Canadian Pharmacists Association
Canadian Pharmacists Association

CPhA files abuse of dominance complaint with Competition Bureau against ESC's new service fee

February 28, 2024 (Ottawa): Today, the Canadian Pharmacists Association (CPhA) announced the submission of a formal complaint to the Competition Bureau of Canada, targeting the longstanding and exploitative practices of Express Scripts Canada (ESC), which recently resulted in the unilateral implementation of a new service fee imposed on pharmacies across the country.

This new mandatory fee, which essentially just allows pharmacists to continue to directly submit claims electronically on behalf of their patients, is the latest in a series of actions by ESC that exploit its dominant position in the market.

For years, ESC has leveraged its standing as the largest pharmacy benefit manager (PBM) in Canada to enforce agreements on pharmacies that leave little room for negotiation. These agreements are often subject to changes with minimal notice, leaving pharmacies without any recourse. The recent imposition of a non-optional service fee on pharmacies is a glaring example of this abuse of dominance, compelling pharmacies to accept terms that are not only unfair but also impact their ability to invest in their operations. This is particularly alarming given that ESC owns its own pharmacy.

CPhA's complaint underscores the broader implications of ESC's practices, which extend beyond contractual grievances to patient care and access. By dictating terms to pharmacies, ESC effectively limits the choices and accessibility of health-care services for Canadians. This not only restricts competition but also undermines the foundational principles of equity and access in the Canadian health-care system.

In bringing this matter to the attention of the Competition Bureau, CPhA seeks not just to address the specific issues related to ESC, but to prompt a thorough examination of the PBM industry as a whole. The practices employed by PBMs have far-reaching consequences for the health-care sector, influencing everything from the availability of medications to the financial sustainability of pharmacies.

"In light of recent news, we hope that the Competition Bureau will give this complaint due consideration,” said Glen Doucet, CEO, CPhA. “The precedent set in the US shows that it is imperative that steps be taken to ensure that the competitive landscape within the pharmacy sector fosters fairness, transparency, and accessibility, in alignment with the values of the Canadian health-care system.”

The Canadian Pharmacists Association remains committed to advocating for the interests of pharmacies and the patients they serve, and is ready to support the Competition Bureau in a potential investigation in any way necessary.

About the Canadian Pharmacists Association

The Canadian Pharmacists Association (CPhA) is the uniting national voice of pharmacy and the pharmacist profession in Canada. As pharmacists undertake an enhanced role in the delivery of health care services, CPhA ensures that the profession is recognized as a national leader in health care, influencing the policies, programs, budgets and initiatives affecting the profession and the health of Canadians. 

For more information, please contact:

Tyler Gogo
Senior Manager, Communications
Canadian Pharmacists Association