Neighbourhood Pharmacies responded to the Ontario Ministry of Finance consultation on policy options for the potential regulation of Preferred Provider Networks (PPNs) with a bold solution to protect informed patient choice, prevent exclusion of able pharmacies and advance sustainability across the pharmacy sector.
After evaluating the two proposed policy options, we oppose a Standardized Mandatory Exemptions model, which undermines patient autonomy, burdens healthcare providers, and risks replicating the negative consequences seen in U.S. systems dominated by insurer-driven networks.
Instead, we recommend the Ministry adopt an “Any Able Provider” model underpinned by a pharmacy sector-led operational readiness framework, including the following:
• Removing the term “willing” from legislation to prevent coercive financial terms and uphold pharmacy autonomy
• Defining “specialty” medications by the complexity of services required, not price alone
• Developing criteria for “Able” based on a pharmacy’s operational readiness to deliver required services
• Ensuring the pharmacy sector leads the development of operational readiness criteria
• Ensuring PPN terms are financially viable and sustainable for able pharmacies
This pharmacy-led, patient-centred approach will preserve patient choice, support competition across pharmacy business models, protect health outcomes, and provide payors with a consistent and transparent basis for pharmacy participation in open PPNs.
To support our Statement, we have also developed some key messages for Members and Partners. We encourage the use of these messages to support any advocacy efforts on this important topic.