treatments, and leverage the skills of
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     in order to predict, prevent, manage and mitigate future crises.       We look forward to working closely with Neighbourhood
        With this mission in mind, Amgen, together with more than 50     Pharmacies and its members to identify the critical steps toward
     other health system leaders, including Neighbourhood Pharmacies,    greater resilience in Canadian healthcare systems.

9   // Neighbourhood Pharmacy Gazette // Winter 2021                                                                  neighbourhoodpharmacies.ca
Take Care - INSIGHTS. ADVOCACY. HEALTHIER CANADIANS - WHAT YOU NEED TO KNOW ABOUT TODAY'S WELLNESS CONSUMER - Neighbourhood Pharmacy ...
INSIGHTS: MENTAL WELLNESS              By Jeff Mehltretter

Mental healthcare part of
long road to recovery
                                                                  These results have prompted some to predict a
                                                                mental health crisis that will be just as damaging to our
                                                                health as COVID-19.
                                                                  What does drug utilization data tell us?
                                                                Psychotherapeutics already represent the largest drug
                                                                category by prescription volume in Canada, according
                                                                to IQVIA.4 We would expect that increased feelings of
                                                                anxiety and depression would be marked by a surge
                                                                in prescriptions to treat these conditions. To date,
                                                                however, that has not happened.
                                                                  While prescriptions dispensed for depression and
                                                                anxiety peaked in June, this was followed by a trough in
                                                                August and reflects the after-effects of provincial 30-day
Few will deny that it has been a long 12 months.                supply policies during the first wave of the pandemic.
We are all feeling the strain of isolation, new routines,       British Columbia, which did not implement a similar
screen fatigue and anxiety about the future. Not to             drug supply policy, shows a very flat trend from March
mention the disturbing social effects accelerated by            2020 onwards.5
COVID-19: political polarization and renewed awareness            Why do we not see an increase in drugs used to
of socioeconomic divides. Even if we as individuals are         treat mental health conditions when Canadians clearly
not particularly worried about infection, a new level of        report increased mental health concerns? Three main
anxiety pervades all of our lives.                              possibilities exist:
   Mental health clinicians and researchers quickly             1.	People remain undiagnosed and untreated because:
realized that this pandemic has the potential to tip              a. t hey have not sought help and are attempting to
those vulnerable to mental health issues from a                       manage on their own; or
healthy, coping state into an anxious, debilitated state.         b. they have found it too difficult to access healthcare.
Since March 2020, a steady stream of survey data
indicates that they are right:
•	Forty per cent of Canadians said that their mental health    Drugs for Anxiety and Depression
   has deteriorated since the onset of the pandemic.1            n Anxiety                    n Depression
•	Twenty-seven percent of those with pre-existing                                     1.10
                                                               Prescriptions indexed

   mental health issues reported an increase in suicidal
                                                                 against Mar 2020

                                                                                       1.05
   thoughts and feelings, up from 18 per cent during the
                                                                                       1.00
   first wave of the pandemic.1
                                                                                       0.95
•	Overall, 24 per cent of Canadians reported their
   mental health was worse during the second wave                                      0.90

   than the first wave.2                                                               0.85
•	Eight per cent of persons felt depressed five to seven
                                                                                              Mar 20

                                                                                                       Apr 20

                                                                                                                May 20

                                                                                                                         Jun 20

                                                                                                                                  Jul 20

                                                                                                                                           Aug 20

                                                                                                                                                    Sep 20

                                                                                                                                                             Oct 20

   days out of every week, a 33 per cent increase from
   June 2020.3                                                  Source: IQVIA Canadian Rx Lite, retail pharmacy. Mar 2020 to Oct 2020.

10   // Neighbourhood Pharmacy Gazette // Winter 2021                                                                                 neighbourhoodpharmacies.ca
INSIGHTS: MENTAL WELLNESS

