Beneva has recently filed three investigation requests with the Ordre des pharmaciens du Québec (OPQ), aiming to put a stop to practices by specialty pharmacies that it describes as steering.
According to information provided to Insurance Portal by Beneva, the insurer submitted three requests to the OPQ’s Syndic, each pertaining to a specific medication.
The insurer says the requests relate to the ethical obligations of specialty pharmacists who are members of the Regroupement des pharmacies de médicaments de spécialité du Québec (RPMSQ). The requests target:
- Pharmacists Daniel Vermette, Marc Chabot, and Mayno Benoit Huynh for the specialty medication Vimizim;
- Pharmacists Gabriel Torani and Habib Haddad for the medication Orladeyo;
- Pharmacists Michael Assaraf and Martin Gilbert for the specialty medication Remicade.
Specialty pharmacies typically operate within the framework of patient support programs offered by pharmaceutical companies. These pharmacies provide patients with access to supervised injection sites for medications that are often very expensive and used to treat rare diseases, multiple sclerosis, rheumatoid arthritis, and cancer.
For example, in 2019, the Société de compensation en assurance médicaments du Québec (SCAMQ) reported a $2.1 million claim for a group benefits plan member for the medication Vimizim, which treats a rare and hereditary disease.
Beneva’s investigation requests follow closely on the heels of a complaint it filed with the Competition Bureau of Canada on May 15, 2025. Unlike the steering-related requests, that complaint addressed allegedly anti-competitive practices and unreasonable fees charged by pharmacists who are members of the RPMSQ, namely: Gabriel Torani & Habib Haddad Pharmaciens inc.; Larivière et Massicotte, Pharmaciennes inc.; Marc Chabot et Daniel Vermette, Pharmaciens inc.; Martin Gilbert Pharmacien inc. Pharmacist Michael Assaraf is no longer on the list (see section: Suspended for 12 months).
In its complaint about unreasonable fees, Beneva stated that the pharmacists involved had tried to “create a veneer of legitimacy” by forming an association. The complaint also called out the managers of patient support programs and accused the pharmacists of entering into “preferred or even exclusive agreements with companies operating patient support programs.”
Specific to Quebec
The three individual complaints address steering, which consists of directing a patient to a specific pharmacy, preventing the patient from making a free and independent choice. “They focus on the steering aspect related to the patient support program. It is clear that pharmacists are not allowed to buy patient lists or engage in such practices,” said Éric Trudel, Executive Vice-President and Leader, Group Insurance, at Beneva, in an interview with Insurance Portal.
Trudel refers to Article 77, section 4 (77.4) of the OPQ’s Code of Ethics, which defines as derogatory to the dignity of the profession the act of obtaining clientele through intermediaries or entering into agreements to that effect. Trudel clarified that the requests only concern pharmacists practising in Quebec.
Not backing down
Beneva has no intention of letting the matter drop, according to Trudel. “We’ve filed three requests since May, and we are preparing a few more,” he told Insurance Portal. “We are convinced that these practices are not only anti-competitive — hence the complaint to the Competition Bureau — but also in violation of the Code of Ethics of the Ordre des pharmaciens du Québec — hence the complaints to the OPQ,” Trudel explained.
Some RPMSQ pharmacists are also facing a complaint from the OPQ Syndic for violating Article 77.4 of the OPQ’s Code of Ethics. According to a search of the OPQ’s hearing schedule by Insurance Portal, a hearing is scheduled for November 27 involving the Syndic and pharmacists Gabriel Torani and Habib Haddad. Torani requested a suspension of the disciplinary proceeding, which was denied by the OPQ’s disciplinary council in a decision published on June 4, 2025.
According to the complaint, the two pharmacists violated the article four times — in 2019, in 2021, and twice in 2022. They allegedly reached agreements through Bayshore Specialty Rx Ltd to obtain clientele from various patient support programs. Bayshore Specialty Rx specializes in developing patient support programs and states on its website that it works closely with pharmaceutical manufacturers.
