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On 8 December 2011, Quebec ’s Minister of Health and Social Services amended the province’s Pharmacy Act by introducing Bill 41 to expand pharmacists’ role in patient care. Quebec  is the only Canadian province with a legal mandate for prescription drug insurance coverage for all residents, with public coverage offered only to those who do not have access to private health insurance through their employer. Bill 41 aims to increase access to health care and reduce physician wait times by extending the scope of pharmacist services to mirror that of physicians (e.g., modify the form of the medication and its dosage). The reform is currently pending due to disputes between the Ministry of Health and Social Services and the Quebec Association of Pharmacy Owners over remuneration for pharmacists. Should Bill 41 come into force, it is unclear whether the expansion of pharmacists’ roles, which in principle would duplicate physician services, should be considered part of the public basket of medically necessary care. Current negotiations suggest that only those with public coverage will also be covered for expanded services thereby placing equity of finance for those with private insurance in question. Le 8 Decembre 2011, le ministre de la Sante et des Services sociaux du Quebec a modifie la Loi sur la pharmacie en introduisant le projet de loi 41 a elargir le role des pharmaciens dans les soins aux patients. Le Quebec est la seule province canadienne avec un mandat legal pour la couverture d'assurance-medicaments pour tous les residents avec la couverture publique offerte uniquement a ceux qui n'ont pas acces a l'assurance-maladie privee par leur employeur. Le projet de loi 41 vise a accroitre l'acces aux soins de sante et reduire les temps d'attente chez le medecin en elargissant le champ des services pharmaceutiques pour refleter ceux des medecins (ex: modifier la forme du medicament et son dosage). La reforme est actuellement en cours en raison de differends entre le ministere de la Sante et des Services sociaux et l'Association quebecoise des pharmaciens proprietaires par rapport a la remuneration des pharmaciens. Si le projet de loi 41 entre en vigueur, il est difficile de prevoir si l'expansion de service des pharmaciens devrait etre consideree comme faisant partie du panier de services publics de soins medicalement necessaires. Les negociations en cours suggerent que seulement ceux avec la couverture publique seront egalement couverts pour les nouveaux services placant ainsi l'equite du financement pour ceux qui ont une assurance privee en question.

Expanding Pharmacist Services in Québec: A Health Reform Analysis of Bill 41 and its Implications for Equity in Financing Care