A number of pharmacists in Alberta are growing disgruntled with the province’s move to lower the price cap on generic drugs, as they say it inadvertently impacts their income and affects patient care.
Peace River pharmacist and pharmacy-owner Michael Kinshella is among those expressing concern that the move will have a negative impact.
The bulk of income to pharmacies comes from rebates from generic drug companies for carrying their product.
“Say there are five companies that make one drug. They come into my store and say, ‘Mike, buy my product,’ and it’s basically like, why should I buy yours over theirs?” Kinshella, who owns Value Drug Mart on main street explained to the Record-Gazette at the store last week.
Without such income, Kinshella says pharmacies will have to adjust accordingly by altering services rendered.
Over the last five years, the provincial government has been incrementally lowering the price cap on these drugs. Five years ago it stood at 75 per cent of the brand name price; as of May 1 the province is pushing for 18 per cent, although so far most companies have not lowered it below 25 per cent.
The province has touted this translates into savings of $80-million dollars a year by decreasing the amount of money it has to pay for generic drug prescriptions. But the move impacts the generic drug companies’ bottom line, which directly impacts the amount of money the companies can afford to rebate back to pharmacies, Kinshella says.
“Every time it (the percentage) dropped there has been a cut to pharmacy and there has been no real dollars to replace what has been taken until now,” Kinshella said in reference to a July 2012 move by government to pay pharmacists for clinical services rendered.
The clinical fees allows pharmacists to charge for services like extending and adapting prescriptions and dispensing emergency supplies of medications.
“We actually introduced compensation for pharmacists for those types of services they were providing free before, now they can for them and be compensated for them,” John Muir, spokesman for Alberta Health told the Record-Gazette.
Kinshella appreciates this but says it does not go far enough.
“This is how pharmacists would like to see the profession,” Kinshella said.
“To the pharmacists who have taken exception to what the government is doing, the government hasn’t come up with a plan to sustain the profession of pharmacy,” he said.
Some services still offered at no cost to patients or Albertans include phoning the physician for refills, free home delivery, packing a week’s worth of pills in bubble wrap and tax receipts at the end of the year, all which may have to be cut to supplement lost income from the rebates.
But Muir says the government is not responsible for the rebates given to pharmacists from the drug companies, but has still taken a number of steps to ease the transition of the move toward the 18 per cent cap on drug costs.
“We’ve worked with them (pharmacists) to arrange for additional funding supports for pharmacists across the province. In fact, that’s an additional $40 million this year that will help support pharmacists in the move to 18 per cent,” Muir told the Record-Gazette by phone.
Because pharmacists do not receive any rebate on brand name medications, they may choose not to carry it and rather order it only if requested, Kinshella says.
Aside from the generic drug rebates and clinical fees, pharmacy income also comes from professional fees (sometimes called a dispensing fee).
“That fee, over the last 17 to 20 years, has seen a 52 cent raise,” Kinshella pointed out. The fee is controlled through the provincial government.
“Pharmacies are not against lowering costs. Our concern is patient care and how we’re going to be able to provide good, quality patient care the patients are getting now with less money.”