2.	People are getting non-pharmacological treatment, such                                             direct, ongoing role to support care—witness the
    as internet-based cognitive behavioural therapy (iCBT).                                            success of the Bloom program in Nova Scotia,
3. People are self-medicating in ways that could cause                                                funded by the province and in its seventh year.
    harm. Two surveys found that approximately one in                                                  In recent years, at least two research projects are
    five Canadians have increased their use of alcohol                                                 underway to evaluate an expanded role for pharmacists
    and controlled substances.1,3 The Public Health                                                    in mental healthcare. A study in Australia concluded
   Agency of Canada reported the highest quarterly                                                     that pharmacists are capable of conducting screening
   count of apparent opioid toxicity deaths between                                                    and risk assessment services for depression, which can
   April and June 2020 since surveillance began in                                                     improve rates of early detection.7
   2016.6 These harmful behaviours compound mental                                                       The increased involvement of community-based
    health concerns and make effective treatment much                                                  pharmacists in mental healthcare is more than an
    more challenging.                                                                                  opportunity. It is a call to action. As these statistics
                                                                                                       attest, for many Canadians the COVID-19 vaccine will
  For all three of these possibilities, pharmacists can                                                be just the first step on a long road to recovery.
play an important role given their frequent interactions
with the public. With appropriate training and
remuneration, they can screen for people who may be                                                                        Jeff Mehltretter is a Consultant at
experiencing new or increased mental health concerns                                                                       Mehltretter Pharma Consulting.
and help them navigate treatment options, including                                                                        jeffmehltretter@gmail.com
iCBT and healthcare apps. Pharmacists can play a

References: 1. Mental health impacts of COVID-19: Wave 2. Canadian Mental Health Association and The University of B.C. in partnership with maru/matchbox; 2. In the News: Mental Health, Stress and
Anxiety. Leger Weekly Survey: Oct 19, 2020; 3. Examining the Impact of COVID-19 on Mental Health and Substance Use among Canadians. Centre for Addiction and Mental Health. 2020 Nov; 4. Licensed
from IQVIA. Rx Premium, retail pharmacy. Annual period ending Dec 2020; 5. Licensed from IQVIA. Canadian Rx Lite, retail pharmacy. Selected drugs from anxiety and depression. Mar 2020 to Oct 2020;
6. Opioid- and Stimulant-related Harms in Canada. Public Health Agency of Canada. 2020 Dec; 7. O’Reilly CL, Wong E, Chen TF. A feasibility study of community pharmacists performing depression screening
services. RSAP. 2015 June;11(3):364-81.

     REGISTER NOW: MAY 11 & 12, 2021

     THE ROAD TO RECOVERY
     Progress at the Height of Uncertainty
     Our virtual Executive Summit brings together pharmacy leaders from a variety of
     disciplines to share insights, tips and opportunities in the business of pharmacy
     and delivery of care. Attendees focus on strategy and relationship-building.
     • Examine fresh ideas and critical trends impacting our economy and pharmacy
     • Gather insights from thought leaders about the road to recovery
     • Pharmacy leaders: benefit from strategic discussions with the thought leaders
     • Premium associate partners: strengthen relationships with retail members
       during private business meetings

11   // Neighbourhood Pharmacy Gazette // Winter 2021                                                                                                                  neighbourhoodpharmacies.ca
ADVOCACY: 2020 YEAR IN REVIEW

How we survived and made
strides in the year that was
The pandemic’s impact is nothing short
of devastating, yet it has also triggered
unprecedented levels of collaboration,
innovation and transformation. Community
pharmacy, in many ways, is in the thick of it.
As we chart new territory in a world with COVID-19,
Neighbourhood Pharmacies invites you to check
out our 2020 Year in Review: Stepping Up Together,
for a detailed retrospective on our Association’s
role in the year that was.
    The Year in Review summarizes how Neighbourhood                The Association developed seven position statements
Pharmacies’ advocacy, education and research work                to inform its strategic direction and establish a
helped to move the needle on critical healthcare                 strong foundation for future initiatives, including our
priorities, including:                                           grassroots advocacy program (more details on page 16).
• Pharmacies’ capabilities to deliver immunizations               The Year in Review includes useful statistics about
   (seasonal influenza, COVID-19 vaccines and all other          community pharmacy, including its contribution to
   recommended vaccinations);                                    the Canadian economy. And you’ll find highlights and
• Modernization of the Controlled Drugs and Substances          quick links to our research reports in the areas of long-
   Act to better enable pharmacists to fight the worsening       term care, specialty pharmacy, Canadians’ wellness
   opioid crisis;                                                attitudes, the early impact of COVID-19
• COVID-19 testing;                                             on pharmacy and national pharmacare.
• National pharmacare (with renewed emphasis given
   the economic repercussions of COVID-19; see page 19             Check out Neighbourhood Pharmacies’
   for details); and                                               2020 Year in Review: Stepping Up Together
• Pharmaceutical supply and drug shortages.

