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Bill 67 / What changes

In effect December 9, 2026

What changes for pharmacists.

A summary of the activities expanded by Bill 67 and its regulation, with the limits to keep in mind. For detailed steps, see the Ordre’s practice guides (in French), which are authoritative.

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The scope of practice is updated. Pharmacists assess health status, and prevent and treat disease through the appropriate use and management of drugs. Assessing physical or mental condition and ordering tests may therefore also serve a therapeutic or preventive purpose. The new regulation on certain professional activities under section 17 of the Pharmacy Act applies from December 9, 2026. Sources: OPQ, summary of what is new (in French) · Québec Ministry of Health, announcement of August 20, 2026 (in French) · Gazette officielle du Québec, September 2, 2026 (Orders 1340-2026 and 1341-2026), pp. 5398-5404 (in French)
01

Prescribing for a common health problem

What it allows

  • Prescribe with no prior diagnosis if the problem is frequent, has typical signs or symptoms that are easy to assess, and improves with limited follow-up and time-limited treatment.
  • The patient must be at low risk of short-term deterioration, and the problem at low risk of harm.
  • The guide gives non-exhaustive examples, such as herpes zoster, yeast vaginitis or uncomplicated urinary tract infection.

Limits to keep in mind

  • The regulations do not set a list of common health problems: each situation is assessed.
  • All criteria must be met. Otherwise, refer the patient to an authorized professional.
  • Also check your own competence and what your setting allows (resources, access to other services).
  • No designated substances (narcotics, controlled drugs, targeted substances).

Sources: OPQ, summary of what is new (in French), p. 2 · OPQ, practice guide on professional activities (in French), p. 16

02

Prescribing for a diagnosed chronic disease

What it allows

  • Prescribe drug therapy for a patient whose chronic disease was diagnosed by an authorized professional (physician, nurse practitioner).
  • The guide notably cites diabetes, hypertension, dyslipidemia, asthma and certain mental health conditions, without an exhaustive list.

Limits to keep in mind

  • The patient’s condition must be at low risk of short-term deterioration.
  • The regulations do not set a list of chronic diseases.
  • No starting of designated substances: this is reserved to practitioners designated by federal laws and regulations.

Sources: OPQ, summary of what is new (in French), p. 2 · OPQ, practice guide on professional activities (in French), p. 21

03

Prescribing for prevention

What it allows

  • Prescribe to prevent diseases, health conditions such as an unwanted pregnancy, or signs and symptoms such as nausea.
  • Prescribe and administer vaccines at any age, subject to the required training.

Limits to keep in mind

  • Prevention happens before the disease appears, in people with risk factors.
  • There is no regulatory list of preventive situations.

Sources: OPQ, summary of what is new (in French), p. 2 · OPQ, practice guide on professional activities (in French), p. 22

04

Ordering and interpreting tests

What it allows

  • Order tests to ensure the safety and effectiveness of prescribed drugs, screen for diseases or help assess physical and mental health.
  • The term “test” covers any laboratory analysis or clinical measurement needed for this monitoring.

Limits to keep in mind

  • The test must relate to your scope of practice, the nature of your activities and your competence.
  • Plan who interprets the result, who follows up and how it is recorded.

Sources: OPQ, practice guide on professional activities (in French), p. 11

05

Extending a prescription

What it allows

  • Extend an expired prescription if you judge that treatment should not be interrupted. There is no longer a general legislative limit on duration.
  • Extend a prescription from any professional authorized to prescribe in Canada, provided they could issue the same prescription if practising in Québec.
  • The extension takes the form of a new prescription signed by the pharmacist.

Limits to keep in mind

  • Assessment, follow-up and recording in the file are still required.
  • Recommend that the patient book an appointment with the professional responsible for their clinical follow-up.
  • Designated substances: extension is possible, up to two years after the prescription was dispensed.

Sources: OPQ, summary of what is new (in French), p. 2 · OPQ, practice guide on professional activities (in French), p. 31

06

Adjusting or stopping therapy

What it allows

  • Change the dosage form, posology, concentration, dose, route of administration, duration or quantity prescribed.
  • Stop a drug when patient safety or the effectiveness of therapy justifies it.

Limits to keep in mind

  • The decision relies on evidence and is made with the patient whenever possible.
  • Designated substances: the form, dose or posology may be changed, without exceeding the total quantity in milligrams originally prescribed.

Sources: OPQ, practice guide on professional activities (in French), p. 29

07

Substituting a drug

What it allows

  • Substitute despite a “do not substitute” note for the same common name, if the situation requires it and the patient consents.
  • Therapeutic substitution: an adverse effect or risk of one when the prescriber cannot be reached in time, a shortage, an administration problem, or unavailability in a facility.
  • Drug not covered by the public or private insurer: it may be replaced with a drug on the RAMQ list.

