Q4 2017 Stakeholder Update Stronger Together

CPhA Organizational Members

Association of Faculties of Pharmacy of Canada Association des facultés de pharmacie du Canada

CPhA Organizational Aliates

® Message from CPhA

From the ongoing opioid crisis, to the introduction of the Cannabis Act and continued health calls for a national pharmacare program, CPhA stayed in front of the health care issues that grabbed national headlines throughout 2017, and the final few months of the year were no different. CPhA was very pleased with the turnout at our Lobby Day on Parliament Hill in October, where over 40 MPs participated in a hands-on Naloxone demonstration. We were also very proud to launch our Choosing Wisely Canada list in November and our PharmAccord proposal in December, a plan that calls for governments to provide full universal drug coverage to all Canadians. You can find additional details about these issues and more inside the Q4-2017 Stakeholder Update.

We also experienced significant change internally at CPhA in the last quarter of 2017. In October we were pleased to welcome Iris Krawchenko as Senior Pharmacist Advisor on our team. A well-known pharmacy leader in Canada, Iris is responsible for staying on top of major issues, trends and research happening in pharmacy to ensure CPhA’s ongoing relevance and responsiveness to members and the profession. In December our Board of Directors announced the departure of CEO Perry Eisenschmid. Glen Doucet, CPhA’s, Vice President of Public and Professional Affairs, has assumed the role of Interim CEO while our board conducts a recruitment process. During this time, CPhA’s staff and board remain fully dedicated to our strategic plan and to achieving our mission and vision.

We’d really appreciate your feedback on the Stakeholder Update. If you enjoy this publication, or you have some changes to suggest, please take a brief moment to complete our satisfaction survey.

www.surveymonkey.com/r/StakeholderUpdate

More information is available at www.pharmacists.ca 3 Issues and Developments

MPs get naloxone trained during CPhA lobby day CPhA held its annual national lobby day on Parliament Hill on October 3. The event brought together CPhA Board members, provincial pharmacy associations and member representatives for a day of meetings with MPs, senators and other government officials to discuss a range of issues, including the opioid crisis, medical cannabis, Indigenous health and the government’s tax change proposals. The lobby day included an interactive naloxone demo, led by Vanier pharmacist Mark Barnes and Canadian Pharmacist of the Year Craig Plain. The event drew a lot of interest from MPs who were eager to participate in the hands-on demonstration. Dozens of MPs were in attendance, including Jody Wilson-Raybould, Minister of Justice; Jane Philpott, Minister of Indigenous Services; , Minister of Democratic Institutions; and Patricia Hajdu, Minister of Employment, Workforce Development and Labour.

Raj Saini, MP for ; Jody Wilson-Raybould, Minister of Justice; Craig Plain, Canadian Pharmacist of the Year; , MP for Ottawa-Vanier.

4 More information is available at www.pharmacists.ca CPhA releases Choosing Wisely Canada list In November CPhA and Choosing Wisely Canada published “Six Things Pharmacists and Patients Should Question.” This list identifies targeted, evidence-based recommendations that can support conversations between patients and clinicians about what care is really needed. The list was developed following a call for recommendations from the pharmacy community in 2016. An expert committee was formed to review and finalize the recommendations. With the release of its recommendations, CPhA joins more than 60 Canadian medical professional societies who have now published more than 280 recommendations or “lists” of unnecessary tests and treatments that patients and clinicians should discuss. Visit www.pharmacists.ca/cwc to view the list and a series of videos that examine the recommendations.

More information is available at www.pharmacists.ca 5 Issues and Developments

CPhA launches proposed PharmAccord, calls for full population drug coverage CPhA presented its PharmAccord plan in early December that will allow governments to provide universal drug coverage to all Canadians, ensure comprehensive access to medications and leverage pharmacist care to better utilize medications and improve patient outcomes. The five-pillar PharmAccord was launched at an iPoliticsLive event in Ottawa, which included a panel discussion moderated by Susan Delacourt, columnist at the Toronto Star. Panelists included John Oliver, MP (Oakville), member of the Standing Committee on Health; Janet Yale, President and CEO, Arthritis Society (Canada); Iris Krawchenko, Senior Pharmacist Advisor, CPhA; and Mostafa Askari, Deputy Parliamentary Budget Officer. Learn more about the PharmAccord at www.pharmacists.ca/pharmacare.

