Province Introduces Biosimilars Initiative
All patients on specified biologic medications must be transitioned by January 31, 2025, to designated biosimilar medications. This is the news released just a few days ago under a new Biosimilars Initiative launched by Manitoba Health. We are interested to know what physicians think about this change. Below, we offer a brief summary with links to learn more, and then invite your feedback.
Under this initiative, drug coverage will transition from more expensive biologic medications to less expensive biosimilar versions, when available. Initially, this include 10 biologic medications current covered under Pharmacare. This transition will require a new prescription from as biosimilars and biologics are not considered interchangeable. This must be done before January 31, 2025 to maintain Pharmacare coverage.
Patients will receive notification letters in the next few weeks, which is expected to result in requests to prescribing physicians. Physicians will receive a list of patients for whom they have submitted Exceptional Drug Status (EDS) forms. Original biologics can be continued instead of a biosimilar, but only for a medical reason.
Manitoba follows several other provinces that have already introduced biosimilar initiatives. The Manitoba Biosimilar Initiative initially will transition away from the following Biologics: Humira, Lovenox, Enbrel, Neupogen, Copaxone, Remicade, NovoRapid, Lantus, Humalog, and Rituxan.
You can learn more here:
Memo to Physicians (link to PDF)
What do you think?
We are interested in what you think about the Biosimilars Initiative. The main concern we have heard so far is about the timing. While Manitoba Health has worked on the Biosimilars Initiative for over four years, physicians and patients are being provided with less than 6 months notice to transition. Many patients have annual appointments with their specialist, so many will require additional appointments to transition them to biosimilars.
Please send your views to us in confidence at practiceadvice@doctorsmanitoba.ca. We will be following up with Manitoba Health.
Scope of Practice Expansions
Across Canada, we are seeing expansions to the scope of practice for other health care professionals along with government funding to support their fully independent practice. This includes, notably, pharmacists and nurse practitioners. Expanded scope of practice can help physicians and patients through stronger physician-led team-based care, but it also has the potential to create risks such as more silos and fragmentation for patients to navigate. We are forming a working group of physicians to help us understand these changes, including where expanded scopes can improve patients’ access to safe and high-quality care, and where it creates new risks for patients or additional burden for physicians.
This summer, the Ontario government announced a plan to expand pharmacists’ scope of practice, allowing them to independently offer primary care for an even broader list of “minor ailments.” Similar retail pharmacy primary care options have been introduced in several other provinces.
In Ontario, retail pharmacists can already treat and prescribe for 19 common ailments, such as cold sores, pink eye, and UTIs. In the first year and half of that initiative, retail pharmacies in Ontario provided over 1 million assessments. The proposed expansion would include 14 more conditions, such as treating shingles, mild headaches, and minor sleep disorders, as well as ordering more lab tests, conducting point-of-care testing, administering more types of vaccines, and expanding medication reviews.
The Ontario Medical Association and individual physicians in that province have been quick to respond, raising concerns about how the expansion will “fragment care in an already fractured health care system,” jeopardize patient safety, and risk more patients falling through the cracks. Physicians have pointed out that what may seem to a patient or pharmacists as a minor ailment could be much more serious. The OMA also pointed to a recent report published by the Ontario College of Pharmacists which said that pharmacists are under corporate pressure to meet growing volume targets for certain services. That report found that 34.2 per cent of respondents said they were under pressure to complete minor ailment assessments in under five minutes.
In Manitoba, the previous government set up funding for retail pharmacists to treat minor UTIs and offer vaccines to more people. The PC Party promised in the 2023 election to expand pharmacists’ scope even further, but they did not win the election to fulfill this election promise. It is unclear whether or not the current government is planning an expansion.
Meanwhile, the federal government is considering guidance to limit fees charged to patients for primary care services. This is largely in response to nurse practitioners and other providers charging patients for service that physicians typically can only offer under provincial health plan, but it is expected to force provinces to consider if and how they fund these providers when they offer medically necessary care.
We want to hear from you. Send your thoughts to practiceadvice@doctorsmanitoba.ca, including where expanded scope of practice could be beneficial and where it can pose risks. If you are interested in submitting your name to join a special working group to look at these issues, please send your name along with details about your practice to practiceadvice@doctorsmanitoba.ca.
Tee Off in 25 Days!
Our Getting Healthy Golf Tournament is less than a month away, on Tuesday, September 3. You can still register, and we now have a contest running for 2 free spots open to medical students, residents and physicians who otherwise would not be able to attend.
Win 2 free spots, courtesy of Doctors Manitoba ($380 value)!
