Pharmacists in Woolwich are joining their counterparts across the province in protesting cost-cutting measures introduced last week by the Ontario government.
The province is attempting to bring the deficit and health care spending under control by reducing prescription drug costs. Last week Health Minister Deb Matthews introduced two measures to do that: limiting the cost of generic drugs to 25 per cent of the brand name equivalent, and doing away with professional allowances paid to pharmacists by generic drug manufacturers.
Pharmacists are warning the reforms could force them to cut their hours, reduce staff and start charging for services that are currently free.
“It’s a significant loss in funding to the pharmacies,” said Alan Martin, owner of Martin’s Pharmacy in St. Jacobs.
Martin said the funding shortfall for his pharmacy would amount to a full-time salary.
“I’m the only full-time staff pharmacist and we’re basically going to be losing funding equivalent to one full-time position. There’s only so much cutting I can do based on our hours and staffing.”
Samer Mikhail, owner of Woolwich Total Health pharmacy in Elmira, said he might be forced to start charging for services such as deliveries that are now free. While the cost-cutting measures might save the government money, it is patients who will wind up paying the price, he suggested, arguing the province would be better off trying to save money by streamlining the approval process for generic drugs.
Currently, generic drugs sell for about half the price of their brand name equivalents; the changes Matthews announced would slash that to one-quarter the cost of brand name drugs, which would save the province about $500 million a year.
The province also plans to eliminate the professional allowances drug companies pay pharmacies to stock their products, which totalled $750 million last year.
In Ontario, drug companies are not allowed to offer pharmacies discounts on their products, a practice permitted in several other provinces. Instead, drug companies can provide a professional allowance to pharmacies, money that is supposed to go to direct patient care. Drug companies are required to report to the province how much they paid out in professional allowances, and pharmacies are required to report how much money they received and where it was spent.
The government says the allowances make generic drugs more expensive than they would otherwise be. Matthews likened them to kickbacks, a statement that had pharmacists crying foul.
Mikhail pointed out that the system of allowances is both legal and regulated by the government.
“It is transparent, it is documented, and the majority of those funds are used for direct patient care.”
Martin explained that pharmacists provide a range of services – checking dosage and possible interactions, liaising with doctors, over-the-counter counselling, diabetes education, contacting insurance companies – which the allowances help pay for.
“It’s more than just counting and putting pills in a bottle,” he said.
Opposition parties at Queen’s Park warn that small, independent pharmacies would feel the brunt of the changes and could be forced out of business. Pharmacy-driven business is estimated to make up 50 per cent of revenue at large drug store chains, while Martin noted that his business is 90 per cent prescription-based.
The province has proposed increasing dispensing fees and paying pharmacists for a wider range of services to make up the difference. But the Ontario Pharmacists Association contends that the fee increases will still leave a significant shortfall. The association is urging the government to reconsider, and two large pharmacy chains – Shoppers Drug Mart and Rexall – have trimmed services in protest.
The government has acknowledged that pharmacists are an important part of the health system, Mikhail said, and has proposed increasing their scope of practice to include renewal of certain prescriptions and administering vaccines. The recent changes announced by the Health Minister contradict those assurances and aren’t helpful, he said.
“We are part of the health care system. We need to work together, not against each other.”