Agreement between CLHIA, third-party payers and AQPP

Good news! A new collaboration agreement has been concluded following talks between insurers (CLHIA¹), third-party payers² and the Association québécoise des pharmaciens propriétaires (AQPP).

This agreement, which came into effect on February 1 and expires on March 31, 2023, is designed to improve efficiency and better manage drug plan costs for the benefit of insureds.

Here are a few examples of measures that will be implemented:

• Insurers will now be able to develop tools for comparing drug prices in pharmacies. With WebRx, insureds in Quebec will soon be able to find out which pharmacies they can go to obtain their medications at a lower cost.
• Pharmacists will be required to charge fair and reasonable prices. This implies recognition that multiplying fees by the number of units is an excessive price. Therefore, prescriptions dispensed for longer periods of time should help to better manage costs.
• A committee to look at what is a fair and reasonable price for specialty drugs will be created.
• Plan sponsors may choose to reimburse services not included in the public drug insurance plan provided by the pharmacist, when they consider these services to be added value.

As a plan administrator you can encourage your plan members to:

• Ask their pharmacist to dispense a 90-day prescription instead of a 30-day prescription, if they need one.
• Compare drug prices from one pharmacy to another in their neighbourhood when the WebRx price comparison tool is available.

You can also give them the leaflet to make them aware of the importance of taking their medication properly.

The agreement is a step in the right direction and we will continue our discussions with all stakeholders to improve the control of drug costs and the sustainability of group insurance plans. We will keep you updated on the implementation of the new measures. Watch for our next communications!

1 Canadian Life and Health Insurance Association Inc.

2 Pharmacy benefit managers