Be one of the 3 lucky pairs selected and prepare to tee off! Contest closes August 14th. To enter: follow @DRMBinfo on Instagram, tag the colleague, classmate, resident, or friend in the comments you would like to bring for a chance to win 2 spots in the Getting Healthy Golf Tournament on September 3rd! No limit on entries.
Still Time to Register
We have an impressive list of amazing prizes, a fun day planned, and limited space left. Join us at one of Manitoba’s première golf clubs, Southwood, to connect with colleagues from across the province. You can register as a single, pair, or a foursome. The event includes access to practice facilities, lunch, 18 holes with a powercart, and an informal dinner.
Prizes include an amazing line-up of tickets to the Blue Bombers, Valour FC, Rumours Comedy Club, 2 rounds of Golf at Southwood, or a one night stay at Inn at the Forks.
Or something different we haven’t advertised yet?
Feeling confident in your long drive? Compete in the long drive contest sponsored by Manulife for the chance to win a $150 Golf Town Gift Card!
Find out more and register at doctorsmanitoba.ca/golf24
The tournament is presented by MD Financial and Scotiabank with support from Bokhaut CPA.
It Pays to Renew with Doctors Manitoba
All fully licensed and retired physician should have received their annual membership renewal notices on Thursday via email. New this year is your ability to claim new rebates and benefits during your renewal!
Last week, our President Dr. Randy Guzman announced three exciting things that you will notice when renewing your membership this year (see his letter here):
The Board has frozen membership fees for 2024/25, keeping our medical association fees among the lowest in Canada.
You will be able to claim a new $1,000 CPD rebate if you’ve completed your minimum Continuing Professional Development credits over the past year.
If you work in rural or northern communities, you can confirm your eligibility for the first year of our new Rural and Northern Retention Benefit.
We encourage you to renew using our online Member Portal Renewal Option, as it will allow you to claim these new rebates and use our new Rebate Check-Up to ensure you haven’t missed claiming any other recent rebates or benefits. To do this:
Log in using your email address and password. If you need help setting up your Member Portal account or accessing it, contact us at portalhelp@doctorsmantioba.ca.
Have your credit card handy to pay your membership fee. You can also indicate you plan to pay via cheque or internet banking.
During the renewal process, you will be able to update your personal and contact information. If it’s not already on file, you can also add your gender identity and race, ethnicity, or Indigenous identity. This is optional and all responses are stored securely. We have expanded the list of options to include Latin American and Jewish based on physician feedback, in addition to existing options such as Black, Middle Eastern, South Asian, Southeast Asian, Indigenous, and White. Having this information on file helps us better understand the different experiences of physicians, address inequities and discrimination, and ensure our Boards and Committees are representative of the broader medical profession.
Click here to learn more about why we collect this, how we protect your data, and what we use it for.
Phenomenal Physicians
Tooba Razi recognized with Canadian Medical Hall of Fame Award
The Canadian Medical Hall of Fame (CMHF) Award recognizes medical students with an established track record of community leadership and superior communication skills who have demonstrated interest in advancing knowledge. Tooba Razi, a student at Max Rady College of Medicine, Rady Faculty of Health Sciences is one of 17 Canadian medical students selected to receive this award!
You can learn more about the awards and read Tooba’s profile here.
Health System Updates
PDSA drives continuous quality improvement
The Plan-Do-Study-Act (PDSA) cycle is a powerful tool for driving continuous quality improvement (QI) initiatives, including those in a primary care setting. It involves four steps: planning a change, implementing the change on a small scale (doing), observing and analyzing the results (studying), and making necessary adjustments (acting). This iterative process allows teams to test change ideas quickly and efficiently, ensuring improvements are effective and sustainable.
The Access Improvement Model (AIM) program provides a structured approach for primary care teams to implement their first PDSA cycle for a self-selected QI project. Participants work to identify one or more root causes of an access-related issue and develop change ideas to address the most pressing root cause, as determined by the working group. The PDSA cycle begins with a detailed plan outlining the steps, along with a prediction of what the outcome(s) will be. Teams then carry out the plan, collect and analyze data, and refine the approach for the next cycle based on their findings. This method ensures that changes are thoroughly tested and adapted to meet the specific needs of the clinic.
We encourage primary care teams to join our AIM program to experience firsthand the benefits of the PDSA cycle. By participating, teams will gain valuable skills in quality improvement, change management, and team-building to ultimately improve patient access and care. If you would like to explore AIM in greater detail, please visit the AIM website and be sure to reach out to us at aim@sharedhealthmb.ca.