Mostafa Askari, Deputy Parliamentary Budget Officer; Janet Yale, CEO of the Arthritis Society (Canada); Susan Delacourt (moderator); Iris Krawchenko. CPhA Senior Pharmacist Advisor; John Oliver, MP for Oakville.

6 More information is available at www.pharmacists.ca CPhA welcomes move to allow pharmacist dispensing of Mifegymiso, calls for universal coverage CPhA welcomed Health Canada’s move to change the Mifegymiso monograph to include pharmacist dispensing, announced in early November. CPhA has long called for Health Canada to remove the restrictive dispensing practices and allow pharmacists to dispense Mifegymiso directly to patients. In addition, Mifegymiso may now be prescribed up to nine weeks into a pregnancy, rather than the previous limit of seven weeks. While CPhA applauds these changes, women still face barriers to access in terms of cost coverage and we continue to call on governments to provide all women with equitable access to this important health care service through universal coverage across Canada.

CPhA disappointed with proposed cannabis regulations, concerned with impact to medical cannabis patients

In Late November, CPhA expressed disappointment with the federal government’s approach to medical cannabis regulations, which display an ongoing lack of concern for medical cannabis patients. CPhA issued a statement following the government’s announcement regarding taxation plans and Health Canada’s announcement to launch a public consultation on cannabis regulations under Bill C-45, which includes changes to the medical cannabis regulations. CPhA intends to participate actively in the consultations, which are open until January 20, 2018.

More information is available at www.pharmacists.ca 7 Issues and Developments

National pharmacy leader joins CPhA as Senior Pharmacist Advisor National pharmacy leader Iris Krawchenko joined CPhA as Senior Pharmacist Advisor in early October. In this newly created executive position, Iris will be an advocate for pharmacists, supporting CPhA’s strategic plan by building and achieving awareness and support among key stakeholders of pharmacists as valued and essential health care providers. Iris is a senior pharmacist practitioner with more than 32 years of combined experience in community pharmacy practice, ownership and management, long term care service provision, and hospital and primary care family health team practice. Iris will advise CPhA on major issues, trends and research happening within the profession to ensure the ongoing relevance and responsiveness of CPhA to its members and the greater pharmacy community.

8 More information is available at www.pharmacists.ca CPhA in the Media

Throughout Q4, CPhA was featured in several articles and provided expertise on a range of important and timely issues including prescription drug coverage, the opioid crisis, pharmacare and drug access, prescription-only codeine, antimicrobial stewardship, CPhA’s Choosing Wisely Canada recommendations, medical cannabis education and more.

CPhA discusses pharmacist dispensing of Mifegymiso Following Health Canada’s announcement to change the Mifegymiso monograph to include pharmacist dispensing in November, CPhA was featured in dozens of news articles, including the National Post, iPolitics and the Ottawa Citizen to provide comment on the role of pharmacists and the need for improved access and clarity surrounding Mifegymiso across Canada.

Medical cannabis patients getting short end of the stick in new Canadian cannabis framework An op-ed on medical cannabis regulations from CPhA’s Iris Krawchenko, Senior Pharmacist Advisor, was featured on Canadian Healthcare Network and National Newswatch in November. In the op-ed, Iris outlined the government’s proposed approach towards legalization, the impact on medical cannabis patients and the role pharmacists should play to improve patient safety and clinical oversight.

