The story of one pill’s cost

Drug: Citalopram, a commonly used anti-depressant. It is the generic version of the brand-name drug Celexa. Step 1: The province negotiates with suppliers on a price for Citalopram, which currently stands at 33.2 cents for a 20 mg tablet. That’s down from last month’s rate of 46 cents. Step 2: Pharmacies arrange to buy the drug from suppliers at that price. For example, a pharmacy might by 1,000 tablets, which would cost $332. Step 3: A patient gets the prescription filled at the pharmacy, usually paying a portion of the cost. How much they pay depends on the type of drug plan they have. Seniors, for example, pay 30 per cent of the cost of a prescription up to a maximum of $25. If a senior was prescribed 100 tablets of Citalopram, they would pay $9.96 of the $33.20 cost. Step 4: The pharmacist bills the provincially funded Alberta Blue Cross for the remainder of the cost, and also bills $10.93 as a dispensing fee. As an additional stream of revenue, many pharmacists have also arranged special volume deals with drug suppliers, who pay back an “allowance” worth about 40 to 50 per cent of the drug costs.

In basic terms, if a pharmacy buys enough of a certain kind of drug that costs $1 per tablet, the supplier gives them back up to 50 cents.

Pharmacists say this income is being squeezed, because if suppliers are forced to adhere to the province’s new lower prices, they won’t have any room to provide allowances.