N.B. Medicare now pays for pharmacists to assess, prescribe for 7 more ailments

New Brunswick Medicare now covers more services provided by pharmacists, in a bid to improve access to primary care.

Effective immediately, patients can seek care at a participating pharmacy, instead of a doctor's office or after-hours clinic, for the following seven illnesses and conditions:

• Contact allergic dermatitis.
• Cold sores.
• Mild to moderate eczema.
• Gastroesophageal reflux disease.
• Impetigo
• Lyme disease prevention after a high-risk tick bite.
• Mild acne.

Health Minister Bruce Fitch says there are about 80,000 visits to physicians each year for these minor ailments.

"So we're freeing up 80,000 appointments, basically for another more complicated ailment that the doctors would be available for," he told reporters at the announcement in Riverview Monday.

About $300,000 has been allocated in this year's budget for pharmacists to assess and prescribe for these, Fitch said.

Patients will still be responsible for the cost of any medications prescribed for these ailments, as well as any fees for injections provided by pharmacy professionals.

More 'good news announcements' pending

Other ailments will likely be added to the pharmacists' list, said Fitch. "We're just going one step at a time."

Making it easier for patients to receive treatment and reducing the number of people going to a doctor or nurse practitioner for common ailments is part of the government's plan, Stabilizing Health Care: An Urgent Call to Action, he said.

"We know there's still work to do and we'll continue to do that work," Fitch said. "But this is another piece."

He hinted an expanded scope of practice for paramedics to assess whether a patient who calls 911 is stable enough to avoid being transported to the hospital could be coming soon, along with more "good news announcements" related to the expansion of Health Link, and collaborative care clinics.

'Prescription for relief'

The New Brunswick Pharmacists' Association has been advocating for years to expand the coverage for pharmacists.

It's a "prescription for relief in our health-care system," according to Andrew Drover, president of the association.

"Today's announcement means thousands of patients will be diverted from emergency departments, doctors' offices and clinics."

Pharmacists are the most accessible health-care practitioners in New Brunswick, according to Drover. And people often go to them first for minor ailments anyway, he said.

"This allows them to access primary health care during their first visit," rather than being directed to another caregiver and then coming back to the pharmacy with a prescription.

New Brunswick pharmacists have been able to assess and treat 34 minor ailments, with no need for a doctor or nurse practitioner to be involved, since 2014. But patients have had to pay a fee of about $20 or $25.

In October 2021, the province began covering non-urgent urinary tract infections in pharmacies for people between 16 and 64 who have previously been diagnosed with an uncomplicated urinary tract infection.

Pharmacists can also provide contraception management and prescribe certain birth control medications, assess and prescribe medication for shingles, and assess and prescribe the antiviral Paxlovid for COVID-19.

In January 2022, New Brunswick added prescription renewals to its list of pharmacy services covered under Medicare. The province said it would allow pharmacists to renew prescriptions at no cost to patients, whether they had a primary care provider or not, and without having to prove it was an emergency.

The change was part of an effort to reduce strain on the health-care system as COVID-19 hospitalizations continued to increase, the government said at the time.

Drover noted there are still 23 ailments pharmacists can assess and prescribe for that aren't currently covered, and he suggested they could do even more. He pointed to Nova Scotia, where pharmacists have authority to deal with other ailments, such as strep throat, and are involved in chronic disease management.

"So we believe that there is other opportunity to move forward and we're very happy to work with the government," he said.

Care sooner, closer to home

Monday's addition to the list of ailments covered by the province "recognizes the knowledge and the education of pharmacists," said Anastasia Shiamptanis, registrar of the New Brunswick College of Pharmacists. "Patient care is at the core of what pharmacists and pharmacy technicians do, and this is a good extension of their role in primary care."

Jonathan Walsh, pharmacist and independent owner of Riverview Guardian Pharmacy, also welcomed the announcement, saying it will help patients get the care they need sooner and closer to home.

"This decision will reduce demand on hospitals, emergency departments, walk-in clinics, and family physicians," he said in a statement. "It also frees up time for our health-care partners, allowing doctors, nurses, and other health-care providers to focus on more complex care cases."

Drover said some pharmacies may need to make some workflow adjustments to accommodate the changes.

This could include having pharmacy technicians, who are licensed by the New Brunswick College of Pharmacists, handle the distribution of medications to free up pharmacists to be more involved in primary care, he said.