Pangaea Express: Ontario Government Consultation on PPNs
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The Ontario government is assessing the role of Preferred Provider Networks (PPNs) in Ontario’s employer-sponsored drug insurance program. The involvement of the Ministry of Finance has significantly elevated the stakes in this matter. The government is opening a consultation process to obtain input from a range of stakeholders including consumers, insurers, pharmacy operators and employers to better understand the benefits and disadvantages of various types of PPNs and to determine whether government regulation may be required.
As written in Ontario’s background report, “The rise in prevalence of PPNs in Canada has led to growing public discussion and media coverage[1] regarding the impact of PPNs on consumer choice. In order to proactively address Ontarians’ concerns, a thorough assessment of public perspectives is needed to inform policy analysis by MOF, MOH, and MLITSD [Ministry of Labour, Immigration, Training and Skills Development]”.
The consultation period is open from August 23 to October 22, 2024. The government announcement makes it clear that it is undergoing a consultation process and is not proposing any action at this time. If legislative changes are required, it will provide an opportunity for future input.
Given the swell of media attention on this topic and the July statement from the Ontario College of Pharmacists, that “OCP has zero tolerance for any payment or reimbursement models involving pharmacies and pharmacy professionals that put patients at risk, disregard patient autonomy, or that get in the way of a pharmacy professional’s duty to put patient interests first”, it is not surprising to see Ontario look further into the pros and cons of these networks.
For more information, please contact Jimmy Fung at jfung@pangaea-consultants.com or Marla Weingarten at mweingarten@pangaea-consultants.com
[1] See Exclusive deals between insurance companies and pharmacies becoming more prevalent in Canada - The Globe and Mail and Exclusive insurer-pharmacy tie-ups on the rise in Canada | Insurance Business Canada (insurancebusinessmag.com).