As Ontarians digest the details of the 2025 budget and process the broad-reaching impact of U.S. economic aggression, headlines offering “key takeaways” fill our feeds. But, amid the scrutiny, one key takeaway has been overlooked: what’s missing.
When it comes to health care, the Government of Ontario is committed to taking action to improve our primary care system through the Primary Care Action Plan, investments in training health-care providers and boosting infrastructure. But, while the team-based approach to reimaging primary care is promising, its current iteration has completely overlooked the important role pharmacists play in delivering primary care. And so does the budget.
For nearly two decades, pharmacists have been integrated into family health teams in Ontario. We estimate there are now almost 200 pharmacists working in interdisciplinary primary care across family health teams and community health centres. These pharmacists provide comprehensive pharmacy services to physicians and patients, enhancing collaboration and improving patient outcomes. They conduct in-depth medication reviews, educate patients and other health-care professionals on the team about drug interactions and optimal treatment plans, and work collaboratively with community-based pharmacists to ensure continuity of care.
Research shows that Ontario physicians working in these primary care teams indicate strong support for their pharmacist colleagues’ recommendations, often implementing their suggestions for improved patient outcomes. This experience shows that our domestic pharmacy programs effectively train pharmacists who can work across multiple settings to provide high-quality care. Ontario must find opportunities to expand on these successes further and prioritize the role of all pharmacists, including more than 12,500 community pharmacists, as integral members of interdisciplinary teams.
It was equally disappointing that the budget did not further expand pharmacists’ scope of practice.
It was equally disappointing that the budget did not further expand pharmacists’ scope of practice. This absence is alarming because for decades, Ontario has fallen drastically behind other provinces in benefitting from full-scope pharmacy care. But we are catching up. Since Ontario expanded pharmacists’ scope of practice in 2023, community-based pharmacists have completed more than one million assessments for things like pinkeye and urinary tract infections. Emerging evidence on this first round of expansion shows that almost one in 10 patients accessing this care are unattached to primary care. Pharmacists are filling that gap. The anticipated next step in expanded scope would build on pharmacists’ ability to provide care and fill care gaps by treating more common ailments, administering more vaccines and performing more point-of-care testing.
The budget rightly prioritized the health workforce shortage and the need to expand medical school seats and programs for future physicians and nurses. But there is also an urgent need to expand opportunities for domestically trained future pharmacists. In fact, while community pharmacists are among the most accessible health-care providers, Ontario has the smallest ratio of pharmacists per 100,000 persons, lower than any other province in Canada. To compound the issue, recent reports from Health Canada and Ontario-based health workforce studies have shown an annual shortage of more than 600 pharmacists in Ontario. This shortage exceeds the number of domestically trained seats we have in the province. Support for training more pharmacists, which we urgently need, is missing.
We have said it before. We will say it again. Pharmacists in Ontario are well-prepared for an expanded role in our health-care system. We are ready to do more to increase access to care and work collaboratively with our colleagues and policymakers to ensure Ontarians receive the high-quality health care they need and deserve.
Excellent summary, Lisa. Your analysis underscores a troubling reality: the Ministry of Health appears disjointed—its left hand unaware of what the right is doing. This lack of coordination is not just bureaucratic inefficiency; it’s a barrier to fully recognizing and supporting pharmacists in their essential role within primary care. The time for passive acknowledgment has passed—Ontario must act decisively to integrate pharmacists as frontline healthcare providers. I wonder how Jane Philpott would respond to such a stark illustration of systemic inertia.
Well put Lisa. By increasing access to primary care teams that include pharmacists and expanding the scope of practice the positive impact of pharmacists’ contributions will be more visible and understood. Whatever the cause whether it be shortage of pharmacists or lack of complementary staff or economic pressures, if pharmacists are seen as heads down and terribly busy behind high shelving in a retail setting, they seem inaccessible and unavailable to provide patient care and advice beyond the counselling of a prescription.