Health committee  Yes, I am a pharmacist. I am practising. I practised yesterday. I own a pharmacy in Montreal.

Health committee  I've been practising for 30 years. I'm going to switch to French. It's going to be easier for me. I don't think so. Quebec's public pharmacare plan was initially free of charge. The deductible and copayment were introduced later, but that was a challenge at one point. I often see social problems in my practice.

Health committee  We don't discuss clinical services in pharmacies in our proposal; we only discuss distribution. Diabetic patients and young women who use contraception methods, such as the morning-after pill, need more than just the drug. These activities should be adequately funded so the drugs are properly and rationally used.

Health committee  Absolutely. That's what the Association québécoise des pharmaciens propriétaires, the AQPP, is proposing. Earlier I said I thought the system wasn't perfect. It's a mixed system; sometimes you have to pay out the full $1,000 ceiling amount if you're insured privately. There should be some protection against that.

Health committee  Thank you for your question, Mr. Julian. I think we have to guarantee coverage for everyone before considering the pharmacists. I think that's the first step. Under a measure in Quebec, no one pays a deductible or copayment of more than $996 a year, regardless of whether the coverage is public or private.

Health committee  Thank you for your question, Mr. Blanchette‑Joncas. It's obviously nonsensical to think that private insurance plans could act as supplementary insurers. There's no viability there. I'm not an insurance expert, but based on what's done in Quebec, it wouldn't work. These are comprehensive plans that provide comprehensive drug coverage in most cases.

Health committee  I don't think that's realistic.

Health committee  It's because of the increase in drug costs. Choices will have to be made. If coverage is comprehensive, if it is 100% covered by the public plan, tough choices will have to be made regarding the technology, which is advancing quickly. The new drugs are extremely costly. It's possible to treat rare diseases, and chronic diseases as well, with biological drugs, for example, which work miracles but are extremely expensive.

Health committee  First, you shouldn't put undue pressure on key actors, on front line actors like the community pharmacies. The Bas-Saint-Laurent example is a telling one. We had the front line single-window pilot project for orphan patients who had no family doctor and were given access to the services of pharmacists at pharmacies to which they were directed, where that was possible.

Health committee  If you compare Quebec's formulary to the one being proposed, even though it's not final, you can see that several millions of diabetes-related prescriptions would be lost. A significant percentage of patients would have to switch drugs, which makes no sense. It's impossible. Quite honestly, we manage stock shortages every day in community pharmacies.

Health committee  Thank you for your question. On at least two occasions, Quebec has enacted various statutes that have expanded pharmacists' scope of practice. Last year, more than 7 million clinical acts were performed at pharmacies, including vaccinations and acts for the management of chronic illnesses.

Health committee  Yes, there's a concern. Some 371 pharmacies shut down when a universal plan was introduced in New Zealand. We're afraid that, if there's no mixed system in Quebec, pharmacies will find it hard to be profitable, which will result in closures and force them to set up in major centres rather than rural areas.

Health committee  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.