More information is available at www.pharmacists.ca 9 CPhA Meetings and Appearances

CPhA highlights Mifegymiso access during health ministers’ meeting in Edmonton

As federal, provincial and territorial (F/P/T) health ministers gathered in Edmonton in mid-October, CPhA was on the ground to engage on some of the key issues affecting the pharmacy profession. CPhA participated in a news conference with Action Canada for Sexual Health and Rights and the Canadian Nurses Association to encourage all provinces to provide universal cost coverage for Mifegymiso. CPhA Vice Chair Christine Hrudka spoke at the event and urged Health Canada to allow pharmacists to dispense directly to patients. CPhA also released an environmental scan of Mifegymiso access to outline the barriers that women are facing and help bring clarity surrounding its accessibility and coverage.

Christine Hrudka, CPhA Vice-Chair, discusses barriers to Mifegymiso access during Action Canada press conference

10 More information is available at www.pharmacists.ca CPhA discusses Canadian pharmacy practice at ASHP Midyear

In December Shelita Dattani, Director, Practice Development and Knowledge Translation, attended the ASHP Midyear 2017 conference in Orlando where she was part of the Pharmacy Practice Around the Globe panel. Sheli discussed the Canadian perspective and gave a presentation on “Pharmacy practice in Canada – Evolving towards an outcome focused role for all pharmacists.” The ASHP Midyear Clinical Meeting is the largest gathering of pharmacists in the world. With its focus on improving patient care, the meeting is attended by more than 20,000 pharmacy professionals from 86 countries.

CPhA and other Canadian health leaders discuss priorities with Minister of Health

CPhA joined representatives from other national health care organizations in mid-October to discuss federal priorities with Minister ahead of the F/P/T health ministers’ meeting in Edmonton. Issues discussed included opioids, cannabis, mental health and homecare. The meeting included representatives from the Canadian Nurses Association, Canadian Medical Association, Canadian Mental Health Association and HealthCareCAN.

More information is available at www.pharmacists.ca 11 CPhA Meetings and Appearances

CPhA joins health leaders to discuss new national guideline for clinical management of opioid use disorder

In November CPhA’s Shelita Dattani participated in a Knowledge Exchange hosted by the Canadian Institutes of Health Research in Calgary. The full day roundtable brought together a range of experts to share best practices and gain a comprehensive understanding of the national guideline for clinical management of opioid use disorder. The group also identified and discussed potential barriers to guideline implementation. Speakers included the federal Health Minister, Scientific Directors of CIHR, CRISM researchers, Dr. Christy Sutherland (Portland Hotel Society), Dr. Evan Wood (UBC), as well as medical health officers from municipal and provincial jurisdictions. Other roundtable participants included representatives from BC Centre on Substance Use, UBC, Government of Alberta, University of Montreal, Health Canada, U of T, College of Physicians and Surgeons of ON and AB, CADTH, CCSA, Alberta Health and PHAC (Dr. Theresa Tam).

12 More information is available at www.pharmacists.ca Practice Advancement

CPhA launches medical cannabis resources to support pharmacists, enhance patient care

In November CPhA launched its first medical cannabis continuing education program to help pharmacists across Canada respond to the evolving health care needs of their patients. The program is part of a new suite of practice tools and resources on medical cannabis that CPhA is developing to support pharmacists, drawing on the best available evidence and experts in the field. The first course, “An Introduction to Medical Cannabis and Cannabinoids,” serves as a foundation to provide pharmacists with an overview of the endocannabinoid system and function, the availability of cannabinoids in Canada (including both prescription and medical cannabis) and their therapeutic and adverse effects. The course also provides an overview of Canadian regulations regarding the use of cannabis for medical purposes and will highlight the evolving role of the pharmacist in the provision of care for patients who have been prescribed cannabis. The online, self-directed course is free to members of provincial pharmacy associations and AFPC. Over 850 pharmacists have registered since the program launched.

Learn more at www.pharmacists.ca/CannabisCE.

