Many physicians have inquired whether the standard applies in the context of providing short-term samples to their patients. It does not. The existing standard is clear that providing short-term samples to patients free of charge is excluded.
Most Canadian regulatory colleges have set out expectations of physicians who sell and dispense drugs to their patients through policy, standards and/or regulations. First and foremost is the expectation that physicians must act in the best interest of their patient. There are requirements to comply with both federal and provincial laws and regulations as they relate to sale and dispensing of drugs, such as the use of proper methods of procurement, chain of custody and secure storage of drugs; records retention for purchase and sale of drugs; appropriate packaging, labeling and patient-related material for drugs they dispense; and the general observation that it is a conflict of interest for a physician to profit from the sale of a drug except in limited circumstances. For that reason, it is expected that physicians will only sell and dispense drugs that are necessary for the immediate treatment of the patient or where the services of a pharmacist are not reasonably available.
The regulations for the practice of medicine in BC require physicians to seek the written consent of the College Board to sell and dispense drugs to their patients. The College is working with the Ministry of Health to consider how best to regulate this area of practice. In the meantime, physicians who sell drugs to patients are encouraged to seek the written consent of the Board as is required. Examples would include physicians who sell vaccines to patients at a travel clinic or sell prescription medications to patients that are administered as part of a procedure.
The standard Sale and Dispensing of Drugs by Physicians is currently under review. Future editions of the College Connector will provide updates. I would also like to remind physicians of the existing standard Promotion and Sale of Products, which stipulates that physicians must only charge patients a reasonable markup of no more than 15% when selling drugs to patients.
While the consultation on the Bylaw amendment has closed, feedback on the standard is still welcome. Comments can be emailed to firstname.lastname@example.org.
Heidi M. Oetter, MD
Registrar and CEO