U of T Pharmacy alumni fill critical gaps in patient care

Since the start of their Doctor of Pharmacy (PharmD) education, Ajay Chahal and Anushya Vijayaraghevan, have been interested in innovating pharmacy practice to fill unmet needs and improve patient care. The 1T8 graduates of the Leslie Dan Faculty of Pharmacy now co-own Wholehealth Pharmacy Fashion District and are delivering innovative programs that remove barriers to accessing medication.

“As pharmacists, patient care is our number one priority. For us, that is what’s important, and the business innovation was kind of a side effect of what we were doing,” says Vijayaraghevan.

As friends and classmates, Chahal and Vijayaraghevan were interested in finding innovative ways to deliver care. In their third year of the program, they participated in the annual business pitch competition, which opened their eyes to the possibilities of innovation in pharmacy practice.

“As pharmacists, patient care is our number one priority.”

After graduating in 2018, Chahal began working in community and hospital pharmacy, including at CAMH, where he specialized in mental health and addictions, and Vijayaraghevan became a staff pharmacist at a community pharmacy.

Around the same time they were starting their careers, cannabis was legalized in Canada, and Chahal and Vijayaraghevan noticed that both patients and healthcare providers lacked information and training about using cannabis with other medications. To address this gap, in 2019 they co-founded Apothecare, a pharmacist-led cannabis consulting company that provides evidence-based information to healthcare providers about cannabis use. It also helps patients use medicinal and recreational cannabis safely alongside traditional medications.

“Patients are going into cannabis retail stores to buy cannabis for medicinal purposes, but there’s no healthcare oversight in these retailers,” says Chahal. “With our cannabis consultation service, we’re tackling that gap and trying to increase access to education so patients can use the product safely.”

Innovative program lowers barriers to accessing medical abortion

When Chahal and Vijayaraghevan opened their own pharmacy in September 2022, they wanted to ensure that their practice focused on providing patients with the care they need and filling gaps in the healthcare system. Shortly after opening, they saw a critical gap in care for people seeking medical abortion. In particular, patients who were prescribed a medical abortion using the medication Mifegymiso could not always easily find pharmacies that could dispense it.

Mifegymiso is banned in certain parts of the United States and restricted in many other states, but even in Ontario, where the drug is not only legal but also covered by OHIP, access can be difficult. Many pharmacies do not carry or dispense the drug , and some people, especially those in rural areas, may not be comfortable using their local pharmacy because of a lack of privacy.

Chahal and Vijayaraghevan saw an opportunity to provide low-barrier access to Mifegymiso and ease stress for patients.

“We’ve always had the perspective to address gaps in care in any population, and we saw that women were significantly underserviced in this area,” says Chahal. “We saw that it would be a big challenge, but we wanted to find a way to fix it.”

With their business partner and fellow alum, James Morrison, their pharmacy has partnered with specialized clinics to provide the medication directly to the patient in need. Healthcare providers at the clinics send the Mifegymiso prescription to a specific pharmacy location, and the pharmacists there dispense and deliver the drug at no cost to the patient. They also provide telephone counselling to those taking the medication.

“We had a vision to provide service and access to all Ontarians, and make sure that we keep the service as low barrier as possible. Many patients come from situations where they can’t afford significant costs, so we wanted to absorb as much of the delivery cost as possible,” says Chahal. “The providers we work with know that we have the capability to ensure that anyone in Ontario gets access to the medication. The provider and the patients don’t need to try to figure out which pharmacy to go to, so we’re alleviating the administrative burden.”

Since the service started last year, they have provided women across the province with the drug, including as far as north of Timmins.

Their medical abortion service was recently recognized with Practice Innovation and Business Innovation Awards from the Pharmacy Practice + Business magazine.

“We’re very proud of this service and to be able to involve our staff, who are all new pharmacy graduates,” says Vijayaraghevan. “It’s exciting to see that you can create a space where you can practise in your own way and also guide new pharmacists who are keen on being a part of it.”