More information is available at www.pharmacists.ca 13 Practice Advancement

Antibiotic Awareness Week shines light on global issue

November 13-19 was Antibiotic Awareness Week, an opportunity to increase the awareness of antimicrobial resistance (AMR) and to encourage best practices among the public, health professionals and policy makers. Throughout the week, CPhA highlighted the vital role of pharmacists in fighting the spread of AMR, which included a series of videos on ways pharmacists can engage in antimicrobial stewardship activities. CPhA’s Shelita Dattani was also featured on Oasis Discussions, the Canadian Dental Association’s online professional development community, to discuss using antibiotics wisely. Learn more at www.pharmacists.ca/AMR.

14 More information is available at www.pharmacists.ca New resources bring clarity to Mifegymiso access and coverage

In November CPhA released an environmental scan of Mifegymiso access to outline the barriers that women are facing and help bring clarity surrounding its accessibility and coverage, which varies greatly across the country. Additional materials released include an online quiz and a webpage with helpful links, practice tools and resources for pharmacists.

CPhA Webinars

CPhA’s pharmacy practice and research webinar series and archives are offered exclusively to members of provincial pharmacy associations and AFPC.

Almost 850 pharmacists attended these webinars this quarter. • Thinking Nationally, Acting Locally: How pharmacists are taking on Canada’s opioid crisis • Pharmacists Facing the Opioid Crisis with Evidence and Experience • Direct Oral Anticoagulants: What’s New & Important and What’s Old & Important — Practical Implications for Pharmacists • Pharmacist-managed travel health clinics under an expanded scope: Evidence of clinical effectiveness and patient satisfaction from Alberta • The role of non-statin therapy in the management of dyslipidemia

Archived webinars are available online exclusively for members at www.pharmacists.ca/webinars.

More information is available at www.pharmacists.ca 15 Products and Services

CPhA and Pharmapod partner on error reporting solution

In late October the Ontario College of Pharmacists (OCP) announced its selection of Pharmapod Canada and CPhA to implement a medication incident reporting platform in Ontario to improve patient safety, reduce errors and help identify root causes of medication incidents. The announcement follows an RFP process from OCP seeking partners to implement a standardized continuous quality assurance program across Ontario pharmacies, which includes the mandatory collection and analysis of medication incident data. Once fully implemented, Ontario will have standardized, accurate and complete tracking of medication incident information across the province that will help provide a complete overview of errors and how they can be prevented to better protect patients.

Therapeutic Highlights CE discontinued

To better focus efforts on programs that reflect our updated strategic plan, CPhA has discontinued Therapeutic Highlights CE. Created in 2010 in partnership with McGill University’s Information Technology Primary Care Research Group, this program was designed to evaluate and ensure that CPhA’s drug and therapeutic content supports frontline health care practitioners across Canada and provides the content they need and want to deliver exceptional patient care. The feedback CPhA received through this initiative resulted in a number of modifications and enhancements

16 More information is available at www.pharmacists.ca to our content, making it some of the most trusted drug and therapeutic information in Canada, used by more than 200,000 practitioners every day. The final Therapeutic Highlights CE email was sent to CPhA Associates on December 26, 2017. Highlights remain available for two months from their published date. Canadian Pharmacists Journal

Since medications are so often used in suicide and suicide attempts, a group led by Dr. Andrea Murphy in Halifax decided to conduct a scoping review of the literature to see what research was available regarding pharmacists’ roles in the care of suicidal patients. This review was published in the Nov/Dec issue of CPJ, and found that while areas such as legal liability, ethical decision-making and medication safety have been covered, there is still work to be done to determine how best to educate and train pharmacists in suicide risk assessment. In another Nov/Dec article, a group from the University of Waterloo examined the expansion of immunization services in Ontario to include 13 additional conditions besides influenza. Perceived advantages and potential barriers of this expanded scope are detailed.