        11,000                                 5 km               $8.2 billion                        163,400
          Community                        Maximum average        Gross domestic product              Canadians directly
          pharmacies                    distance to a pharmacy     directly generated by                 employed by
           in Canada                      for most Canadians         pharmacy sector                   pharmacy sector

12   // Neighbourhood Pharmacy Gazette // Winter 2021                                                    neighbourhoodpharmacies.ca
INSIGHTS: COVID-19 VACCINATIONS               By Matt Boudreau

Canada’s maze for
vaccine distribution
The dawn of a new year brings a
light at the end of the tunnel. While
COVID-19 continues to tear through
communities across Canada, the
rollout of new, effective vaccines
promises an eventual end to the
ongoing pandemic.
   As with all publicly funded vaccines, Public Services
and Procurement Canada (PSPC) orders and procures
the products on behalf of the federal government and
all provincial and territorial governments. PSPC and
the Public Health Agency of Canada then face a raft of
distribution challenges—and a patchwork of approaches             pharmacy and pharmacist participation be maximized?
to distribution across our provinces and territories.             How will we avoid the shortages some provinces saw
There are two distinct phases to the COVID-19 vaccine             in this year’s flu season? Different provinces will have
rollout: initially, a slow and halting trickle of doses that      different solutions.
are rationed to those in most need. Later, as production            To complicate matters further, provinces and
ramps up and more products are approved, mass                     territories have no say in which vaccines they receive,
vaccination will kick in and the goal will be to get as           their quantities or timing. The federal government
many people protected as quickly as possible.                     makes these decisions. Provinces may prefer to have
   In Canada, our federalism makes this more                      more of the vaccine that can be stored in refrigerators,
complicated. We cannot have a truly national effort               which opens the door wider for pharmacy involvement,
in distribution of the vaccines because healthcare is             but this is not something they can control. Federal and
the constitutional responsibility of the provinces. As            provincial leaders will inevitably politicize gaps in supply
a result, different parts of the country have different           and distribution.
priorities and distribution models.                                 These are existential issues for government. Every
   We see evidence of this in the provinces’ respective           elected official in Canada, from provincial backbenchers
plans and stages. For example, Nova Scotia would                  to the Prime Minister, knows that vaccine rollout
like to involve pharmacists as vaccine administrators             will decide their fate at the next election. For all the
closer to the beginning of its distribution plan, while           novel complications a COVID-19 vaccine campaign
Saskatchewan will involve pharmacists as the campaign             poses, governments must learn from past success—in
broadens and Ontario plans for the inclusion of                   this case, the central role pharmacy has assumed in
pharmacy locations in its final stage.                            seasonal influenza vaccination campaigns.
   The success of mass vaccination is inconceivable                 This brings us to the final, and in some ways most
without the wide-scale involvement of pharmacy. Many              difficult, challenge: making sure enough Canadians
decisions need to be made: Who will be prioritized?               are confident in the vaccine to achieve herd immunity.
How will compliance with a two-dose regime be                     There are promising signs. Recent public opinion polling
ensured? How will the vaccine be safely administered              indicates the willingness to get immunized has inched
to large numbers? How will supply be tracked? How will            upwards since vaccine rollout has begun.

13   // Neighbourhood Pharmacy Gazette // Winter 2021                                                    neighbourhoodpharmacies.ca
INSIGHTS: COVID-19 VACCINATIONS

Vaccine
distribution
in Canada                                                            APPROVES

                                                                                                   ADDITIONAL
                                      COVID-19          COVID-19       COVID-19       COVID-19     COVID-19
                                       Vaccine           Vaccine        Vaccine        Vaccine     Vaccines

                PROCURED BY

                                                                            ADVISES

                                                        Provincial and territorial governments                  DISTRIBUTES TO

                                             PROVINCIAL AND TERRITORIAL GOVERNMENTS DISTRIBUTE TO

                                      Public Health                 Hospitals and
                                    and primary care                                              Pharmacy
                                                                   long-term care

  But any of the difficulties described above could                          experts, healthcare workers on the frontline and
negatively impact consumer confidence. And in an age                         fixtures of the community (remaining open throughout
of fake news, when so many people are deeply skeptical                       the pandemic), few are better placed than Canada’s
of experts and politicians, even the best-designed                           pharmacists and pharmacies to make vaccine rollout a
public education campaign by government will have its                        success—and defeat this terrible disease.
limits. Pharmacists again can make a critical difference
in dispelling vaccine hesitancy.
  Whatever approach a province takes for distribution,                                     Matt Boudreau is a Senior Account Director
the best way to make sure millions of Canadians choose                                     at Hill+Knowlton Strategies.
to get vaccinated is to leverage their bonds of trust with
their healthcare providers. As drug and medication

14   // Neighbourhood Pharmacy Gazette // Winter 2021                                                                     neighbourhoodpharmacies.ca
Month
          THANK YOU
          PHARMACY                                                MA

Across the country, Canadians have relied on you to support them
through the COVID-19 pandemic. This March and every day, thank you,
pharmacy, for your dedication to your patients and your profession.