“This practice increases costs for group benefit plans,” Trudel points out, noting that the issue is specific to Quebec, where pharmacists are not required to disclose their fees — unlike in other provinces such as Ontario.
Suspended for 12 months
Trudel mentioned that Michael Assaraf, one of the specialty pharmacists targeted by the insurer, was suspended from the OPQ for 12 months beginning July 11, 2025. The decision made headlines. An article published by the Journal de Montréal on August 16, 2025, reported that Assaraf had contested the OPQ’s decision since it was first issued in 2020.
The article states that Assaraf’s lawyer had argued for a fine instead. However, the OPQ decided otherwise. Its disciplinary council had already ordered Assaraf to pay a total of $95,000 in fines on January 25, 2021. Assaraf was previously a member of the RPMSQ. Following his suspension, he sold his pharmacy shares to pharmacist Lynn Steinberg Weinberg.
12-month investigation process
Responding to questions from Insurance Portal, OPQ spokesperson Nancy Marando said that steering is an issue the Order is watching closely. “Several disciplinary decisions have been issued in recent years regarding pharmacists who obtained clients through intermediaries or within the framework of patient support programs,” she added.
In addition to the two previously mentioned cases, Marando cited three more, including one involving Martin Gilbert. In 2022, the OPQ disciplinary council found Gilbert guilty and fined him $40,000 for violating several articles of the OPQ’s Code of Ethics, including Article 77.4.
Is the steering phenomenon growing, and how many requests are currently under review? Marando said she could not answer those questions. “Investigation requests and ongoing investigations are confidential,” she said. The OPQ spokesperson explained that “cases only become public when the Syndic decides to file a formal complaint with the disciplinary council.” The nature of the requests remains confidential as well.
If the Syndic decides to proceed, the investigation generally takes 12 months. At the end of the investigation, the Syndic determines whether or not to file a disciplinary complaint with the council. If a complaint is filed, the case becomes public.
“That’s why you won’t find the cases filed by Beneva on the Canadian Legal Information Institute (CanLII). If the investigation requests were filed recently — and you mentioned they are post-May 15 — then the investigations are most likely still underway,” Marando said.
Not out of the woods yet
Another process is currently underway — a proposed class action filed on June 12, 2024, in Quebec Superior Court in the Montreal district by the Association québécoise des pharmaciens propriétaires (AQPP) against specialty pharmacies. “It is moving forward but has not yet been approved,” AQPP spokesperson Marilie Beaulieu-Gravel told Insurance Portal.
The AQPP is seeking compensation for financial damages suffered by its members due to the actions of 10 of them — owners of six pharmacies — as well as three patient support program managers and three infusion clinic networks. In addition to the seven pharmacists named earlier, the class action also targets AQPP members Christine Larivière, Hélène Massicotte, and Jérôme Bergeron.
The association denounces anti-competitive practices and what it describes as an outrageous level of concentration in the distribution of specialty medications. “More than 40 per cent of specialty medication distribution is controlled by less than 0.5 per cent of pharmacies in Quebec,” the AQPP alleged.
RPMSQ defends itself
As of press time, the Competition Bureau had yet to issue any decision regarding Beneva’s complaint about unreasonable fees charged by specialty medication pharmacists.
Trudel said the complaint remains active. “We’ve been interviewed by the Competition Bureau and have answered their questions. The file is still open and under review,” he said.
In a statement published on its website on May 16, the RPMSQ defended itself against any accusations of steering. It stated that the free and informed choice of patients is a fundamental principle applied by all its member pharmacies. “Moreover, RPMSQ member pharmacies explicitly confirm the patient’s decision to obtain services from their pharmacy and remind them that they may choose another pharmacy,” the group asserted.
Its members also defended their fees, arguing that labour costs are significant. “The complexity of the molecules being handled requires more time per patient, which in turn limits the number of prescriptions processed daily,” the RPMSQ explained in its statement.
