NAPRA Annual Report 2024

About
NAPRA

2024-2028 Strategic Plan

Strategic Area #1

Strategic Area #2

Strategic Area #3

Transition to a Remote Work Model

The year 2024 marked the first year of implementation of NAPRA’s new Strategic Plan, a five-year plan developed to align with NAPRA’s renewed vision of Pharmacy regulatory excellence. This report highlights meaningful progress made in 2024 in the strategic areas identified as critical to advancing the central purpose of NAPRA, which is to provide the best possible support to its Members – the pharmacy regulatory authorities (PRAs) across Canada as well as the Canadian Forces Health Services – as they focus on their primary mandate of protecting and serving the public interest.

Significant activities undertaken in 2024 include:

Conducting research on models for licensure and labour mobility nationally and internationally to identify best practices.

Completing a preliminary background report to inform NAPRA Members’ work as they explore the question of national role definitions for pharmacy professionals.

Engaging with interested parties at the federal, national, pan-Canadian, and international levels on behalf of NAPRA Members.

Coordinating a community of practice for PRAs across Canada to address common issues and share knowledge and experiences relevant to pharmacy regulation, including hosting 14 PRA Roundtables, six information-sharing sessions related to NAPRA’s continuous quality improvement and medication incident reporting (CQI-MIR) and compounding documents, and more.

Maintaining the National Drug Schedules (NDS), including regular updates to the NDS listings, removal of all natural health products from the NDS, and review of three drug scheduling submissions by the National Drug Scheduling Advisory Committee (NDSAC). 

Advancing work on the NDS Modernization Project.

Managing Pharmacists’ Gateway Canada, which celebrated its 10th year in 2024 and has registered 32,725 international pharmacy graduates since its establishment in 2014.

NAPRA is privileged to work with a remarkable team of committed Board members, staff, and experts who support various NAPRA initiatives. NAPRA is grateful for their dedication and contributions that make our collective success possible.


About NAPRA

Visit the About NAPRA page for background information on NAPRA, including who we are, what we do, and our current Board of Directors.  Previous years’ annual reports are available here.  

This short presentation highlighting the respective roles of NAPRA and its Members as well as NAPRA’s programs and services to its Members and its impact on pharmacy practice in Canada also provides an excellent introduction to the organization and its work.

NAPRA’s Board of Directors is elected in the spring of each year. In May 2024, the following Board of Directors was elected to serve until May 2025.

From back to front and left to right: Kevin Hamilton (College of Pharmacists of Manitoba); Greg Eberhart (Alberta College of Pharmacy); Sean Meredith (Canadian Forces Health Services); Barbara Harvey (Government of Nunavut – Department of Health); Debbie Fischer (external Director); Noelle Patten (College of Pharmacy of Newfoundland and Labrador); Heather Christ (New Brunswick College of Pharmacists); Steph Connolly (Government of Yukon – Community Services – Professional Licensing and Regulatory Affairs); Michelle Wyand, Vice Chair (Prince Edward Island College of Pharmacy); Shenda Tanchak (Ontario College of Pharmacists); Manon Lambert (Ordre des pharmaciens du Québec); David Collie, Past Chair (external Director); Adele Fifield, NAPRA Executive Director (ex-officio); Bev Zwicker, Chair (Nova Scotia College of Pharmacists).

Not pictured: Connie Beck (external Director); Jeana Wendel (Saskatchewan College of Pharmacy Professionals); Ravan Bedingfield (Government of Northwest Territories – Department of Health and Social Services – Professional Licensing Office); Suzanne Solven (College of Pharmacists of British Columbia).

NAPRA 2024-2028 Strategic Plan: Year 1

Building on past progress and articulated around a keen understanding of the most pressing issues facing its Members, NAPRA’s 2024-2028 Strategic Plan marks the beginning of a new era, outlining clear priorities for action in strategic areas that will drive the association’s focus in the near future. These include facilitating a national dialogue on key facets of pharmacy regulation in Canada, engaging with Health Canada and other key national, pan-Canadian, and international organizations, and centrally coordinating major programs and initiatives on behalf of NAPRA’s Members. Progress made in 2024 in each of these areas is highlighted below.