     Pharmacy
     Appreciation
     Month                         MARCH 2021          #PAM2021
     THANK YOU
     PHARMACY        MARCH 2021   #PAM2021
ADVOCACY: POSITION STATEMENTS                 By Jennifer Deschenes

Where we stand on
current healthcare issues
Advocacy drives everything we do at
Neighbourhood Pharmacies. With the immense                               Our Top 7 Priorities
and often competing pressures facing governments
                                                                         1. C
                                                                             reating Capacity        4. N
                                                                                                          ational Pharmacare
during the pandemic, 2021 is unquestionably a year                          in Public Health          5. M
                                                                                                          edical Cannabis
to showcase to decision-makers the incredible value
                                                                         2. Creating Capacity        6. Pharmaceutical Price
pharmacy provides healthcare systems nationwide.                             in Primary Care              Compression
  Neighbourhood Pharmacies’ seven position                               3. P
                                                                             harmacists’ Scope       7. Pharmaceutical Supply
statements encapsulate our priorities, communicate                          of Practice                   & Drug Shortages
recommended actions and articulate the benefits to
governments, Canadians and other stakeholders.
The full statements are available on our website.                      Creating Capacity in Primary Care
                                                                                    • Pharmacies are often Canadians’ first
Creating Capacity in Public Health                                                    and/or most frequent point of contact with
             • Pharmacies are a preferred destination                               the healthcare system.
               for immunization services.                                           • Pharmacists can alleviate backlogs in
             • The pharmaceutical distribution system                     primary care.
               facilitates vaccine distribution with a                 • Almost all provinces have authorized pharmacists to
  high degree of efficiency.                                              assess and prescribe for common ailments. Yet only
• Pharmacist-administered point of care testing                          three provinces fund this service (with limited funding
   supports disease screening initiatives, including                      in a fourth).
   rapid COVID-19 testing.                                             • Electronic health records, lab results and point of care
• Pharmacists are prepared to deliver additional                         testing enable pharmacists to effectively monitor chronic
   support in managing prescribed opioid therapy                          disease therapies and screen for infectious disease.
   and supporting harm reduction strategies.
                                                                       RECOMMENDATIONS
RECOMMENDATIONS                                                        • Implement fair, sustainable public funding for primary
• Enable pharmacists to administer all vaccines and                      care services by pharmacists to encourage their
   fund pharmacists’ vaccination services.                                uptake by both pharmacists and patients.
• Use the pharmaceutical distribution system for all                  • Enable pharmacists to conduct point of care testing,
   vaccines.                                                              order lab tests and access lab test results.
• Enable pharmacists to conduct point of care testing,                • Enable pharmacies to access electronic health records.
   order lab tests and access lab test results.
• Make permanent the temporary changes to Health                      Pharmacist Scope of Practice
   Canada’s Controlled Drugs and Substances Act and                    • Pharmacists can do more to cost-effectively close gaps
   build on that to further expand pharmacists’ role in                   in today’s healthcare system.
   opioid therapy management.                                          • Underutilized capabilities in the pharmacist’s scope of
• Fund pharmacists’ services to educate on the use                       practice include: the ability to renew, adapt and initiate
   of naloxone and use pharmacies as a network for                        prescriptions, administer medications by injection,
   distribution.                                                          conduct testing and administer immunizations.

