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Extending Prescribing Privileges in Canada

Introduction Prescribing, traditionally the domain of physicians and dentists, is extending to other professions, including nurse practitioners, optometrists, pharmacists, midwives and podiatrists, who can prescribe specific drugs in Canada under specific regulations or policies. The evolution of types and roles of prescribers is one outcome of the overall Canadian strategy to increase accessibility, choice and quality of care for patients. It is also a response to an anticipated shortage of physicians in Canada, as “boomer” physicians retire and younger physicians seek a different worklife balance from their predecessors. These changes have implications for patients, policy-makers and non-physician prescribers in Canada, and will require collaboration between physicians and the other health care providers. The prescribing process in Canada is complex. In terms of numbers, the volume of prescriptions written is very large (over 400 million annually), with approximately 22,000 human drug products on the market. In terms of the prescribers’ context and scope, beyond medicine and dentistry there is no consistent provincial/territorial legislation on which health professionals can prescribe, under which conditions (e.g., continuing care) and which drugs they can prescribe. In addition, there is a lack of consistency among provincial and employer-sponsored drug plans on which prescribers will be accepted for drug reimbursement for patients.