Limits to keep in mind

  • In every case, inform the patient and record the substitution in the file.
  • Shortage: reasonable steps to obtain the drug must have been taken.
  • Announced withdrawal: no earlier than three months before the planned date.
  • If in doubt about a “do not substitute” note, contact the prescriber.

Sources: OPQ, summary of what is new (in French), p. 3 · OPQ, practice guide on professional activities (in French), p. 32

08

Administering a drug

What it allows

  • Administer a drug for therapeutic purposes when it is prescribed, for example an injection of vitamin B12 or heparin.
  • New authorized routes: rectal, otic, ophthalmic and transdermal.
  • There is no longer an age limit, including for vaccines.

Limits to keep in mind

  • The required training must be passed, notably to administer vaccines.
  • Plan the equipment, the space and the ability to respond to an emergency.

Sources: OPQ, summary of what is new (in French), p. 3 · OPQ, practice guide on professional activities (in French), p. 35

09

Taking a throat or nasal sample

What it allows

  • Take a sample from the pharynx or beyond the nasal vestibule with no prescription, for example for a rapid test for group A strep or coronavirus disease.
  • Depending on your assessment, prescribe treatment if the result is positive.

Limits to keep in mind

  • These are the only invasive techniques authorized for pharmacists for assessment purposes.
  • You may, however, order a test requiring another invasive sample if it relates to your scope of practice and competence.

Sources: OPQ, summary of what is new (in French), p. 1 · OPQ, practice guide on professional activities (in French), p. 10

COMING

Advanced pharmacotherapy

What is planned

  • A training attestation issued by the Ordre will target holders of the master’s degree in advanced pharmacotherapy.
  • It will allow prescribing in broader situations, notably to treat a disease diagnosed by an authorized professional.

Limits to keep in mind

  • These powers depend on a separate regulation: check whether it is in force.
  • They do not apply to all pharmacists, only to attestation holders.

Source: OPQ, summary of what is new (in French), p. 3

IN COLLABORATION

Communication and collaborative practice

What it changes

  • Current regulations do not require communication, but the Ordre asks pharmacists to send any information that may influence future clinical decisions.
  • For anything beyond the pharmacist’s autonomy, a consultation request or an advanced partnership practice agreement (EPAP) remains possible.

Limits to keep in mind

  • A consultation request concerns a specific patient and comes from a professional authorized to prescribe. The pharmacist replies in writing.
  • An EPAP is signed between physicians or nurse practitioners and pharmacists who share the same patients and files.

Sources: OPQ, summary of what is new (in French), p. 3 · OPQ, practice guide on professional activities (in French), pp. 24-25

Coverage and billing, checked November 8, 2026: services insured from December 9, 2026 are set by Order 1341-2026. According to the AQPP, most will be insured, but some services or tests may involve fees, notably for strep, urinary tract infection and ambulatory blood pressure monitoring. An agreement between the AQPP and the government was ratified for 2025-2030; it concerns public plan fees. Insured does not mean free in every case. We do not publish rates: see the AQPP and the RAMQ. Sources: Gazette officielle du Québec, September 2, 2026 (Orders 1340-2026 and 1341-2026), pp. 5398-5404 (in French) · AQPP, adoption of the Bill 67 regulations, August 20, 2026 (in French) · AQPP, agreement ratified, June 19, 2026 (in French) · RAMQ, pharmacists’ manual (in French)

Read more

The essentials

What is Quebec’s Bill 67?

Its official name, what it changes for pharmacists, which other professions it touches and why December 9, 2026 matters: the essentials, with sources.

Chronic disease

Chronic disease: when can a pharmacist prescribe?

Prior diagnosis, low risk of deterioration, therapeutic targets and communication: what the Ordre’s guide provides for chronic disease in Québec.

Substitution

Drug substitution: what the pharmacist may do

“Do not substitute” notes, shortages, adverse effects, drugs not covered: the situations in the Ordre’s guide, and what must be recorded in the patient’s file.

Tests

Can a pharmacist order tests and lab work?

Monitoring, screening, help with assessment, results and critical values: what the Ordre’s guide provides when a Québec pharmacist orders and interprets a test.

Adjustment

Can a pharmacist adjust or stop a medication?

Patient safety and treatment effectiveness: what a Québec pharmacist may change, the new prescription, and the rules for designated substances.

Administration

Injections at the pharmacy: when may a pharmacist administer a drug?

Four situations, authorized routes, training and record-keeping: what the Ordre’s guide provides for pharmacists administering drugs in Québec.

Bill 67 / December 9, 2026

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