16   // Neighbourhood Pharmacy Gazette // Winter 2021                                                         neighbourhoodpharmacies.ca
ADVOCACY: POSITION STATEMENTS

RECOMMENDATIONS
• Fund pharmacy services beyond medication fulfillment       • Fund pharmacists’ services to educate and
   to capitalize on pharmacists’ expanded scope of practice      counsel patients on the use of medical cannabis.
   and foster a more efficient use of healthcare resources.   • Follow the drug scheduling model of the National
• Consider the value of pharmacy services using a               Association of Pharmacy Regulatory Authorities
   system-wide lens. Where pharmacy services are                 (NAPRA) for the scheduling of cannabis health products.
   equivalent to services provided by other healthcare
   providers, reimbursement levels should be the same.        Pharmaceutical Price Compression
                                                              • Canadians deserve fair prices for prescription drugs.
National Pharmacare                                           • Government-imposed price reductions reduce funding
                 • Canada’s pharmacies serve millions of         to pharmacies since the current funding model
                   patients across the country, and the          includes mark-ups based on the price of the drug.
                   sector has a deep understanding of            Pharmacies serving patients who require complex
          the gaps that currently exist in drug coverage.        specialty medications are most negatively affected.
• An overwhelming majority of Canadians are
   concerned about the potential impact of a national         RECOMMENDATIONS
   pharmacare program on their existing drug coverage.        • Consult with pharmacy on drug pricing policy to avoid
                                                                 unintended impacts on pharmacy and patient care.
RECOMMENDATIONS                                               • Modernize the funding model for pharmacy to more
• Prioritize coverage for the uninsured and                     effectively recognize the value of services rendered.
   underinsured, including those with rare diseases.
• Build upon current federal-provincial-territorial          Pharmaceutical Supply & Drug Shortages
   efforts to work together to provide drug coverage                       • Drug shortages place burdens on
   to Canadians who need it most, while ensuring                              patients and healthcare providers.
   continuity of coverage for those who already have it.                   • Drug shortages have become a regular
• Establish guiding principles to ensure an equitable                        occurrence. Pharmacists and pharmacy
   approach, while maintaining the integrity of existing       staff dedicate many hours to overcome shortages,
   provincial and private plans.                               which takes time away from patient care.
                                                              •T
                                                                herapeutic substitution enables pharmacists to
Medical Cannabis                                               address shortages in a timely fashion. However, most
           • Pharmacists are well situated to educate,        provinces have not granted this authority or have
              support and counsel patients on the safe,        limited its application.
              effective use of medical cannabis.
           • Many cannabis users today self-medicate          RECOMMENDATIONS
   without guidance from healthcare providers.                • Establish ongoing collaboration between all
• Cannabis health products (CHPs) have emerged                  stakeholders to prevent drug shortages, mitigate harm
   as a category to describe cannabis products that              to patients and develop policies that lead to a more
   contain cannabidiol (CBD), which does not cause the           robust, sustainable pharmaceutical supply chain.
   psychoactive (i.e., mind-altering) effects associated      • Compensate pharmacies for time spent overcoming
   with products that contain tetrahydrocannabinol               drug shortages as part of continuity of care.
   (THC). CHPs should not be classified as prescription       • Harmonize therapeutic substitution authority for
   products as this would make them less accessible              pharmacists across all provinces.
   than recreational cannabis.

RECOMMENDATIONS                                                           Jennifer Deschenes is Director,
• Amend the federal cannabis regulations so                              Communications & Stakeholder
   pharmacists and pharmacies are authorized to                           Relations, at Neighbourhood Pharmacies.
   dispense and distribute medical cannabis.                              info@neighbourhoodpharmacies.ca

17   // Neighbourhood Pharmacy Gazette // Winter 2021                                               neighbourhoodpharmacies.ca
MEMBER Q&A: CALGARY CO-OP

All for one, one for all
A conversation with Judy Roberts and Sonal Ejner at Calgary Co-op,
member of Neighbourhood Pharmacies

