Following two public consultations with stakeholders, the Government of Ontario (Ministry of Finance) is moving forward with legislation to regulate preferred provider networks (PPNs).
As we previously reported, there has been increasing scrutiny of closed PPNs, which are arrangements set up by the payer (e.g., insurance companies) where prescription drugs can only be accessed by patients through a limited group of pharmacies. The contractual agreements for such arrangements are not transparent.
According to the Fall Economic Statement, the proposed legislation would enable an “Any Willing Provider” framework, along with introducing a standardized, transparent process for patients to seek exemptions from PPNs where appropriate. This new framework would allow any pharmacy to join the network if they are willing to match a PPN’s financial terms.
Bill 68, which passed First Reading on November 6, 2025, sets out the proposed amendments to the Insurance Act to implement this new framework:
“New section 299.1 of the Insurance Act provides that if an insurer provides reimbursement or other payment in respect of a drug dispensed by an operator of a pharmacy, the insurer shall provide the same reimbursement or other payment in respect of that drug for all operators of pharmacies that dispense it, subject to certain limits.”
According to the government, the intent of the “Any Willing Provider” framework is to enable expanded consumer choice and competition in the pharmacy sector, while maintaining cost-effective access to medications.
As stated in its March 2025 notice, the Ontario College of Pharmacists (OCP) had deferred further steps pending clarification from the Ministry of Finance regarding its approach on PPNs. We expect OCP to issue its position in the coming year in light of the latest development. While Bill 68 amends the Insurance Act and therefore only encompasses PPN arrangements subject to that Act, the OCP’s position can have a broader impact and encompass any PPN arrangement involving a pharmacy.
Should you have any questions, please do not hesitate to contact a member of the Life Sciences Regulatory & Compliance Group.
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