Pharmacy Professionals > Business Pressures in Pharmacy Practice

Business Pressures in Pharmacy Practice

One of four goals within the College’s 2024-2028 Strategic Plan is focused on ensuring pharmacy business practices do not interfere with the well-being of pharmacy professionals or their ability to meet the Standards of Practice or Code of Ethics. It’s critical that quality of care comes before business interests and that pharmacy professionals have the autonomy to make decisions in the best interest of their patients.

In March 2024, following significant feedback from registrants, the OCP Board approved the following position statement:

OCP has zero tolerance for business practices that compromise the ability of pharmacists and pharmacy technicians to deliver safe and effective care to their patients.

In addition, the OCP Board recognized the potential risk of harm to patients from the growing use of Preferred Provider Networks (PPNs). Read more about our approach on the Preferred Provider Network (PPNs) page.

If you are a pharmacy professional who wants to report business pressures to the College, please visit the Business Pressures Reporting page.

Latest Update June 2025

New Progress Update Available

We are pleased to present our latest progress update sharing how we are addressing business pressures in pharmacy in Ontario under four key streams: regulatory programs, data collection and public reporting, legislation and regulation changes, and engagement and outreach. Read the June 2025 progress update here.

For a full list of all of the actions we are taking, please review the March 24 Board meeting materials, item 6.1d, starting on page 90.

Previous progress updates are available from March 2025, December 2024 and June 2024.

Strategic Approach and Progress

The College’s approach to addressing business pressures is comprehensive, incorporating elements related to regulatory programs, data collection and reporting, legislation and regulation changes, and engagement and outreach. While we have been able to move forward with certain actions and changes quickly, others will require significant collaboration, resources and time.

Highlights include:

  • Implementation of a screening process for information provided to us (through complaints, reports and the online submission form) for relevance to business pressures. This has enabled us to open dozens of investigation files at the individual pharmacy and corporate ownership level.
  • Creation of an anonymous online reporting form, with over one hundred submissions as of March 2025.
  • Requirement for pharmacist directors of pharmacies to complete a self-declaration, upon opening the pharmacy, that they will not allow business interests to undermine the pharmacy’s ability to provide safe and quality care to patients.
  • Initiation of a pilot project to shift our focus during pharmacy operational assessments from processes to outcomes to better identify if patient care is being compromised.
  • Development, with our national partners, of an updated survey to determine the current state of workplace practices and measure the impact of initiatives.

For a full list of actions, please see the March 24 Board Meeting materials, starting on page 90.

Timeline and Publications

The College is committed to sharing our progress addressing business pressures, including implementation of the zero-tolerance approach.

What We Heard from Pharmacy Professionals

In early March 2024, the College distributed an anonymous survey to registrants to help determine the prevalence and nature of business pressures that they may be experiencing. More than 4,300 pharmacy professionals responded.

We also hosted a series of four town halls that provided registrants with an opportunity to share, anonymously if they chose to, their experiences with business pressures that impacted their professional autonomy and the impact that has on patient care. In all, approximately 1,300 registrants participated in the town halls, sharing more than 3,000 written comments and about 100 verbal comments related to their experiences.

In July 2024, we published our final report on what we heard from pharmacy professionals: Under Stress and Duress.

We are grateful to the thousands of pharmacy professionals who provided feedback through the survey and town hall meetings and for showing courage and commitment to patients by coming forward to share these experiences with us.

FAQs

  • The College has heard from pharmacy professionals about ongoing concerns they have about pressures being placed on them to perform services that get in the way of their ability to provide the kind of care they want to provide to their patients. More significantly, we’ve heard that these pressures can impact pharmacy professionals’ wellbeing and place pressures on them to make decisions that prevent them from meeting their obligations as regulated pharmacy professionals.

    Examples include the use of operational plans, volume targets or financial pressures that impede pharmacist autonomy to make decisions in the best interest of their patients.

  • MedsCheck reviews can save lives and are an important part of a pharmacist’s role in helping patients take their medications safely. The service, when done properly and in accordance with program requirements, provides significant benefits to patients and to the health system.

    Publicly funded programs are designed and managed by the Ministry of Health so changes to the MedsCheck program are not within the College’s authority.

    However, registrants and pharmacies are required to comply with all relevant rules associated with these and other programs and must put patient needs first by practicing according to professional and operational standards and their ethical obligations. The College can take a role in ensuring compliance.

  • No. Patients should trust in the safety and quality of the care provided by their pharmacy professionals. By addressing these pressures now, our goal is to ensure that quality is preserved, and all patient care is guided by the best interest of the patient at all times.

  • Most corporate-owned pharmacies have majority pharmacist ownership.  While the College does not have authority over corporations, pharmacists–even those who act in their capacity as corporate directors rather than providers of patient care–are accountable to us.

    We continue to explore what more we can do to assure ourselves and the public that no matter what ownership models are in place, pharmacy professionals have the autonomy to use their own knowledge, skills and judgment in the delivery of patient care.

  • Pharmacy professionals have raised similar issues previously. In response, in 2020 in collaboration with system partners, patients, pharmacy professionals and pharmacy ownership representatives, we developed a set of shared accountability principles.

    Unfortunately, registrants continued to share with us that they are under increasing pressures from corporate ownership to focus on volume and financial targets over what is in the best interests of patients. It now seems clear that some of those who participated in the development of the principles are choosing not to apply them. We acknowledge that what we have done up until now is simply not enough. We are thankful to registrants for sharing their concerns with us.

    Our new strategic plan includes a focus on addressing business interests that impede pharmacy professional autonomy and impact their wellbeing. As shared on this page, we are currently implementing several strategies as part of our strategic goal and zero-tolerance approach.

  • No. The College will fully exercise its authority but will need to work with other system partners, including government, to address these issues.

  • The College does not have oversight or any regulatory influence over pharmacy funding models as this is not within its legislated mandate. However, we will consider whether and to what extent funding plays a role in the delivery of safe and ethical care to patients.

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