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Protect your right to choose your pharmacy.

Some Ontarians still face barriers to accessing their medications from the pharmacy they trust.

That’s why we’re encouraged to see the government launch a second consultation to explore policy solutions – like Any Able and Willing Provider (AAWP) legislation – to help protect patient choice and ensure access to care across the province.

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Background

In 2024, the Ontario government launched their first consultation to better understand the role of Preferred Provider Networks (PPNs) in employer-sponsored drug plans.

Under the current system, insurance companies and intermediaries such as Pharmacy Benefits Managers (PBMs) can restrict you from using your pharmacy of choice for all (or even just one) of your medications, by establishing PPNs with specific pharmacies. This can interrupt your access to care and introduce unnecessary risks to your health.

Through the initial consultation process, patients and pharmacy professionals shared concerns about how PPNs can restrict access to care and impact how you access your medications.

Now, the Ministry of Finance has launched a second public consultation – this time focused on specific policy options, to address PPNs.

This consultation represents a major step forward – and an opportunity to ensure Ontarians can access the medications they need, at the pharmacy they choose.

What OPA Is Calling For

To protect patient choice and ensure fair access to care, the Ontario Pharmacists Association (OPA) is calling on the government to adopt a patient-first approach as it considers guidelines for PPNs.

OPA supports the overall direction and concept of AAWP legislation in Ontario. While a full ban on PPNs is preferred, if the government moves forward with its decision, there must be clear provisions along with appropriate oversight and enforcement that:

Protect patient choice: Ensure that patients can continue to choose the pharmacy that best meets their needs without being restricted to a specific provider network. 
Protect patient access: Recognize that patients – especially those in rural, remote, or underserved communities – require flexible options to avoid additional travel or cost burdens. 
Prohibit penalizing patients for using their preferred pharmacy: Prevent plans from including terms that penalize a patient for choosing an out-of-network pharmacy. 
Eliminate restrictions on PPNs: Allow any pharmacy that meets the terms of a PPN to join, supporting a level playing field, and ensure that criteria for participation do not impose unnecessarily restrictive definitions of “Able” that could exclude qualified providers from operating within their full professional scope. 
Guarantee fair terms: Ensure participation terms for PPNs are fair, transparent, and achievable. 
Protect professional autonomy: Ensure that pharmacy professionals maintain the autonomy and ability to provide patient care based on their professional obligations under the Standards of Practice and Code of Ethics.
Prevent conflicts of interest: Include safeguards to avoid business relationships affecting patient care and choice (e.g., when companies that manage drug plans also own the pharmacies they steer patients toward). 
Promote transparency: Develop clear and consistent expectations for how PPNs operate and report on participation.

To ensure a comprehensive and robust approach, OPA also supports the Ontario College of Pharmacists (OCP) in continuing to explore regulatory solutions focused on the roles of pharmacists and pharmacies to protect patient and professional autonomy. Establishing clear guidance and expectations is essential to strengthening the intent of the changes and to prevent the creation of unintended challenges.

Together, these changes will help to protect patient choice and promote better health outcomes in addition to ensuring that the practice of pharmacy remains patient-centered, safe, and ethically sound, while fostering fair competition for all pharmacies.

Our Progress So Far

Since 2016, OPA has been a leading voice on this issue, highlighting issues around closed PPNs on patient choice and access.

November 2016

OPA prepared an assessment of “Any Willing Provider” (AWP) legislation in Ontario to evaluate potential legislative approaches and stakeholder impacts.

November 2017

OPA submitted formal input on Bill 160: Strengthening Quality and Accountability for Patients Act and presented at the Standing Committee on General Government, warning against the risks of closed PPNs and calling for AWP legislation.

February 2018

OPA published a position paper on AWP legislation, outlining the case for protecting patient choice and ensuring all pharmacies have the opportunity to participate in benefit plans under fair conditions.

June 2023

OPA commissioned three expert reports to strengthen its position against closed PPNs. These included reports on patient safety, PPN economics, and the ethics of mandated PPN participation.

Summer 2024

In response to increasingly restrictive practices, OPA ramped up its advocacy efforts – meeting with policymakers and calling for AWP legislation.

Fall 2024

The government launched a consultation. We heard from over 400 patients and pharmacy professionals sharing stories about how PPNs were limiting access to care.

Spring 2025

As a result of continued advocacy, Budget 2025 included a commitment to a second consultation focused on regulatory solutions.

We’re closer than ever, but the work isn’t over yet.

How You Can Help

To make a real impact, we need your voice.

We need decision makers in government to hear directly from you – the patients and pharmacy professionals affected by these policies every day.

Make Your Voice Heard

We’ve made it easy for you to share your voice for AAWP legislation with the government.

Simply submit a pre-written letter directly to the government, expressing your support for AAWP legislation based on a patient-centric framework.

If you are a pharmacy professional or pharmacy operator, submit the letter below

Name(Required)

Email(Required)

City(Required)

Province(Required)

Role(Required)

(pharmacist, pharmacy technician, pharmacy owner, etc)

Pharmacy Name

(if you are a pharmacy owner/operator)

Message(Required)

Dear Minister Bethlenfalvy,

I am writing to you today in response to the Ministry of Finance’s second consultation on Preferred Provider Networks (PPNs) in Ontario, as outlined in the consultation paper Preferred Provider Networks in Group Insurance Plans, from May 29, 2025. I appreciate the opportunity to share my perspective as a pharmacy professional, in support of a policy approach that supports both patient access and fair competition.

