Since January 2023, Ontario pharmacists have quietly logged 2.4 million minor ailment assessments — across 99% of the province's pharmacies. Turns out the degree covers more than counting pills. The government noticed. This July: nine new conditions, six new vaccines. Five more conditions expected in 2027, heading toward 33 total. The profession made its case with volume, not arguments. The numbers did the talking.
Good morning. 🫡
Quick Scan
Before the queue hits double digits.
- Starting July 2026, Ontario pharmacists can administer six publicly funded vaccines — RSV, pneumococcal, shingles, tetanus, diphtheria, and pertussis. If your pharmacy isn't already enrolled in the program, applications are open now. Deadline: June 30.
- Canada approved the first generic semaglutide in the G7 — while everyone else was still debating it.
- Honda suspended its $15B EV complex in Alliston indefinitely — the same week Canada opened the door to 49,000 Chinese EVs at 6.1% tariff. If you've been eyeing a BYD, your timing is impeccable.
- The global economic map shifted hard over the last decade — India up 83%, Japan down 14%. Canada held its own. Barely.
- 6% fat milk just hit Ontario shelves — Sealtest responding to consumer demand and full-fat dairy's moment in the cultural conversation. Health Canada still recommends lower-fat options for adults. Your patients are going to ask.
Main Story
28 Conditions. Still One Question Nobody's Answering.
The July 1 scope expansion isn't news. What comes next is.
What happened: You already know. Nine new conditions, six new publicly funded vaccines — effective July 1, 2026. Calluses, dandruff, dry eye, head lice, jock itch, mild headache, nasal congestion, ringworm, warts. Five more conditions are expected in early 2027, bringing Ontario's total to 33.
So what: Ontario pharmacists have delivered 2.4 million minor ailment assessments since 2023 — that's not a pilot, that's a track record. The profession earned this expansion. What sits underneath it is a number that rarely gets said out loud: Ontario's ODB dispensing fee has been $8.83 since 2012 — nearly unchanged for over a decade while the cost of running a pharmacy hasn't stood still. Quebec pharmacists negotiate their dispensing fees through their provincial association. Ontario's has been $8.83 since 2012. Same country. Different conversation. Scope keeps expanding. The fee doesn't move. That's not a reason to slow down — it's context for what "doing more" actually means on the ground.
Now what: OCP's mandatory learning requirements are still being finalized — public consultation closes May 31. The implementation clock is ticking faster than the regulatory framework. July 1 will arrive on schedule regardless.
⚡ Rapid Fire
💊 Rybelsus is having a week.
Health Canada approved a new Rybelsus formulation — smaller round tablet, new dose ladder of 1.5/4/9 mg replacing 3/7/14 mg, same efficacy, no new Rx needed. Existing patients switch at the pharmacy level — know before your patient knows.
Counter tip: In the US, Novo Nordisk just retired the Rybelsus brand entirely and rebranded the same new formulation as the "Ozempic pill" to ride the brand recognition. Not in Canada yet, but when your patient asks for it, now you know what they mean.
Meanwhile, Novo Nordisk and Rexall launched Novo Nordisk Care Rx — home delivery for Ozempic, Wegovy, and Rybelsus at in-store prices (excluding Quebec), with pharmacist phone support. Groundbreaking stuff. Apparently you can now get your semaglutide delivered to your door — a service that, coincidentally, every independent pharmacy with a fax machine and a courier account has been offering for years. But sure, press release.
📈 Tirzepatide: 16x in one year.
The 2026 Express Scripts Canada Drug Trend Report dropped this week and the tirzepatide number is the one to bookmark: claimant numbers rose nearly 16-fold year over year. Not 16% — 16 times. Total drug spending rose 7.3% in 2025, hitting $706 per plan member. Specialty drugs represent just 1.1% of claims but 31.6% of total spend. If you're not already fielding Mounjaro coverage questions daily, you will be soon.
🧴 The oral psoriasis pill is coming — file it now.
