Ontario Teachers Insurance Plan restricts some teachers to buying from in-house pharmacy

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The Ontario College of Pharmacists is set to discuss the OTIP deal at its July 8 board meeting as part of an effort to push back on patient restrictions and what are known as preferred pharmacy networks

Ontario teachers with certain chronic conditions are being told that they can only get their medications from their insurance plan’s in-house pharmacy – a move the plan says saves money, but some pharmacists say inappropriately restricts patient choice.

Teachers who get their drug coverage through OTIP can get most of their prescriptions filled at the pharmacy of their choice – unless they have certain chronic conditions that require taking expensive specialty drugs. Mr. Yochim, who will attend the board meeting in July with Ms. Miller, says patient steering is a growing problem within Canada that is being imposed upon people under the guise of cost savings.

OTIP said it set up the in-house pharmacy as a way to save plan members money, with all proceeds generated by the plan directed back to the plan’s sponsors. He said that on the plus side, the in-house pharmacies may be able to focus on service because they would receive predictable sales volumes. But “the con is, you end up with the same logic of steering patients to specific pharmacies.”

 

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