Grits seek ban on generic drug fees

Some pharmacists in downtown Toronto stopped dispensing drugs for at least an hour on Wednesday to protest a cost-cutting move by the provincial government.

In their March 25 budget the Liberals promised to lower generic drug prices and on Wednesday Minister of Health Deb Matthews said that would be accomplished by cutting an allowance paid to pharmacy owners by the manufacturers of the drugs.

The allowance — which amounted to $750 million in 2009 — is intended to fund patient services. However, Matthews said, the pharmacies’ own reports show they haven’t — going instead to fund fringe benefits, bonuses, reduce overhead costs and boost profits.

"I will not go so far as to call them kickbacks or rewards, but I can tell you there are people who would do that," Matthews said. "One thing is for sure: They're very, very large payments."

Scrapping the allowance will lower the cost of generic drugs by at least 50 per cent — to 25 per cent of the cost of the original brand-name drug from 50 per cent — for Ontario's public drug system, private employer drug plans and people who pay for their own drugs, Matthews said.

During a luncheon speech to the Canadian Club, Matthews said Ontario pays 50 times as much as the U.S. Department of Veterans Affairs for a blood pressure medication called amlodipine.

"Professional allowances tremendously inflate the cost of drugs. We are paying far too much," Matthews said.

In an official statement, Shoppers Drug Mart said their pharmacists were unable to dispense medication because there was a conference call deliberately scheduled while Matthews was making her speech.

Reduced services

Some pharmacists have said the cuts will force them to reduce service.

"For neighbourhood pharmacies, the government's cuts will mean reduced hours of operation, less staff and fewer patient services," said Ben Shenouda, president of the Independent Pharmacists Association of Ontario.

While pharmacists would earn less in dispensing fees, the government said it plans to balance that loss by paying them a fee for doing more one-on-one work with patients.

The Ministry of Health said it will continue to ensure pharmacists are fairly compensated for helping patients by increasing dispensing fees by at least $1 for every Ontario Drug Benefit prescription filled. There will also be $150 million, including a new $100-million fund, to compensate pharmacy owners for the professional services they provide.

Last December, the provincial government passed a law that allowed pharmacists to increase the scope of their services in remote areas. The province promised to increase dispensing fees by up to $4 in rural communities and under-serviced areas with new dedicated funding in the budget.

Pharmacists said Wednesday the compensation is not enough.

Pharmacies compensated

"When you take $3 out and put $1 back in ... I don't think so. These dollars were used for professional services that pharmacists do every day in every town in this province," said Donnie Edwards, a pharmacist in Ridgeway, Ont.

"What I'm afraid of is my patient who calls me on a Saturday night with cancer and is sick to their stomach and needs medication, and it's going to be hard to be available. I won't be able to have the phone line to answer them."

Changing the business model would affect patients because pharmacists would no longer be able to spend time with a patient for consultations, he added.

During the past year at least 100 pharmacy owners failed to provide any documentation related to the payments they have collected, while 650 pharmacy owners provided incomplete reports, the government said.

Some pharmacies have also allegedly been involved in a resale scheme in order to receive professional allowances multiple times for the same product — a practice that has resulted in the government taking legal action against them.

The ministry's proposed changes build on steps taken in 2006 when the government sought to lower generic drug prices to 50 per cent of the price of the original brand name drug, and helped fund access to 150 new prescription drug products.