Strategic Area #1: National Dialogue on Key Facets of Pharmacy Regulation in Canada

In recent years, there has been an increased focus across all levels of government on facilitating labour mobility between Canadian jurisdictions for health professionals and expediting the licensure of internationally trained health professionals. As the regulatory bodies for pharmacy in Canada, NAPRA’s Members are at the forefront of efforts to tackle the challenges of cross-jurisdictional movement of pharmacy professionals and accelerated foreign credential recognition for international pharmacy candidates while safeguarding patient safety. In support of longer-term efforts towards the alignment of pharmacy licensure processes and requirements in Canada, NAPRA started work in 2024 researching models for licensure and labour mobility nationally and internationally, with the aim of identifying best practices.

A related issue in the efforts to ensure consistency, fairness, and quality pharmacy care across the country is role definition for pharmacists and pharmacy technicians within the Canadian healthcare context. In this regard, NAPRA has completed a preliminary background report to inform its Members’ work as they engage in a national dialogue on, and possible development of, national role definitions. A related working group has also been formed.


Strategic Area #2: Strategic Engagement

As the national alliance of all Canadian pharmacy regulatory authorities (PRAs), NAPRA is uniquely positioned to be the eyes, ears, and voice for its Members on behalf of whom it engages with various interested parties at the federal, national, pan-Canadian, and international levels. 

Central to NAPRA’s engagement-related activities is engaging with Health Canada and other relevant federal government departments to ensure that NAPRA Members’ perspectives are shared on pertinent issues. Having identified the issue of Federally Enabling Pharmacists as Prescribers of Controlled Substances as one of key significance to its Members, NAPRA held meetings with Health Canada officials to discuss the topic and share its Members’ views. NAPRA also responded to various consultations by Health Canada related to this topic throughout 2024.

NAPRA also provided input into a variety of other Health Canada consultations, including on:

  • Non-prescription drug action plan 
  • Outsourced drug preparation
  • Cannabis
  • Drug shortages
  • Controlled substances

In addition to the above, NAPRA participated in various Health Canada meetings on topics such as drug shortages, cannabis legislative review, nicotine replacement therapy, as well as general update sessions.

NAPRA continued to engage with various non-governmental organizations on matters of mutual interest at the national, pan-Canadian, and international levels.

Highlights of engagement activities undertaken with non-governmental organizations in 2024 include:

NAPRA’s verification role in the National Association of Boards of Pharmacy’s Healthcare Merchant Accreditation Program which serves to identify safe and legitimate online pharmacies and online sources of pharmacy information.

NAPRA participation on external committees and boards of interested parties such as the International Pharmaceutical Federation’s Regulators Advisory Group (FIP RAG), the Canadian branch of the Alliance for Safe Online Pharmacies (ASOP Canada) as observer, and the Canadian Council for Accreditation of Pharmacy Programs (CCAPP).

Close collaboration through the year with PRAs and the Pharmacy Examining Board of Canada (PEBC) in relation to NAPRA’s work with international pharmacy graduates.

Facilitation of connections and consultation between NAPRA Members and organizations of interest, in addition to those mentioned above, such as the Canadian Pharmacists Association (CPhA), the Canadian Society of Healthcare-Systems Pharmacy (CSHP), the Association of Faculties of Pharmacy of Canada (AFPC), the Canadian Council on Continuing Education in Pharmacy (CCCEP), the Indigenous Pharmacy Professionals of Canada (IPPC), and the Canadian Generic Pharmaceutical Association (CGPA). 

Participation of key interested parties on the NAPRA Competencies Working Group and National Drug Schedules (NDS) Modernization Project multi-sector advisory table. A long list of interested parties was also invited to participate in public consultations on the NDS Modernization Project.

NAPRA attendance at the CPhA Summit on Pharmacy in Primary Care as well as the 2024 annual conferences of the Council on Licensure, Enforcement and Regulation (CLEAR) and the Canadian Network of Agencies for Regulation (CNAR).