Icotyde (icotrokinra) — FDA approved March 2026, the first oral IL-23 receptor blocker for moderate-to-severe plaque psoriasis — once daily, no injection. Your patients on Skyrizi or Tremfya injections are going to start asking about it. J&J projects $10.5B in sales by 2032. No Health Canada submission confirmed yet — US only for now. But worth knowing now: one oral pill replacing an injectable biologic, expanding indications on the horizon. Your patients will ask before coverage is figured out.
🤖 The AI scribe got the drug wrong. 60% of the time.
Ontario's Auditor General tested 20 approved AI scribe systems used by Ontario doctors. All 20 had at least one inaccuracy. Nine fabricated clinical information that was never mentioned. Twelve captured a different drug than what the doctor actually prescribed. Seventeen missed key mental health details. The province weighted "domestic presence in Ontario" at 30% in its procurement scoring. Accuracy of medical notes: 4%. The prescription that lands on your counter tomorrow may have been informed by a note that got the drug wrong. That's not hypothetical — that's 12 of 20 approved systems, tested last month.
🔢 Notable Numbers
7.3%
The increase in total Canadian prescription drug spending in 2025, per the 2026 Express Scripts Canada Drug Trend Report. Average spend per plan member hit $706, up from $658. The drivers: GLP-1s, specialty biologics, and newer chronic disease therapies. The trend line is not flattening.
50%+
The share of Canadians aged 65 and older living with two or more chronic conditions simultaneously, per a March 2025 Statistics Canada Health Report. Multimorbidity isn't the exception at your counter — it's the majority. And the population getting older every day.
414
New dementia diagnoses every single day in Canada as of 2025, per the Public Health Agency of Canada. Nearly 772,000 Canadians are currently living with dementia — projected to pass one million by 2030. These patients are on complex medication regimens. They're already at your counter.
🔬 The Evidence
We always link to the original. Old studies get flagged. If the data has moved on, we'll say so. Fact-check us — a newsletter that can't survive a skeptical pharmacist isn't worth your Wednesday morning.
GLP-1s and alcohol use disorder — the signal is getting harder to ignore.
A 2025 eClinicalMedicine systematic review and meta-analysis pooled data across randomized controlled trials and observational studies looking at GLP-1 receptor agonists and alcohol consumption. The finding: patients on semaglutide and liraglutide consistently showed reduced alcohol use, lower relapse rates, and fewer alcohol-related diagnoses — not as a side effect anyone was tracking, but as a pattern that kept showing up. Mechanistically, the theory is dopamine pathway modulation — the same reward circuitry GLP-1s seem to dampen for food. No approved indication, no Canadian coverage for this use. But your patients on Ozempic who quietly mention they're drinking less? Not imagining it. Worth knowing before they ask. (Published 2025 in The Lancet's eClinicalMedicine — most comprehensive meta-analysis available to date.)
The Pick
🎧 Listen: Hidden Brain — psychology and human behaviour, no politics, no jargon. Just why people do what they do. Good for the commute or the drive between locations.
🎬 Watch: Dopesick on Disney+ — eight episodes on how OxyContin got approved, marketed, and defended. Hits differently when you're the one who dispensed it.
💡 Try: Notion — free, works on your phone, good for anyone drowning in tabs, screenshots, and forwarded emails they keep meaning to deal with.
💬 Counter Talk
A fax arrived at pharmacies this week. A virtual care clinic advertising their renewal service now that PrescribeIT is gone and the fax backlog is back. Physician or NP, same-day, billable to the province. First thing they ask the patient for is their health card number. The pharmacist reading that fax is also authorized to renew that blood pressure medication — but authorized and billable are two different things in Ontario. They either charge the patient cash and hear "why would I pay you when my doctor does it free?" or they absorb it quietly and move on. The clinic sends a fax. The pharmacist is standing in the middle of it, unbillable.
😂 Meme of the Week
Every weight-based antibiotic dose. Every time. God bless the 2.2.
That's it. If this landed, forward it to a pharmacist who'd get it.
— The Sig Happens Team 💊