                           What has the pandemic meant for                   Certified Diabetes Educator (CDE) and the
                           pharmacy?                                         pharmacy that’s most convenient to them.
                           It has propelled pharmacy forward as a            Pharmacists at our five Centre of Excellence
                           destination for primary care services. Patients   locations onboard, train and educate patients
                           have more broadly come to recognize that          on specialty products.
                           they can go to their pharmacy for many               On the technology side, online appointment
 Judy Roberts              services. This was a real boon for physicians     booking has freed time for staff. Our central
 Senior Director,
                           during the early weeks of the pandemic, and       fill pharmacy does all compliance packaging
 Pharmacy
                           we continue to see elevated pharmacists’          and robotics dispense frequently prescribed
                           prescribing activity even since physicians’       medications in high-volume pharmacies.
                           offices have reopened. For adult vaccinations,
                           70 per cent of the prescriptions at Calgary       How do you collaborate with other
                           Co-op are now prescribed by our pharmacists.      healthcare providers?
                              The pandemic accelerated the uptake of         Advanced training is a core practice.
                           virtual care and this was another opportunity     Our certified pharmacists include CDEs,
 Sonal Ejner               for pharmacy to shine. We were able to            Tobacco Reduction Educators, Certified
 Pharmacy
 Professional Services     launch our virtual platform quickly. Video        Respiratory Educators and those with the
 Manager                   consults are especially impactful for patients    ISTM Certificate in Travel Health. We have
                           who prefer to stay home or need to self-          experts in anticoagulation management, pain
                           isolate. Our patient uptake for video consults    management, mental health and more. They
                           doubled last month, and referrals from family     regularly collaborate with other healthcare
                           physicians and specialists to our certified       providers as members of a patient’s healthcare
                           pharmacists has dramatically increased.           team. For example, the CDE Greenlist is an elite
 FULL COMPANY NAME
 Calgary                                                                     group of CDE pharmacists who work closely
 Co-operative
 Association
                           How is Calgary Co-op operationalizing             with endocrinologists and complex patients to
 Limited                   expanded services?                                support ongoing care in the community setting.
                           Twelve full-time clinical pharmacists rotate        As well, our goal is for all of our pharmacists
 ESTABLISHED
 1956                      through our pharmacies for appointments           to have additional prescribing authorization
                           with patients. They consult with in-store         (APA).* Currently 95 per cent do, which means
 PHARMACY
 LOCATIONS
                           pharmacists on other patients, provide            they can universally offer prescribing for minor
 23 in Alberta             training and serve as mentors. They truly         ailments and other conditions and prescribe
                           champion a patient-centred environment.           and administer vaccinations and other
 PHARMACY BANNER
 Calgary Co-op               At our Specialty HUB, three pharmacists         injections. We’re proud of our pharmacists’
 Pharmacy                  operate a centralized concierge service for       ability to competently step in and work with
                           patients requiring specialty drugs and to         physicians to seamlessly prevent gaps in
 RETAIL FORMAT
 Supermarket               coordinate other services. For example, if a      patient care.
 chain                     physician is looking for diabetes support, he
                                                                             *Pharmacists in Alberta can apply to obtain additional prescribing
                           or she sends the referral to the HUB and we       authorization (APA), which enables them to prescribe any Schedule 1
                           match the patient with a clinical pharmacist      drug as well as blood products.

18   // Neighbourhood Pharmacy Gazette // Winter 2021                                                               neighbourhoodpharmacies.ca
INSIGHTS: NATIONAL PHARMACARE                 By Karen Welds

How COVID-19 is marking
a new path for pharmacare

The pandemic has
put many public
policy initiatives on
hold—and in the
case of a national
pharmacare
program, it may
indelibly change
what comes next.

Economic recovery, pandemic preparedness and                    An Act to enact the Canada Pharmacare Act, which was
public opinion may have set pharmacare on the                   debated—and defeated—on February 24.
path toward a fill-the-gaps, mixed-payor approach                 As well, the COVID-related issues of economic
rather than the single-payor model put forward by the           recovery and long-term pandemic preparedness
Liberal government’s Advisory Council in June 2019.             are key new talking points. The past year has been
  “There’s an opportunity, during this kind of holding          a hard lesson in the importance of a resilient, self-
period, to bring solutions to government ahead of them          sustaining economy. “The new priority in Ottawa is to
really reigniting their work on pharmacare,” said Jesse         build up domestic industry, including pharmaceutical
Shea, Public Affairs Consultant, Enterprise Canada, at          manufacturing. It’s about creating a strong healthcare
a webinar in January for members of Neighbourhood               sector in Canada so we are better prepared for the
Pharmacies. “It’s an opportunity to implement a mixed-          future,” noted Katie Heelis, Health Practice Lead,
payor solution that is a triple win for government, for         Enterprise Canada, at the January webinar.
industry and for Canadians.”                                      The economic contributions of the pharmaceutical
  “Now is the time to provide a fresh influence on              industry and retail pharmacy—sectors that are
decisions,” agrees Jeff Mehltretter, Consultant,                advocating for a mixed-payor model for pharmacare—
Mehltretter Pharma Consulting. “The pandemic has                carry more weight. “Communicating your economic
created an openness to rethink how to proceed.”                 value and footprint in Canada is more important than
(See page 17 for details on Neighbourhood Pharmacies’           ever,” said Heelis.
position on national pharmacare.)
  While decisions around COVID-19 take priority,                How Canadians feel
the pharmacare discussion is also on the table, as              To contribute further to the conversation,
evidenced by the New Democratic Party’s Bill C-213,             Neighbourhood Pharmacies enlisted Pollara Strategic

