Thank you, Mr. Chair.
Good afternoon and thank you for inviting me to appear before you in my capacity as president of the Association québécoise des pharmaciens propriétaires.
I am here today with Geneviève Pelletier, director of pharmaceutical affairs.
I represent the 2,050 proprietor pharmacists of the some 1,900 community pharmacies operating in all chains and under all banners across Quebec.
A significant characteristic of the Quebec industry is that only pharmacists may own a pharmacy, as a result of which professional independence and ethics take precedence over business decisions, and patient welfare is owners' main priority. We have a unique pharmacy network in Quebec.
From the outset, I would emphasize that our association supports the Canadian government's wish to improve access to and the affordability of prescription drugs for Canadians. However, we assert that the health minister's objectives can already be met under the system in place in Quebec.
Accessibility and the primary care they provide are distinguishing features of Quebec's community pharmacies. Our pharmacy teams offer a multitude of services that extend far beyond drug dispensing and monitoring, and the efficient provision of those services is largely responsible for our pharmacies' financial health and thus for the funding of those services.
However, we are very concerned about Bill C-64 in its present form. A national single-payer pharmacare program would jeopardize the pharmacy model to the detriment of patients.
The current funding of Quebec pharmacies relies mainly on professional fees associated with the dispensing and monitoring of prescription drugs. Variations in those fees can influence pharmacies' ability to provide services to patients. Under the mixed public-private system, pharmacies can provide their services in a stable, predictable manner for the plan manager, the Régie de l'assurance maladie du Québec.
Under the proposed public single-payer principle, pharmacists' fees for dispensing and refilling prescriptions for diabetes medications and contraceptives would be a single amount negotiated for covered drugs. In that scenario, the impact on Quebec proprietor pharmacists would be significant because those drugs are commonly used by patients who are covered by the private component of the general drug insurance plan. That accounted for nearly 7 million acts in 2023.
It is precisely the flexibility of the present mixed public-private model that enables Quebec pharmacies to develop, operate in all regions and provide a host of services to patients. The mixed nature of the system allows proprietor pharmacists to adjust to the specific needs of their local clientele and to react efficiently to market competition. Without that flexibility, the financial health of the pharmacy network would be undermined, and the impact would be even greater in remote regions. It is therefore essential that you maintain the mixed system, which will guarantee our network's survival and effectiveness.
The financial health of pharmacies both guarantees access to prescription drugs and protects pharmacists' clinical role in the provision of primary care and the management of chronic illnesses.
In the past 12 months alone, more than 7 million clinical acts have been performed in Quebec pharmacies in support of primary care. If that primary care, so essential to the health system, were undermined, even more patients would be left to their own devices.
I would remind you that, by promoting accessibility, affordability and optimum use of pharmaceutical products and by providing universal coverage for all residents, the Quebec model already meets the objectives that would be established under the proposed national program.
In some situations, particularly for low-income individuals covered by the Régie de l'assurance maladie du Québec, the insured's contribution declines to zero under the present system.
Consequently, Quebec's mixed system both meets the objectives set forth in the bill and enhances the public system currently in place.
In conclusion, a national single-payer plan in Quebec would be counterproductive and would run counter to the objective of improving drug access. It would also undermine Quebec's community pharmacy model, a system well established in the communities and the envy of the other Canadian provinces.