Pharmacists across Ontario have voiced concern in recent weeks over the drug reform legislation instituted by the McGuinty government. The owners of Muxlow Pharmacy in Meaford share those concerns.
David Glass, one of the proprietors of Muxlow Pharmacy sat down with The Meaford Independent to explain the position of pharmacists.
Glass has been a pharmacist since 1981 and has plied his trade at the Meaford Muxlow location since 1987, and according to Glass the recent reforms will affect his ability to deliver the same level of service that he and his partners have been delivering for many years.
“The early 1990's is a good frame of reference for us,” said Glass, “At that time we were negotiating our fee that we get from the government (for prescriptions filled under the Ontario Drug Benefit program) and at that time the fee that we negotiated was $6.47. In 2010 the fee is $7.00, so the fee has gone up 50 cents in 20 years.”
Glass said that 70 percent of the prescriptions filled at Muxlow fall under the ODB plan. The dispensing fee for the remainder of prescriptions filled is $12. While pharmacies are free to charge whatever fee they wish for standard prescriptions outside of the ODB Glass says that the policy at Muxlow is to charge the provincial average.
As part of the drug reform legislation the fee from the province to pharmacists for ODB prescriptions will increase by one dollar to $8. Glass said that the government has indicated that there will be higher fees paid to rural pharmacies that qualify, but as yet pharmacists are unclear what the qualification criteria will be, and who will be entitled to receive fees higher than the new $8 fee.
The main point of contention in the recent reforms is the discontinuing of the ability of pharmacists to negotiate professional fees from their suppliers which for the last several years have made up for the lack of increase in the fee paid to pharmacists by the government.
According to Glass the practice of supplementing the revenues of pharmacies with funds from drug suppliers was sanctioned by the government, and because of that he takes exception to the government using the term “kickback” when referring to these revenues.
“That is a very inflammatory term,” argues Glass, “There is a reason that they use that term. (They use it) because it implies something that is hidden, something that is not out in the open.”
But Glass says that not only was the government well aware of the arrangement, they encouraged it, and the revenues received were audited annually and taxes were paid on those revenues.
“This is something that the government knew that we were doing. They accepted that we were doing it, and it gave them a reason not to renegotiate our fee, and to keep the fee the same because we were getting the difference that we needed to run our business from our suppliers,” said Glass, “There was absolutely nothing hidden about it.”
But by eliminating these revenues from suppliers, Glass says that many pharmacies will suffer and some will go out of business. He argues that if the practice of receiving rebates from suppliers is to be discontinued then the fee paid by the government needs to be revisited. Glass suggested that if the fee was adjusted to reflect inflation over the last 20 years, it would currently be in the neighbourhood of $14 to $15.
The position of the McGuinty government is that the reforms will save Ontario residents money and increase the level of healthcare in the province through the resulting decreases in the cost of generic drugs, and that the changes will ultimately see more prescription drugs available to Ontarians.
As for the Muxlow pharmacy in Meaford, Glass feels that the establishment will survive, but there will need to be changes in service and staffing levels.
Currently the pharmacy employs roughly 20 full and part time staff. With the loss of income that will come with the reforms, Glass said that they will not be able to maintain that level of staff.
Services such as free delivery of prescriptions will also need to be either discontinued, or a fee will need to be imposed on those kinds of services.
“At the end of the day we have less money to hire staff,” said Glass, “I think this store will survive, it will be in a different form, and I don't think that we will be able to do some of the things that we have done in the past for free.”
He also anticipates slower service similar to the ever growing wait times at hospital emergency rooms due to government cutbacks, Glass suggests that it will take longer to have a prescription filled as a result of decreased staff levels.
According to Glass the lack of action and planning with regard to this issue by all provincial governments in Ontario over the last 20 years has culminated in the current dispute between pharmacists and the province. He also feels that the hard feelings could have been avoided if there had been a joint effort from all parties to find a solution.
“What we have is a government whose best idea is to club the service providers over the head, and say that will fix the problem instead of having an open and constructive debate with everybody because we are all going to have to pay for this,” suggested Glass, “We don't mind being part of the solution, we don't mind taking less, we really don't, but everyone is going to have to share this. And doing this to the pharmacies isn't going to fix the problem.”