19   // Neighbourhood Pharmacy Gazette // Winter 2021                                               neighbourhoodpharmacies.ca
INSIGHTS: NATIONAL PHARMACARE

Insights to conduct in-depth public opinion polling
about pharmacare in November.
                                                             FIGURE 1    Canadians’ top healthcare priorities
  “It’s a story of good intentions versus brass tacks,”
summarized Craig Worden, President, Pollara Strategic       What would you say are the two most important healthcare
Insights, at the webinar. “Canadians would ideally like     priorities that deserve additional attention and funding?
everyone to have coverage for prescription drugs but,
                                                            n First choice       n Second choice
when asked to make choices about healthcare policies,
pharmacare trails considerably behind other initiatives
                                                                        COVID-19                      23%                      6%         28%
and issues as a public priority.”
  When asked to name the two healthcare priorities
most important to them, Canadians scored pharmacare            Mental health care       7%            10%         17%
eighth, close behind the similar priority of improved
access to medications (Figure 1). However, “both fall             Care for seniors    5%           10%         14%
far behind higher priorities for Canadians like mental
health, senior care and better access to family doctors,”
said Worden.                                                 More family doctors         8%         5%      12%

  The poll dived deeper by asking respondents to
                                                                Improved access
consider 13 specific healthcare initiatives, such as              to healthcare/      5%         7%        12%
improved long-term care and more support for                  reduced wait times

Canadians with opioid addiction. Were they more or
                                                               More medical staff      6%        5%      11%
less deserving of federal government funding than
a new national pharmacare program? All 13 were
                                                             Improved access to
deemed more deserving, most by a significant majority.      medications/reduced       5%         7%        11%
                                                               medication costs
  The poll also sought to paint a more accurate picture
of the number of Canadians without prescription drug           National universal
                                                                    pharmacare        5%      4%      9%
coverage. In November 2020, initial results indicated
that 16 per cent did not have coverage and another
                                                            Source: Pollara Strategic Insights, November 2020. N=4,120 adult Canadians.
six per cent did not know. This compared to 14 per          Discrepancies in totals due to rounding.

cent and six per cent, respectively, in the time period
immediately before the start of the pandemic.
  However, these numbers do not tell the full story.         FIGURE 2    Prescription Drug Coverage in Canada
“The problem is that many Canadians do not know if
                                                             Canadians who:                                       10%
they have coverage, especially if it’s from a government                                                          Do not have coverage
program,” noted Worden. To get at this, the poll asked
additional questions of respondents in the “do not                                                                4%
                                                                                                                  Do not know
have” or “do not know” categories to determine their
eligibility and awareness of government programs in
                                                                                                                  Note: Initially, 16% of
their jurisdiction (for example, OHIP+ in Ontario).                                                               respondents reported
  After reassigning respondents who were eligible for                                                             not having coverage and
                                                                                                                  6% did not know. These
a government program or who indicated they were                                                                   respondents were asked
part of a named government program, Pollara found                                                                 additional questions to

that the incidence rates for those without coverage                           86%                                 factor in their eligibility or
                                                                        Have coverage                             possible participation in a
significantly decreased, to 10 per cent who did not                                                               government program that
                                                                                                                  provides coverage, resulting
have coverage and four per cent who did not know
                                                                                                                  in final calculated levels of
(Figure 2). This is a difference of two points from the                                                           10% and 4%, respectively.
pre-COVID time period, when the adjusted results were
eight per cent without coverage and four per cent who       Source: Pollara Strategic Insights, November 2020. N=4,120 adult Canadians.

did not know.

20   // Neighbourhood Pharmacy Gazette // Winter 2021                                                            neighbourhoodpharmacies.ca
INSIGHTS: NATIONAL PHARMACARE

