Patient Steering, PPNs, and the Danger to Patient Safety in Canada

A recent announcement that Novo Nordisk and PocketPills are teaming up to deliver Ozempic and Wegovy directly to patients has raised serious alarms across the pharmacy profession. At first glance, this might appear to be an “innovation” in access and convenience. But in reality, this is a classic example of a Preferred Provider Network (PPN)—a practice that restricts patient choice, undermines patient safety, and prioritizes profit and data collection over healthcare.

What Are PPNs and Patient Steering?

• PPNs (Preferred Provider Networks) occur when pharmaceutical companies, insurers, or virtual pharmacies enter into exclusive arrangements that funnel patients into a single channel of care.
• Patient Steering happens when patients are pressured—directly or indirectly—to use a specific pharmacy or delivery service, often through insurance coverage rules, manufacturer programs, or subtle marketing tactics.

On the surface, these arrangements are marketed as “convenient, private, and modern.” In reality, they:

• Limit patient choice by excluding trusted community pharmacists.
• Undermine continuity of care since important medications are excluded from the patient’s main pharmacy profile.
• Risk patient safety because chronic disease patients often take multiple interacting drugs that require pharmacist monitoring and counselling.

The Problem with Biologics and Mail Delivery

Ozempic and Wegovy are biologic medications that require specialized cold-chain handling and storage.

• If exposed to freezing temperatures (for example, in a mailbox overnight in a Canadian winter), the medication becomes inactive and ineffective.
• Biologics like these are not pills that can sit on a shelf—they are fragile and must be handled with precision by trained healthcare professionals.
• Mailing them across vast geographies in Canada, exposed to delays, heat, or freezing, is reckless and unsafe.

This isn’t just hypothetical. Every winter, Canada sees subzero conditions from coast to coast. Freezing during transport is inevitable—and frozen medication is wasted medication. Worse, patients may unknowingly inject a product that no longer works, delaying treatment and putting their health at risk.

The Privacy and PHIPPA Problem

Another major concern is how counselling is being delivered.

• PocketPills and Novo Nordisk advertise “confidential pharmacist access” via text or email.
• But under Ontario’s Personal Health Information Protection Act (PHIPPA), unencrypted email is not a secure channel for transmitting personal health information.
• This approach puts patient privacy at risk, while also reducing counselling to a few lines of digital text instead of a comprehensive, face-to-face discussion.

This is especially dangerous given that Ozempic and Wegovy patients typically have multiple chronic conditions (diabetes, hypertension, high cholesterol, heart disease). These medications interact with other drugs and require careful dose adjustments. It is impossible to provide the complete, comprehensive, caring, and connected counselling patients deserve through email exchanges.

The Quebec Exception

It is telling that this program is not available in Quebec. Why?
Because Quebec has strong laws against PPNs and patient steering that protect patient choice. Patients there cannot be coerced into abandoning their community pharmacist for a manufacturer’s preferred partner. If Quebec can protect patients, why can’t the rest of Canada?

Who Really Benefits?

While marketed as patient-centered, these programs are designed to:

• Protect Novo Nordisk’s brand-name market share in the face of soon-to-arrive Canadian-made, lower-cost generic alternatives.
• Collect patient data through sign-ups, call centers, and digital platforms.
• Help insurers and delivery services like PocketPills profit through exclusive backroom arrangements.

The patient, unfortunately, does not benefit. In fact, the patient loses:

• Choice of pharmacist
• Continuity of care
• Medication safety
• Personal data security

A Call to Action

This is dangerous and unacceptable. Patients should not be pawns in corporate arrangements between insurers, manufacturers, and online pharmacies.

We call on policymakers and regulators to:

1. Ban patient steering and PPN arrangements in Ontario and across Canada.
2. Entrench patient choice in legislation.
3. Enshrine patient safety and continuity of care as non-negotiable principles of our healthcare system.

Healthcare should put the patient first—not be profit-driven.

If you agree, please contact your local MPP and tell them you want strong laws, like Quebec’s, to protect patients from unsafe, profit-driven steering arrangements.

Our Commitment

• We provide in-person counselling on all your medications.
• We ensure safe handling and storage of sensitive drugs.
• We protect your privacy under PHIPPA.
• We work closely with your physicians and care team for continuity of care.

Your health is too important to be outsourced to a call center and a courier truck.

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.