Strategic Area #3: Central Coordinating Role

NAPRA’s central coordinating role includes providing continued support to its Members with the implementation and maintenance of major programs and initiatives requiring a national lens, such as producing model documents for Members to use as desired, facilitating the pharmacy regulatory authority (PRA) community of practice and knowledge sharing, and centrally managing the National Drug Schedules and Pharmacists’ Gateway Canada.

NAPRA Documents

NAPRA develops and publishes model documents that PRAs can use as desired, based on their specific needs. Given this, there can be slight differences between jurisdictions, and pharmacy professionals are responsible for knowing and adhering to the requirements in the province(s)/territory(ies) in which they practise. National documents help to align requirements across the country and reinforce their credibility, dependability, and acceptance throughout Canada. This contributes to the delivery of consistent quality care from coast to coast.

In 2024, NAPRA published the revised NAPRA Language Proficiency Requirement Policy as well as the Professional Competencies for Pharmacists and Pharmacy Technicians at Entry to Practice in Canada. Originally published in 2022, the Model Compounding Competencies for Pharmacists and Pharmacy Technicians in Canada was republished in 2024 with minor administrative changes made to the original document to refer to the new NAPRA professional competencies for pharmacists and pharmacy technicians at entry to practice.

Pharmacy Regulatory Authority Community of Practice and Knowledge Sharing

NAPRA facilitates regular PRA Roundtables with the aim of supporting information sharing and collaboration among its Members. Fourteen such meetings took place in 2024. 

NAPRA also hosts regular information-sharing meetings related to its suite of compounding documents, as well as its continuous quality improvement and medication incident reporting (CQI-MIR) document. In 2024, NAPRA hosted a total of six information-sharing sessions related to the compounding and CQI-MIR documents. Meetings of the Pharmacy Technician and the Registration and Licensure Information-sharing Groups as well as two Cross-jurisdictional Roundtables were also held over the year.

National Drug Schedules

Health Canada, NAPRA, and the provincial/territorial governments each have distinct roles related to drug scheduling in Canada. Health Canada has the authority and responsibility to authorize health products (e.g., drugs, natural health products, and medical devices) for sale in Canada. As part of this process, Health Canada determines whether a drug requires a prescription for sale in Canada. NAPRA’s role in the process begins after Health Canada has authorized a drug for sale in Canada and determined whether it requires a prescription for sale.

On behalf of its Members, NAPRA administers the National Drug Schedules (NDS) program, a national drug scheduling model established with the aim of aligning the provincial/territorial drug schedules so that the conditions of sale for non-prescription drugs would be more consistent across Canada. The NDS consist of three schedules / four categories of drugs.

In 2024, NAPRA continued to effectively manage the ongoing operations of the NDS program. Regular updates to the NDS were completed to align with changes to the Health Canada Prescription Drug List (PDL) and schedules to the Controlled Drugs and Substances Act (CDSA) and its regulations, as well as changes due to National Drug Scheduling Advisory Committee (NDSAC) review decisions. Finally, additional changes were made to the NDS to match natural health products policy decisions implemented over the year.

The NDS were modified in early 2024, pursuant to scheduling decisions made at the NDSAC meeting held in December 2023 to review ophthalmic brimonidine 0.025%. Fixed-dose combinations of acetaminophen and ibuprofen were also reviewed at the meeting but there was no change recommended to the existing scheduling.

The NDSAC reviewed three drug scheduling submissions in 2024. The NDS were modified following a review of pediatric desloratadine in June and nirsevimab in September. 

A meeting was also held in December 2024 to review cetirizine for use in children 2 to 11 years. The Committee’s recommendations regarding this scheduling submission were to be approved by the NAPRA Board of Directors in early 2025.

Work on Phase 1B of the NDS Modernization Project, launched in 2023 with the objective of determining the most appropriate drug scheduling model for the future (including conditions of sale), continued to progress in 2024. Background research and environmental scanning activities were completed, and numerous engagement activities were held with select groups of experts, resulting in agreement on the most feasible options for consultation. A broad public consultation on two proposed non-prescription drug (NPD) scheduling models and their associated conditions of sale for consideration for the modernized program was held from May-July 2024, the results of which were discussed by a group of experts in September 2024. A recommended model was to be reviewed by the NAPRA Board of Directors in January 2025.