  Among those who reported having prescription drug                               that replaced all existing government and private
coverage, 80 per cent were satisfied with their current                           insurance plans, down from 30 per cent in 2018
primary plan, up from 71 per cent in a survey Pollara                             (Figure 3). The majority (57 per cent) prefer an
conducted for Neighbourhood Pharmacies in 2018.                                   approach that focusses on maintaining existing drug
  Overall, 82 per cent of Canadians supported the                                 plans and providing coverage specifically to those who
idea of a national universal prescription drug coverage                           do not currently have it. Another 17 per cent felt that
program. However, when asked about specific models                                pharmacare should focus exclusively on Canadians
for pharmacare, only 25 per cent supported a program                              facing extreme circumstances, such as providing
                                                                                  coverage for expensive drugs treating rare diseases.
                                                                                    “Public opinion is clear: Canadians are satisfied
 FIGURE 3    Canadians’ support for national pharmacare
                                                                                  with what they have and don’t want to see a lot of
                                                                                  their tax dollars go toward a new pharmacare,” says
                                       82%                                        Mehltretter. “Instead, we can improve upon our
             Support the idea of
            a national universal
     prescription drug coverage
                                                                                  existing mixed-payor system, and Neighbourhood
            program that would                                                    Pharmacies will continue to present suggestions to
          provide all Canadians
      access to the prescription
                                                                  Support a       government on how to do that.”
                                                                  program that
        medications they need.                    25%             would replace
                                                                  all existing
                                                                  government
                                                                  and private                Karen Welds is a journalist with
                                                                  insurance
                                                                  plans.
                                                                                             more than 25 years of experience
                                                                                             covering community pharmacy.
Source: Pollara Strategic Insights, November 2020. N=4,120 adult Canadians.                  info@neighbourhoodpharmacies.ca

            Working Together
            to Put Canadians First
            Your partner in building a healthier Canada.

21   // Neighbourhood Pharmacy Gazette // Winter 2021                                                                  neighbourhoodpharmacies.ca
THE LAST WORD

A united voice is key
to pharmacy’s future
We’ve heard about the importance                        Oftentimes, the average pharmacist-
of advocating for pharmacy,                             owner isn’t even aware of what is
especially in expanding the role of                     being done on their behalf to positively
pharmacists on the healthcare team.                     impact their future.
But as we approach another year of                         In my current role at McKesson, I’m
pandemic life in Canada, I’ve realized                  hoping to help change that. I’m on a
just how critical this advocacy will be                 team devoted to government relations
if we want our profession to thrive in                  and advocacy, where bringing a united
post COVID-19 times.                                    voice for the profession of pharmacy is
   As a pharmacist practising in Canada                 part of the mandate.
for the last 20 years, I’ve had the                        I’m also proud to be a board member
opportunity to work as a pharmacy                       of Neighbourhood Pharmacies, which         Smita Patil,
manager and lead multi-store operations                 represents the profession and business     RPh, BSc.Pharm
for both chains and banners. My role was                of pharmacy across all pharmacy            BOARD MEMBER
                                                                                                   Neighbourhood Pharmacy
to support pharmacy teams in building                   formats, including independent             Association of Canada
operational efficiencies and optimizing                 pharmacies. Policymakers and               SENIOR DIRECTOR
workflow to enable them to spend                        governments prefer a single voice and      INDUSTRY AFFAIRS
quality time caring for their patients.                 a strong message, and the Association      McKesson Canada

   Subsequently, I transitioned to a                    is equipped to provide that.
pharmacy services team with a national                     Neighbourhood Pharmacies’
responsibility that further expanded                    three regional caucuses inform and
my perspective. With high-performing                    disseminate what the Association
teams working at their maximum                          is doing on behalf of community
potential, I could redirect my focus                    pharmacies. As a member of all three

                                                                                                   ‘‘
to the bigger picture; namely, the                      caucuses and Co-Chair of the Central
hurdles preventing the profession as                    Regional Caucus, I feel privileged to
a whole from moving forward. The                        be able to provide a national lens,        Policymakers
most common feedback I heard when                       which helps nurture collaboration          and
working with independent pharmacy                       during conversations and the setting       governments
owners, whether in operations or                        of objectives.                             prefer a single
pharmacy services, was that they felt a                    If anything, the last year has shown
                                                                                                   voice and a
better job could be done in advocating                  us that pharmacists have the ability and
for their needs at the government level.                willingness to come together and do
                                                                                                   strong message,
   It’s not that our provincial associations            whatever it takes to care for patients     and the
haven’t been doing their part, but until                in need. It has also shown that when       Association is
recently, the business of pharmacy and                  we communicate and collaborate, we         equipped to
the needs of the pharmacist-owner
haven’t always been top of mind.

22   // Neighbourhood Pharmacy Gazette // Winter 2021
                                                        can influence change that benefits our
                                                        communities, and our profession.
                                                                                                   provide that.
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                                                                                                      neighbourhoodpharmacies.ca
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