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Guest Post: Increasing Wellness Through Pharmacists Providing OTCs
PharmaCare has created a consolidated list of fully covered First Nations Health Benefits (Plan W) over-the-counter (OTC) drugs. The online OTC list provides a simple, sortable reference tool to help healthcare providers, health advocates, and patients navigate Plan W and understand which OTC items are eligible benefits.
The list provides easier access to treatments, says First Nations Health Authority’s (FNHA) Director of Pharmacy Cindy Preston. She notes it is within a pharmacist’s scope of practice to recommend any of the 514 formulations on the list, all of which fall under PharmaCare’s Full Payment Policy.
“The list allows pharmacists to provide pharmaceutical care to patients without the hindrance of affordability,” Preston says.
PharmaCare’s Full Payment Policy applies to all items under Plan W (the “W” is for wellness), which means pharmacies may not charge any amount directly to patients.
How to provide drugs on the OTC list
Pharmacists will either be presented with a prescription for an OTC from a prescriber, or can personally recommend them by consulting the list.
To recommend a Plan W OTC drug, a pharmacist must complete the Plan W OTC Recommendation form. After the client signs the form, the pharmacist must enter the drug in PharmaNet. Pharmacists should retain the recommendation form along with any related prescriptions.
Please note that insulins and Plan W non-drug OTCs (e.g., diabetic supplies, inhaler spacers and IUDs) do not require the recommendation form, but they do need to be entered into PharmaNet.
The OTC drug list can be sorted by drug identification number (DIN), natural product number (NPN), chemical name, brand name or manufacturer name. A PDF copy of the list is also available to print.
Culturally safe care
In 2017, the FNHA transitioned its pharmacy coverage from the federally based Non-Insured Health Benefits plan to PharmaCare’s Plan W. Since this transition, pharmacists have had access to a list of Plan W OTC’s that are prescribed, and a list of select OTC drugs that pharmacists recommend. This second route to access OTCs (recommendation by pharmacist) has always been underutilized.
“It’s been my experience that some pharmacists are reluctant to recommend OTCs for payment through Plan W and instead advise their clients: ‘This is my recommendation [from the list] for the symptoms, but you’ll have to pay for it,’” says Candy-Lea Chickite, FNHA Healthy Medication Use Project Analyst.
“I’ve come across a pharmacy that will only complete an OTC Recommendation form with an appointment booked between noon and 4:00 pm on weekdays. I’ve seen other cases where pharmacists unfamiliar with Plan W coverage refuse to fill a prescription for an eligible OTC drug. There are more cases where the pharmacist is unwilling or unfamiliar with how to bill an OTC claim through their local system and directed the client to pay at the front or come back in a few days.” These are only a few of the stories arising where client-pharmacist interaction didn’t leave the client with a feeling of culturally safe care.”
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“Cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the health care system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.” – Creating a Climate for Change, FNHA |
The update to the OTC list provides clarification to pharmacists: they can provide medication counselling, help navigate available treatment options, process the item for payment, or advise the client to seek an in-depth assessment from an MD, NP, etc. Practicing within one’s full scope of practice will give all patients the feeling that they are cared for.
“Both the OTC list and the OTC Recommendation form are great tools for a structured claiming process that pharmacists can use as they support wellness through the provision of OTC medications,” states Preston.
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“Cultural humility is a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience.” – Creating a Climate for Change, FNHA |
Resources
- Plan W OTC drug list
- HLTH 4571 - Plan W OTC Recommendation form (PDF, 932KB)
- About Plan W
- First Nation Health Benefits (Plan W) Section 7.12
- Creating a Climate for Change
Emma Judd, Communications Specialist, Pharmaceutical Policy, Legislation and Engagement
British Columbia Ministry of Health | Pharmaceutical, Laboratory and Blood Services Division
- Cultural Safety and Humility