In the News

EXPANSION OF OHIP+ FOR SENIORS

The government of Ontario has announced that seniors 65 years of age or older will no longer have to pay a deductible or co-pay for their medications under the Ontario Drug Benefit program. This will be accomplished through the expansion of the OHIP+ program, which already covers free prescription medications for youth aged 24 and under. Ultimately, the program will make over 4,400 medications completely free for everyone 65 and older who is OHIP-insured.

Patients who are wondering whether their medications are covered by the Ontario Drug Benefit program or OHIP+ can use Ontario’s online search tool to look up the medication.

This change will take effect on August 1, 2019.

INCREASING HARMS OF OPIOIDS

A recent study by researchers at St. Michael’s Hospital found that the rate of opioid-related deaths in Ontario has tripled over the past fifteen years, and was responsible in 2015 for one out of every six deaths of residents between the ages of 25 and 34.

The provincial government has reported that there were 1,053 opioid related deaths in Ontario from January to October 2017, an increase of 52 percent over 2016. Partially in response, the Ministry of Health and Long-Term Care has recently begun distributing shipments of posters and brochures to pharmacies to help educate patients about prescription opioid use. Pharmacists are asked to hang the posters in visible areas of their pharmacy and provide the brochures to their patients when they pick up their opioid medication.

To assist pharmacy professionals in providing reliable, take-home information for patients or their caregivers who may have questions and concerns about opioids, the College has created a list of resources specifically for patients (see Opioid Resources for Patients). Pharmacy professionals are reminded that the College has released an Opioid Strategy for Pharmacy. Additionally, resources continue to be added to the Opioid Practice Tool.

MIFEGYMISO

In 2017, more than 4,000 prescriptions for Mifegymiso were dispensed to Canadian women.

Pharmacy professionals are reminded that in November 2017, the College revised its Mifegymiso guidance document to reflect a November 7, 2017 Health Product Risk Communication from Health Canada which updates the Product Monograph and Risk Mitigation Plan. These updates extend the gestational age requirement, update the dispensing requirements, and remove the requirement for mandatory prescriber education and pharmacist and prescriber registration with the manufacturer.

Additionally, pharmacy professionals are reminded that the Safe Access to Abortion Services Act came into effect on February 1, 2018, allowing pharmacies who provide abortion services to establish safe access zones of up to 150 metres around the pharmacy. Details on how to apply can be found on the government’s Safe Access Zones webpage.

UPDATED NALOXONE GUIDANCE

On April 25, 2018 the College revised its naloxone guidance to reflect revisions made by the Ministry of Health and Long Term Care to the Ontario Naloxone Program for Pharmacies (ONPP). All injectable and intra-nasal naloxone spray (INNS) kits provided by pharmacies will require (1) a rescue breathing barrier and (2) an updated insert with instructions (English and French). This new insert must replace any current instructional insert being used.

Please also note that pharmacists, where possible, must ensure that a quarterly report relating to outcomes for individuals who were provided a naloxone kit, be completed and returned to the Ontario Ministry of Health and Long-Term Care. Please view question #16 of the Ministry’s naloxone kits FAQ for professionals on page six to learn more. Visit the Ministry’s website for more information and to read the Frequently Asked Questions.

As always, pharmacists who are dispensing naloxone should be familiar with the College’s updated guidance on dispensing or selling naloxone.

UPDATES FROM HEALTH CANADA

REGULATORY AMENDMENTS FOR PRESCRIBING AND DISPENSING METHADONE

As of May 19, 2018, federal regulatory amendments allow practitioners to prescribe, administer, sell or provide methadone without applying for or obtaining an exemption under subsection 56(1) of the Controlled Drugs and Substances Act. This is for both the treatment of opioid use disorders and for analgesia.

Pharmacists will no longer need to verify if a practitioner holds a valid exemption to prescribe methadone.

Pharmacists are reminded that the College has a Methadone Maintenance Treatment (MMT) and Dispensing Policy. All other parts of the policy still apply.

MANDATORY WARNING STICKER AND HANDOUT TO ACCOMPANY ALL DISPENSED OPIOIDS

Health Canada has also announced that they are making warning stickers and patient handouts mandatory with all prescription opioids dispensed. The sticker will be applied to each container that is given to a patient and warn that the medication can cause dependence, addiction and overdose. The handout will inform patients of the signs of opioid overdose, warn them to keep the medication out of reach of children and not to share it, and advise of other serious warnings and potential side effects.

Pharmacy professionals should ensure that patients start receiving the sticker and handout as of October 2018.

NEW GUIDANCE DOCUMENTS REGARDING MANAGEMENT OF POST-CONSUMER RETURNS AND UNSERVICEABLE STOCK

Health Canada has released two new guidance documents meant to clarify the recommended procedures for the collection, handling and destruction of narcotic post-consumer returns and unserviceable stock:

These guidance documents reflect the Section 56(1) Class Exemption for Pharmacists, Practitioners, Persons in Charge of a Hospital and Licensed Dealers for the Provision and Destruction of Unserviceable Stock and Post-consumer Returns. The College’s Destruction of Narcotics, Controlled Drugs and Targeted Substances Factsheet has been updated to reflect these changes. Pharmacy professionals, designated managers and hospital pharmacy managers should review these materials.