The Ministry of Health and Social Services (MSSS) says it is “very concerned” by the ease with which it is possible to obtain a prescription for Ozempic through a Quebec telehealth platform.
In a survey published last Friday, The Press demonstrated how easy it is to get semaglutide injections – intended for type 2 diabetics, but widely used as an appetite suppressant – by lying about your body mass index and submitting a bogus photo of your figure.
Read the survey “From Ozempic in a few clicks”
The process of obtaining a prescription from the Livewell site took a few minutes, while the medication was delivered by a pharmacy in Ontario and another in Quebec in less than 48 hours. It is a nurse practitioner registered in Quebec who approved the weight loss treatment based on a virtual questionnaire of approximately 30 questions.
No in-person, videoconference or telephone consultation with a health professional was required. Furthermore, the procedure did not require a blood test or verification of medical records.
The MSSS “would like to remind you that the use of medications must be done with the greatest caution” and that “it is strongly recommended to consult qualified health professionals in order to benefit from a personalized clinical evaluation according to the standards of the professional practice,” indicates spokesperson Marie-Pierre Blier in an email.
The Ministry specifies that it has had discussions with the Order of Pharmacists of Quebec (OPQ), “which shares its concerns”.
Discussions to come
The president of the OPQ, Jean-François Desgagné, said he was “taken aback”, “without words” and “angry” following the revelations of The Press. “I think it is urgent that regulatory bodies, notably Health Canada, clean up this,” he reacted.
Professionals and experts in the health sector fear, among other things, that platforms like Livewell will serve as shortcuts for patients struggling with eating disorders who wish to obtain Ozempic to lose weight, a contraindicated combination.
Other discussions with the OPQ are planned soon, notes the MSSS. “It is also envisaged to have exchanges with other Canadian jurisdictions, considering the involvement of entities outside Quebec. »
The OPQ, for its part, intends to address the issues raised by companies like Livewell at the next meeting of an interprofessional committee also bringing together the Order of Nurses of Quebec and the College of Physicians of Quebec.
The president of the Quebec Association of Pharmacist Owners, Benoit Morin, said he reacted with “a lot of concern” to the investigation of The Press. “It made me feel very insecure. In Quebec, I continue to think that we have a fairly tight distribution network. But it highlighted that there are still holes,” he says.
PHOTO MARCO CAMPANOZZI, LA PRESSE ARCHIVES
The president of the Quebec Association of Pharmacist Owners, Benoit Morin, in 2021
He believes that “we need to find a way to better protect people” by reviewing provincial and federal regulations.
Livewell offers patients delivery of their medication to their local pharmacy or through an online pharmacy partner, Pocketpills. “It should always be the patient’s pharmacist. Why are we offering another option? », asks Mr. Morin.
Regulations without teeth
Lawyer Marco Laverdière, professor in the health law and policy program at the University of Sherbrooke, emphasizes that the legislative framework established since the COVID-19 pandemic has no influence on commercial platforms like Livewell.
He recalls that the telehealth issues covered by Bill 11, adopted in 2022, and a recent draft regulation only target “the public sector, i.e. services provided in establishments and those covered under the public health care plan. Health Insurance “.
Provisions provide in particular that a patient has the right to benefit from a corridor of services – whether care or follow-up – in person, which a transactional site like Livewell does not allow.
“We found ourselves preventing and controlling the risk where it is probably the least pronounced”, that is to say in the public sector, observes Mr. Laverdière.
The supervision of private “shells” is based solely on the ethical requirements of the health professionals who are associated with them, underlines Me Laverdière. Quebec orders can sanction people, but they are powerless against commercial third parties themselves.
“It creates complicated environments,” notes Mr. Laverdière. This raises questions that arose during the Charbonneau commission, when we wondered whether the Order should supervise not only engineers, but also engineering firms. This is where the practical conditions were defined which ended up posing a problem. »
As for possible conflicts of interest or breaches of professional independence, telehealth platforms leave room for doubt. It should be noted that Livewell charges $99 for a consultation to obtain Ozempic, but reimburses customers who do not obtain a prescription. In addition, medications delivered by Livewell’s Ontario partner pharmacy cost 20% more than those obtained from a Quebec online pharmacy.
“We are able to have access to the “terms and conditions” which give an idea of the operating procedure, but we do not have access to behind the scenes: what are the links between the professionals and the companies in question, the contracts which are signed ? We understand that they are independent workers who are responsible for their own practice, but within a very, very narrow shell. »
With Alice Girard-Bossé, The Press