Last winter, as word of the upcoming changes filtered down, some pharmacists were asking patients at the counter to sign petitions to complain. Without the rebate money, some fear they could go under. The government did little to relieve those concerns last week. It promised to pay pharmacists an extra $100 million for counselling, and it’s hiking dispensing fees by $1—or up to $4 in underserved regions—to make up for the loss of rebates. Pharmacists say it’s not nearly enough. “They’re taking $3 out and putting $1 in,” said Donnie Edwards, the pharmacist from Niagara who raced to Toronto through heavy rain to meet reporters after Matthews announced the changes last week. “We’re going to make sure patients are aware that it’s detrimental to their health.”
Pharmacists are already saying they will have to take steps to deal with the reduction in income, by offering fewer free services or shorter hours for example. But while patients will notice those reductions, many won’t be likely to see the potential upside—lower generic drug prices—because only 15 per cent of Ontarians pay for their prescription drugs themselves. The rest are insured either by the government, by their employers or by their own insurance companies.
The Ontario government was careful to invite some key allies to Matthews’ press conference. Sid Ryan, president of the Ontario Federation of Labour, said the announcement is “a gutsy move and long overdue.” The cost of drugs is going up so fast, he said, that negotiators at the bargaining table have to make an awful choice between maintaining drug plans or laying off employees. Beside him was Rick Perciante, acting CEO of the Canadian Cancer Society. People who are fighting for their lives, he said, “shouldn’t have to worry about how they’re going to pay for cancer drugs. The changes will allow [for] greater access.” Matthews was counting on that support: “This is a fight I’m prepared to take on with the pharmacists.”
Less than a week later, Shoppers Drug Mart shortened hours at several stores in Matthews’ home city of London. It announced that customers there would have to pay for home delivery of prescriptions. In a statement, CEO Jürgen Schreiber said the decision was “a difficult one for our associate-owners” but “given the impending funding cuts,” Shoppers must “modify our business model to ensure the long-term sustainability of our stores.” (Shoppers did not return phone calls from Maclean’s seeking comment for this story.)
If nothing changes, more pharmacies will have to take steps to cut costs, said Nadine Saby of the Canadian Association of Chain Drug Stores: “I don’t think they’re going to have a choice.” She sees nothing wrong with ending the rebates, but only if dispensing fees double and other fees are hiked to pay pharmacists for helping patients manage their drugs. That demand, which could cost the government hundreds of millions of dollars, shows just how high the stakes are.