This consultation represents an important step forward in shaping a framework that promotes access and fairness within Ontario’s pharmacy benefits landscape. As someone who works closely with patients every day, I believe a full ban on PPNs would be the most effective. However, among the options presented in the consultation, I believe that Any Able and Willing Provider (AAWP) legislation offers the most promising path toward achieving these goals. As you consider next steps, I encourage the government to also ensure that clear provisions along with appropriate oversight and enforcement are established to:

– Protect patient choice: Ensure that patients can continue to choose the pharmacy that best meets their needs without being restricted to a specific provider network.

– Protect patient access: Recognize that patients – especially those in rural, remote, or underserved communities – require flexible options to avoid additional travel or cost burdens.

– Prohibit penalizing patients for using their preferred pharmacy: Prevent plans from including terms that penalize a patient for choosing an out-of-network pharmacy.

– Eliminate restrictions on PPNs: Allow any pharmacy that meets the terms of a PPN to join, supporting a level playing field, and ensure that criteria for participation do not impose unnecessarily restrictive definitions of “Able” that could exclude qualified providers from operating within their full professional scope.

– Guarantee fair terms: Ensure participation terms for PPNs are fair, transparent, and achievable.

– Protect professional autonomy: Ensure that pharmacy professionals maintain the autonomy and ability to provide patient care based on their professional obligations under the Standards of Practice and Code of Ethics.

– Prevent conflicts of interest: Include safeguards to avoid business relationships affecting patient care and choice (e.g., when companies that manage drug plans also own the pharmacies they steer patients toward).

– Promote transparency: Develop clear and consistent expectations for how PPNs operate and report on participation.

To ensure a comprehensive and robust approach, I also support the Ontario College of Pharmacists (OCP) in continuing to explore regulatory solutions focused on the roles of pharmacists and pharmacies to protect patient and professional autonomy. Establishing clear guidance and expectations is essential to strengthening the intent of the changes and to prevent the creation of unintended challenges.

As a pharmacy professional, I encourage the Government of Ontario to move forward with AAWP legislation based on a patient-centric framework that defines the required parameters for PPN arrangements, as outlined above. This approach would help protect patient choice and access, support enhanced patient health outcomes, and promote fairness across the pharmacy sector.

Thank you for your continued engagement on this important issue and for the opportunity to provide input.

Sincerely,  
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@{input (City):8}, @{input (Province):9}
@{input (Role):13}
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If you are a patient, caregiver or concerned citizen, submit the letter below

Name(Required)

Email(Required)

City(Required)

Province(Required)

Message(Required)

Dear Minister Bethlenfalvy,

I am writing to you today in response to the Ministry of Finance’s second consultation on Preferred Provider Networks (PPNs) in Ontario as outlined in the consultation paper dated May 29, 2025, titled Preferred Provider Networks in Group Insurance Plans. I appreciate the opportunity to share my thoughts on this important issue from a patient perspective.

As an Ontarian, I remain concerned about the impact of PPNs on my ability to choose my preferred pharmacy. These networks often limit options, directing me to pharmacies that may not be the most convenient, accessible, or aligned with my personal needs.

This second consultation is an opportunity to build on what was heard during the initial review and move toward an approach that protects patient choice while supporting access, fairness and continuity of care.

As such, I encourage the government to move forward with Any Able and Willing Provider (AAWP) legislation that includes clear provisions along with appropriate oversight and enforcement to:

– Support my ability to choose: I value being able to choose the pharmacy that best meets my needs, whether that’s based on convenience, trust, or continuity of care.

– Protect my access to care: For patients like me, having flexible pharmacy options helps avoid unnecessary travel, costs, or delays.

– Avoid added costs for using my preferred pharmacy: I hope to continue accessing care from the pharmacy I trust, without facing higher co-pays or out-of-pocket expenses.

– Support continuity of care: Maintaining a consistent relationship with my pharmacist helps me manage my health more safely and effectively, especially when dealing with chronic conditions.

– Enable my pharmacy team to prioritize my care: Allowing my pharmacy team to practice based on their professional obligations will ensure that I can continue to receive safe and quality care.

In parallel, I support the Ontario College of Pharmacists in continuing to explore regulatory solutions focused on the roles of pharmacists and pharmacies to protect patient and professional autonomy. Establishing clear guidance and expectations is essential to strengthening the intent of the changes and to prevent the creation of unintended challenges.

I have discussed my concerns about PPNs with my pharmacy and believe the Government of Ontario should introduce AAWP legislation based on a patient-centric framework, ensuring that I, and all Ontarians, retain the right to choose the pharmacy that best meets our individual needs.

Thank you for your leadership on this issue and for considering the patient voice in shaping what comes next.

Sincerely,   
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@{input (City):11}, @{input (Province):12}

If you have any questions or need more information, please reach out to info@opatoday.com.
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Together, we can shape a health care system that values patient choice, protects pharmacy professionals’ autonomy, and promotes equal opportunities for all pharmacies in Ontario.

About OPA

With over 8,500 members, OPA is Canada’s largest pharmacy-based advocacy organization and continuing professional development provider for pharmacy professionals.

By leveraging the unique expertise of pharmacy professionals, enabling them to practice to their full potential, and making them more accessible to patients, OPA is working to improve the efficiency and effectiveness of the health care system while improving access to convenient care.

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