Happy New Year! I have a pretty good feeling about 2018. As you know, 2017 was an eventful year that, in many ways, set the stage for more of the same this year.
I’d like to start by welcoming three new government appointees to the Board. One third of our Board is comprised of public appointees who bring a different perspective to the conversations we have at the Board table, and provide an invaluable service to our organization and, ultimately, the public. I would like to thank Kris Gustavson, George Walton and Norm Embree for their valuable contributions over the past few years, and welcome Justin Thind, Ryan Hoag and Tracey Hagkull to the College Board! We look forward to working with you in continuing to shape BC’s health system in the coming years.
The opioid crisis continues to be a top priority for us and many of the province’s public health organizations. We’ve worked to make naloxone – a drug that’s been around for decades without the profile or need it has now – as available as we possibly can. And while naloxone has unfortunately not been able to significantly reduce the number of fentanyl related deaths in our province, it still saves a life every time it is used. We’re also working with the British Columbia Centre on Substance Use and the Ministry of Health to make and implement significant changes to the Provincial Substance Use Disorder Guidelines in order to reflect contemporary practice. For the first time ever, we are supporting the use of oral and injectable narcotics other than methadone and suboxone.
Much of the country is awaiting the legalization of recreational cannabis, slated for July. And while no changes to the availability of cannabis for medical use has been announced, the issue continues to draw a great deal of media attention as pharmacy chains announce their plans to make it available through their stores. Our position, however, has not changed. While we continue to recognize the value of the clinical involvement of pharmacists in its use and distribution, we are concerned about the lack of availability of pharmaceutical grade cannabis. We are also concerned about the potential negative impact of the cannabis on patient health: cannabis smoke contains many of the same carcinogenic chemicals found in tobacco smoke. We’ll be watching to see what new cannabis regulation comes out from Health Canada and the Province of BC over the next year that might affect pharmacy practice, and responding accordingly.
Medication safety has always been a major concern for us, and continues to be at the core of what we do as a health regulator.
In March of 2016, Melissa Sheldrick lost her son Andrew to a medication error. Andrew’s pharmacist had mistakenly compounded his prescribed tryptophan with baclofen, resulting in Andrew’s death. Andrew is survived by Mrs. Sheldrick, who has become a passionate proponent of mandatory medication error reporting, working with pharmacy regulators to shift the culture of pharmacy across the country and spread error reporting programs to make our health system safer than it already is. After hearing from Mrs. Sheldrick, the Board has decided to look into exploring the inclusion of Mandatory Medication Error Reporting as part of our existing quality management requirements.
Another issue that we’ve tried to highlight, through many of our initiatives over the past few years, is the accessibility of pharmacists as frontline medical professionals. We know that pharmacists are drug experts who are more accessible to the public than any other health profession. This is a vital facet in many of the initiatives we work on, two of which have seen significant progress in the past year: access to Mifegymiso, and pharmacist prescribing.
Last year, we took a strong position to ensure access to Mifegymiso through pharmacies in the province. Health Canada and the manufacturer initially required that physicians dispense the drug. We felt that this was not only inappropriate, but ignored the vital role of pharmacists in the medication cycle. In addition, it did not recognize that the delivery of health care is within the mandate of the provinces (and Colleges), rather than the federal government. Eventually, this was recognized and it was made clear that the normal process of pharmacist distribution should be supported as this would provide access to better quality care for women in the province.
The value of pharmacist prescribing to the public has been on our minds for quite some time. Other jurisdictions, including our neighbours to the east, have recognized this value and experience positive outcomes by giving patients the ability to access prescription medications through pharmacist prescribing for over a decade now. In light of this, last year, we undertook an extensive consultation and found that there was more public comfort with pharmacist prescribing in collaborative environments that in individual practice settings. Our board has directed us to submit a proposal for pharmacist prescribing in collaborative practice to the Minister of Health for his consideration, and we look forward to discussing this issue later in the year.
Finally, the Ministry of Health made changes to the Pharmacy Operations and Drug Scheduling Act, requiring the College to collect and review Criminal Record Histories for all pharmacy owners in the province, beginning later this year. This is intended to ensure that individuals who have relevant criminal histories are prohibited from owning pharmacies in our province. While this is a significant undertaking for our office, we are positive that this will allow us to better fulfill our mandate of protecting the public.