Ontario regulator to hear concerns over teachers’ insurance restricting choice of pharmacy

As the school year comes to an end, high-school teacher Amy Miller is preparing for an appearance before Ontario’s pharmacy regulator to advocate against a recent move by the Ontario Teachers Insurance Plan. The plan’s new specialty-drug pharmacy, MemberRx, takes away teachers’ rights to choose their own health care provider, she will argue.

Unlike a PPN, plan sponsor pharmacies are owned by the plans themselves. But in OTIP’s case, what it has in common with a PPN is the direction of patients exclusively to a designated pharmacy. Cubic Health chief executive officer Mike Sullivan said the mandatory nature of MemberRx is necessary to make it work.

In OTIP’s case, those plan sponsors are the Employee Life and Health Trusts for each of Ontario’s teachers’ unions. “I consider my benefits part of the compensation for the job that I do,” she said. “This is about privacy and choice, and those are fundamental in our democracy.” “We were paying money out of the plan into pharmacies for dispensing fees and for other services. We thought if we could bring that in-house, maybe we could take that revenue and reinvest it back into the plan,” he said.

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