Taxpayers end up footing the bill

Re Nursing homes charge pharmacies ‘bed fees,’ Oct. 17 As a retired health-industry executive with a spouse in long-term care, this rang a lot of alarm bells for me.

While there may be nothing legally wrong with pharmacies offering rebates/programs/services as part of a tender offer, the reality is that we taxpayers are paying the dispensing fee of $5.57, and the resident is paying a dispensing co-pay of $2. So, at the very least, the taxpayer portion of the dispensing fee should be reduced by the amount of the rebate, because, in effect, the rebate is baked into the “dispensing fee cake” and we taxpayers, along with the residents, are paying for the whole cake.

The article also addresses the issue of the pharmacies charging a dispensing fee for each seven-day supply instead of for a 30-day supply. While pharmacies argue that they only supply on a sevenday basis to avoid wastage when prescriptions change, the reality is that this population is mostly on generic drugs, and many of their drugs are for chronic ailments and therefore don’t change.

The numbers get large when you consider the average number of drugs each resident gets. As an example involving three drugs per person, which is probably low:

Current taxpayer subsidized cost (weekly supply) = $5.57.

Dispensing fee x three prescriptions per resident x 200 residents x 52 weeks = $173,784 per annum.

Taxpayer Subsidized Cost (if monthly supply) = $5.57.

Dispensing fee x three prescriptions per resident x 200 residents x 12 months = $40,104 per year - a 76-per-cent saving.

Also, the residents’ co-pay would be reduced from $62,400 to $14,400.

The government has done a lot to drive cost out of the system through adoption of generic formularies; however, more investigation needs to be done on the dispensing practices, associated fees and the distribution chain itself to determine the scale of savings available that could be reallocated to improving other LTC services or even adding LTC capacity that is so desperately needed. Marilyn McGown, Oakville