Dear Editor,
I can't believe how one sided and poorly researched the Kaisha Thompson article about Ontario's Drug reform was. She start by saying that there are two sides to every story, but she have obviously not gone to the trouble of speaking to a pharmacy owner. If there are truly too many pharmacies , surely you can find a pharmacist to set the record straight.
This is not our fight, but since she mentioned it, she claims that New Zealand pays more for enalapril than we do. Do you honestly think pharmacists make 22% profit on enalapril???? We make less than 8%. NO ALLOWANCES AT ALL. Not a nickel! Do you know that in that country, drugs are subsidized by the government? Ontario pays for BRAND name enalapril (Vasotec) because of a back door private deal (kickback) made between Ms Stevenson and Merck Frosst, same for Zantac. There is undenied proof of that
Do you not find it strange that in their comparison of prices abroad, MoH would pick molecules not even in their top 20? That would be like saying your whole grocery bill is unreasonable because the price of mayo is 20 times more than in New Zealand. Do you not find it strange that we are comparing one drug with New Zealand instead of a basket of the top molecules, as StatsCan would when doing a proper study? Do you not find it strange that Ms Mathews is comparing the price of one drug with the price of the same drug in one country then another drug in another country? Do you not find it strange that Ms Mathews is comparing TWO brand name products with their GENERIC counterparts? A pertinent question would be: How much does it cost to produce a generic in New Zealand vs Ontario? Generics come to the market faster here because of challenges to the patent made by generic manufacturers, at a cost.
The third molecule in their comparison is Metformin. It costs pharmacists $48. per 500 in Canada and if you compare what someone would pay here compared to south of the border, you would find that we actually pay less.
This is what MoH wants you to believe this is about. IT ISN'T AT ALL. Pharmacists are FOR reduced generic prices and the elimination of Professional Allowances.
I personally take offence to her use of the word: kickback.
According to Webster, a kickback is hidden, and is given to sway someone's opinion or judgement. Therefore, your MoH is accepting kickbacks from brand name manufacturers to include them in the formulary. Ms Mathews lists these new drugs which have no greater efficacy than their less expensive alternatives in return for millions of dollars which do not show up in MoH statement of revenues. The two requirements of the definiton of a kickback are met. secrecy and influence to the benefit of the person in power. By accepting these kickbacks, hardworking people are paying an inflated price for brand name drugs, which represent 75% of the bill.
Professional Allowances, on the other hand are not hidden. they are taxed, reported, and audited. They do not affect a pharmacist's judgement since the selling price is essentially set by our government.
Ontario is a deadbeat parent. It has not increased renumeration for dispensing medication and front line health care to seniors and welfare recipients in more than 20 years. When pharmacists approached Mr Harris in 1996 for an increase, his response was to "stop pestering him" and go after the generic suppliers for rebates,volume discounts,allowances.
How can she then say that this money is not our own? How dare she say that we should not allow this loss to affect store hours and service? We have no choice! Also, since she seems to know, please tell us exactly how this $100 million will be paid?
Allowances are the only reason the system has not crashed yet. When Mr McGuinty learned that the public system was heavily subsidized by the generics, he created bill 102, in order for him to quantify how much money was "out there" and was warned that his system would fail. Now he is confident he can pocket this money and still not address the dispensing fee. And THAT is what this fight is about. RECOGNIZING THE VALUE OF PHARMACY SERVICES. Pharmacists are already doing alot, before asking them for additional services, they need to be recognized for what they already do. everyday, all the time. Pharmacist are obliged to "throw away money at ... ads" to protect their livelihoods as well as their employees' and to set the record straight as the most trusted and accessible professional. MoH thew the first few stones.
Pharmacists are FOR reasonable price reductions in generic AS WELL AS brand name medications (contrary to MoH) , FOR a reduction in usage (not adressed by Moh), FOR a reduction in administration costs (ignored by MoH) and FOR the elimination for the professional allowances (created by MoH). All of this as long as the dispensing fee is brought up to a fair level. Fair being what the increase should have been over 20 years, or what they are paid in other provinces.
Fairness and respect.
Guy Caron, Pharmacist
Beausejour Clinic Pharmacy
Orleans, Ontario
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