West Nile monitoring prompts spraying order
Mosquito spraying has been ordered for the City of Winkler, the town of Altona and portions of the RM of Rhineland, two areas of Winnipeg and portions of the RMs of Macdonald and West. St. Paul. This is due to a high number of Culex tarsalis mosquitos and evidence of mosquito infection with West Nile Virus. Public health officials note that wet conditions early in the season and recent hotter, drier weather have created ideal conditions for Culex tarsalis mosquitoes that can spread the West Nile virus. The risk for potential human exposure to WNV at this time is high in the Southern Health-Santé Sud region, and this will likely continue during the historical high-risk period (mid-July to mid-August). At this time, no locally acquired human cases of WNV have been confirmed in Manitoba.
CAGS education survey
Surgical assisting has become more and more complex, especially with the increase in advanced MIS procedures, and the skill set requires far more than “just being a retractor holder.” The Canadian Association of General Surgeons (CAGS) recognizes that these skills can be challenging to acquire and that there are limited resources for training and mentoring.
The CAGS Education Committee would like to gauge interest from Surgical Assistants across the country in incorporating training and educational opportunities at our annual meeting. We have created a short survey to gather feedback, such as likelihood of attending, course format and content. We are hoping that this can guide our efforts.
We would greatly appreciate it if you could take the time to complete this survey.
My Health Team coming to Northern Manitoba
Northern Manitoba will finally receive a My Health Team. With an investment of over half a million, the Team will support an expansion of addictions and mental health services offered at the Beatrice Wilson Health Centre. There are fourteen other My Health Teams in Manitoba. Read more.
New mobile clinic for homeless and at-risk Winnipeggers
The government and the Aboriginal Health and Wellness Centre are establishing a mobile clinic as a one year pilot to offer primary care services to underserved populations. Health Minister Uzoma Asagwara explained that “people sometimes struggle to see a doctor or get regular check-ups when they are in precarious situations.” The clinic will include physicians, nurses and other workers who set up at designated locations to provide primary care services to unhoused or precariously housed individuals. Read more.
ICYMI
Here’s the latest and most popular stories, in case you missed them:
Upcoming Events
You can always review upcoming events on our events calendar page.
CADDRA 2024 Early Bird Registration
Registration is open for CADDRA 2024 at the Fairmont Hotel in Winnipeg this September. The educational event is for professionals in ADHD research and healthcare. Pre-conference options on Friday, September 27th, include ADHD Research Day and ADHD Primer for Healthcare Professionals. The main conference is on Saturday and Sunday, September 28 – 29. Check the schedule and register by August 23rd for early bird rates!
MAAP 2024 Summer Symposium and Retreat
This year’s Manitoba Association of Asian Physicians symposium will take place August 23 and 24, at Elkhorn Resort in Clear Lake. The CME is accredited for 7 Mainpro credits and will focus on psych health, gyne, geriatric medicine and emerging technologies.Register now.
Canadian Surgery Forum
For the first time ever the largest surgical meeting in Canada will be held in Winnipeg, Manitoba from September 25 – 28. To help celebrate, the Canadian Surgery Forum will do a draw of all Manitoba surgeons who register and attend to receive a refund of their conference registration post event.*
Held at the RBC Convention Center at 375 York Ave., the Canadian Surgery Forum includes scientific and educational sessions offered through interactive symposia, panel discussions, postgraduate courses, debates, plenary sessions, video sessions, and ‘Meet the Fellowship Director.’
The theme of CSF 2024 is “Surgery Through Inclusive Innovation.” Delegates can expect over 50 accredited sessions across all participating sub-specialties, with full and half-day post graduate courses, content geared towards community and rural surgeons, and free child care!
Visit canadiansurgeryforum.com for speaker bios, the conference program, travel and accommodation information, and to register!
Members of CAGS and CSF partner sub-specialty societies qualify for special discounted member rates!
Don’t forget, Doctors Manitoba members are reimbursed for continuing medical education expenses.
For all conference information, including registration information and pricing, and the scientific program, please visit the CSF 2024 website.
*Draw excludes the cost of post-graduate courses.
Federation of Medical Women in Canada Educational Conference & AGM
The FMWC conference is set for the Fairmont Château Laurier Hotel in Ottawa September 27 – 28, 2024, a special ACCREDITED event to celebrate the organization’s 100th anniversary. Come and network with medical leaders from across Canada including award winner Dr. Theresa Tam, Canada’s Chief Public Health Officer, CMA Co-Presidents Dr. Kathleen Ross and Dr. Joss Reimer, plus Globe & Mail health columnist André Picard and a special virtual presentation by Dr. Jane Philpott! Register here.
Scotia Households for Physicians
Sponsored content
Through the Scotiabank Healthcare+ Physician Banking Program, as a physician when you open or switch to an Ultimate Package or Preferred Package chequing account, you pay no monthly account fee.
For a limited time, with Scotia Households, you can invite up to 3 household members to enjoy savings on their banking — if they set up qualifying transactions. *Conditions apply. Offer ends March 31, 2025.