On March 27, 2024, the Government of Québec issued Order in Council 680-2024, which amends the Community Pharmacy Access Program for Certain COVID-19 Pharmaceutical Treatments. This amendment follows a series of previous agreements and orders aimed at improving access to COVID-19 treatments through community pharmacies, addressing the ongoing public health challenge posed by the pandemic. Under the Act respecting the Ministère de la Santé et des Services sociaux, the Minister of Health is mandated to develop programs tailored to the needs of individuals and communities. The Régie de l’assurance maladie du Québec (RAMQ) is tasked with administering health insurance plans, which includes overseeing costs for services and goods provided under these plans.

The Community Pharmacy Access Program was first entrusted to the RAMQ under Order in Council 318-2022 on March 16, 2022. Since then, the program has undergone several amendments to expand its scope and improve access to treatments. Notably, on May 9, 2022, an initial amendment added a new pharmaceutical treatment to the program. A second amendment on August 8, 2022, introduced a new format for Paxlovid™, specifically for patients with kidney failure. A third amendment on December 5, 2022, modified criteria for the use of various COVID-19 treatments, including Paxlovid™ and Evusheld™. The program’s scope was expanded on December 7, 2022, to include influenza treatments. On March 22, 2023, the program’s term was extended to March 31, 2024, while influenza treatments were removed. Finally, on December 20, 2023, a fourth amendment refined the criteria for Paxlovid™ and discontinued coverage for Evusheld™.

The recent amendment recognizes the ongoing need to adapt to the evolving landscape of COVID-19 treatments, aiming to further improve the Community Pharmacy Access Program in response to the changing needs of the population and the dynamics of available pharmaceutical treatments. The specific changes outlined in Order in Council 680-2024 include an extension of the program’s duration from March 31, 2024, to May 31, 2024, allowing continued access to critical treatments as public health officials monitor the situation. Additionally, the order replaces the existing table in Schedule B with updated information regarding unit costs and maximum quantities for Paxlovid™ treatments. For Paxlovid™ (nirmatrelvir and ritonavir), one package (containing 20 tablets of nirmatrelvir and 10 tablets of ritonavir) will be priced at $800, with a limit of one unit per service. For patients with renal failure, the same package will also be priced at $800, but with a limit of two units per service for other patients.

By extending the program and refining the criteria for pharmaceutical coverage, the government seeks to ensure that residents can receive necessary treatments in a timely manner, particularly as the healthcare landscape continues to evolve in response to the pandemic.

Quebec (OC 680-2024) April 10, 2024