In accordance with its Policy for Natural Health Products (NHPs), NAPRA was to complete the elimination of all NHPs from the NDS with the removal of ephedrine and pseudoephedrine on January 2, 2024, in the stepwise, risk-based approach initiated in 2019. Following a request from Health Canada to delay the removal of single-ingredient ephedrine and pseudoephedrine from the NDS and further discussions held in early 2024, NAPRA agreed to the requested delay and moved forward with the removal of all listings for combination products with ephedrine and pseudoephedrine from the NDS on March 1, 2024. Health Canada having implemented a measure to address single-ingredient ephedrine and pseudoephedrine, NAPRA proceeded with their removal from the NDS in June 2024. Therefore, as of June 10, 2024, all products with a Natural Product Number (NPN) or Drug Identification Number-Homeopathic Medicine (DIN-HM) from Health Canada are outside the scope of NAPRA’s NDS.

The Background on Update to NAPRA NHP Policy outlines in further detail the history of NHPs as they relate to the NDS. 

Pharmacists’ Gateway Canada

International pharmacy graduates (IPGs) who wish to practise pharmacy in Canada (except those in Quebec and those who are eligible for the streamlined/expedited pathways offered in Newfoundland & Labrador, Nova Scotia, and Prince Edward Island) must enrol in Pharmacists’ Gateway Canada for International Pharmacists (Gateway) as their first step in the process to become a licensed pharmacist in Canada. NAPRA administers and maintains Gateway in support of its Members, who are responsible for regulating all pharmacists in Canada.

The public-facing part of the Gateway website provides pertinent, clear, and complete information to the thousands of IPGs each year seeking to learn how to become licensed pharmacists in Canada. Gateway guides applicants through every step in the licensure process for each province and helps IPGs identify the requirements that can be completed before their arrival in Canada.

In addition, Gateway provides tremendous value not only to IPGs but to all other parties involved in the licensure process – i.e., pharmacy regulatory authorities (PRAs), the Pharmacy Examining Board of Canada (PEBC) – as it establishes a central national document repository to support seamless communication among all concerned.

Established in August 2014, Gateway was proud to celebrate its 10th anniversary in 2024. There were 4,361 IPGs newly enrolled in Gateway in 2024, comfortably surpassing annual enrolment targets. By the end of December 2024, a total of 32,725 IPGs had enrolled in Gateway since its inception.

The Gateway team provides direct support, by phone and email, to IPGs as they progress through the various stages of the licensure process and to others interested in the licensure process. In 2024, the Gateway team responded to 5,140 inquiries, of which 80% were via email and 20% by phone.

The NAPRA Diagnostic Tool and Learning Modules (DTLM) is an online learning program that addresses participants seeking to increase their understanding of the knowledge and skills required for pharmacy practice in a Canadian setting and/or are preparing to meet the requirements of the PRAs for licensure in their respective jurisdictions. Interest in the DTLM continued to grow in 2024, with a total of 141 participants enrolled in the program by the end of the year.

Finally, the Gateway team continued to engage with PRAs across Canada and the PEBC through the year to exchange information and coordinate efforts to assist IPGs on their licensure journey.

Threaded throughout NAPRA’s 2024-2028 Strategic Plan is the need to ensure NAPRA’s organizational capacity to continue to ably support its Members as they work to protect and serve the Canadian public interest through effective pharmacy regulation in their respective jurisdictions.


Transition to a Remote Work Model

NAPRA had been successfully using a remote work model, with greatly reduced use of its office space, since the COVID-19 pandemic. Therefore, NAPRA made the decision to divest of its office space and moved to a remote model effective December 2024. By extension, that decision helps ensure NAPRA’s organizational capacity to support the mandates of its Member organizations which is an area of focus in NAPRA’s 2024-2028 Strategic Plan.