More information is available at www.pharmacists.ca 17 CPhA Organizational Aliates

®

Partner Spotlight

SANDOZ CANADA CPhA Organizational Affiliate since January 2017 www.sandoz.ca Sandoz Canada is part of Sandoz International GmbH and a subsidiary of Swiss multinational Novartis AG. A leader in its field, Sandoz Canada develops, markets and distributes a broad line of generic, biosimilar, consumer and specialty products. Sandoz, a division of the Novartis Group, is a global leader in generic pharmaceuticals and biosimilars. Our mission is to discover new ways to improve and extend people’s lives. We contribute to society’s ability to support growing healthcare needs by pioneering novel approaches to help people around the world access high-quality medicine. Our global portfolio of approximately 1000 molecules, covering all major therapeutic areas, accounted for 2016 sales of USD 10.1 billion. In 2016, our products reached well over 500 million patients and we aspire to reach one billion. Sandoz is headquartered in Holzkirchen, in Germany’s Greater Munich area.

What is the biggest challenge facing the healthcare system? Healthcare systems are under significant budgetary challenges which will continue into the future. Generic and biosimilar medicines play a key role in increasing access to high quality medicines for patients while helping to lower bills for patients and the healthcare system. The consumer products market also enables patients to practice “self-care’’ with or without the help of a healthcare professional, reducing the governmental budget for these services.

In addition, the multiple levels of reviews, from regulatory to health technology, and pricing requirements to gain market access in Canada are growing in complexity and

18 More information is available at www.pharmacists.ca duration. Canada’s lead time for access to medicines is getting to be much longer than what we see in comparable economies.

As a division of the Novartis Group, our purpose is to discover new ways to improve and extend people’s lives. We contribute to society’s ability to support growing healthcare needs by pioneering novel approaches to help Canadians access high- quality medicine.

All partners in the healthcare system should collaborate more to enhance patient access by providing increased information, broader therapeutic options, and greater access to healthcare professionals who could help patients directly.

What is one thing that Sandoz is working on that would be of interest to the broader pharmacy community?

Sandoz Canada is known for having the most reliable supply chain in the industry, ensuring that patients have access to high- quality medicines. In the 2016 Advantage Report comparing 10 generics companies, Sandoz was rated #1 and significantly exceeded industry standards in all performance areas, including supply chain management and customer service & support.

Sandoz Canada is collaborating with pharmacists, wholesalers, banners and government authorities to respond to patients’ medical needs and meet the highest standards for quality, service and regulatory compliance. We are a trusted advisor to our customers, partners, and communities by implementing the best, most ethical and transparent business practices. Patient safety and well-being is our top priority.

With our worldwide network and rigorous international quality standards, patients and customers can have confidence in the safety and effectiveness of our medicines.

More information is available at www.pharmacists.ca 19 LOOK WHO’S COMING TO

CANADIAN CONGRÈS DES PHARMACISTS PHARMACIENS DON’T MISS CONFERENCE DU CANADA 2018 THIS!

KEYNOTE SPEAKER MARY WALSH Acclaimed Comedian & Mental Health Advocate

Acclaimed comedian Mary Walsh is best known for her multi-Gemini-Award-winning work on CBC’s This Hour Has 22 Minutes. Outside of her work in television and film, Mary is also a respected mental health and addiction awareness advocate who shares her prior experience with alcoholism in an effort to create change in the lives of others. Mary is also the recipient of the Order of Canada and the Governor General’s Lifetime Achievement Award in the Performing Arts.

Register today at www.pharmacists.ca/conference

Fredericton, NB JOINTLY PRESENTED BY: OUR VALUE, OUR STORY June 2–5, 2018

Fredericton, NB OUR VALUE, OUR STORY June 2–5, 2018

What do youCANADIAN think of thisCONGRÈS Stakeholder DES Update? Share your thoughtsPHARMACISTS on this publicationPHARMACIENS with us at: www.surveymonkey.com/r/StakeholderUpdate CONFERENCE DU CANADA

Fredericton (N.-B.) CanadianNOTRE Pharmacists VALEUR, Association NOTRE HISTOIRE 1785 Alta Vista Drive, Ottawa, ON K1G 3Y6Du 2 au 5 juin 2018 1-800-917-9489 613-523-0445 [email protected] www.pharmacists.ca Fredericton (N.-B.) NOTRE VALEUR, NOTRE HISTOIRE Du 2 au 5 juin 2018