Local pharmacists express displeasure with government fee deal
The government’s new pharmacist fee schedule is a huge blow for pharmacies, say local pharmacists.
“This is a disaster for pharmacies,” said Greg Bueckert, pharmacist and owner Greg’s Remedy’s Medicine Hat. “They’re asking us all the time to do more and they’re paying us less to do it.
“Services we provide as a pharmacist are worth a lot more than we get,” said Tony Caixeiro, pharmacist, owner and manager of Crestwood Pharmacy.
Caixeiro calls the government’s position “disappointing.”
The new schedule will save the government $150 million over the next two years, reducing fees paid to pharmacists from 12.3 per cent to 4.3 per cent in the next two years, Minister of Health Sarah Hoffman announced Wednesday. It will help to address the province’s financial pressures and will save Albertans’ money.
Pharmacists only became aware of the changes after the media was informed Wednesday. The Alberta Pharmacists’ Association was under a non-disclosure agreement with the government, said Alberta Pharmacists Association CEO Margaret Wing.
Bueckert knew talks were taking place but thought the target was savings of about $30 million. He believes administration costs in the system should have been the target for reductions rather than frontline services.
“We are being hit on all sides on this particular one,” said Bueckert. “Get rid of some of the junior vice presidents (instead).”
Some of the changes, to come into effect May 17, include a prescription dispensing fee reduction from $12.30 to $12.15. Administering a publicly-funded vaccine will go from $20 per shot to $13.
Pharmacists providing a comprehensive annual care plan for a patient will receive $100 rather than the $125 pharmacists with prescribing authority get now. Follow-ups to the care plan will be $20, and only $12 will be covered per year, per patient.
A medication management assessment will be reduced from $75 to $60 for pharmacists with prescribing authority.
Bueckert warns there will be unemployed pharmacists after this fee change.
In July 2012, an increased range of services by pharmacists was introduced to enhance patient care. Since then pharmacies have been building on that model.
“They’d offered this as one way to have some profitability, and now that it is being used they’re saying they’re not going to pay for it anymore,” said Bueckert.
That agreement five years ago was introduced to recognize valuable services pharmacists were providing and were not to be compensated for.
Pharmacists used to be considered the anchor in a pharmacy with a few other products for sale on the side, said Caixeiro. That has changed. Independently-owned pharmacies in particular are having to depend of niche markets of products and services as the main part of the business, with the pharmacist a minor part.
Caixeiro believes the government is not recognizing the service pharmacists provide, which helps keep people out of emergency rooms and saves money in the process. Crestwood Pharmacy will not change the service it provides, and Caixeiro hopes at some point the government will realize the benefits.
For patients who have medications dispensed daily, pharmacist will only be allowed to bill the government three fees per patient, per day. Monthly dispensing fees will be limited to two per drug per patient within a 28-day period. Opioid dependency treatment will be excluded.
A new “risk-sharing” component to ensure budget targets are met will take effect April 1, 2019 as the second year of the agreement begins.
“At least 10 per cent of government funding to pharmacies will be withheld each quarter to be used to address any budget shortfall. That percentage can increase, if required, to meet budget targets. If expenditures are less than budget, the holdback will be redistributed to pharmacies,” says the Alberta Health website.
“That’s deadly,” said Bueckert, noting pharmacists may simply not get paid at all for some of the work they have done. “That’s a very precarious position.”