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Ontario pharmacists blast further reimbursement cut
April 24th, 2012
TORONTO – The Ontario Pharmacists' Association (OPA) called an Ontario government plan to cut pharmacy reimbursement for generic drugs misguided, noting that such a move would mark the second such reduction in two years.
Ontario Premier Dalton McGuinty late Friday announced 2012 budget maneuvers that included a proposal to lower the cost of the top 10 generic drugs to 20% of the price of the branded equivalent, estimating that the move would generate an additional $55 million a year in savings.
In 2010, Ontario slashed the cost of generic drugs paid for by the Ontario Drug Benefit and Trillium Drug Benefit plans to 25% of the cost of the branded product, down from 50% of the branded product price. The province also plans to phase out professional allowances paid to pharmacists.
Yet OPA pointed out Monday that Ontario has not gone ahead with measures that would widen the range of health care services that pharmacists can provide, which the association said could yield more than $130 million in health system savings annually and dramatically improve accessibility for many Ontarians.
"This is a very surprising and short-sighted proposal," OPA chairman Darryl Moore said in a statement on Friday's budget announcement. "The government passed legislation in 2009 that would increase the scope of services pharmacists could provide — health care that would improve patient outcomes, reduce hospital emergency room admissions and take some pressure off overloaded physicians offices — and yet have not implemented that legislation."
According to OPA, since 2010 the Ontario government has obtained roughly $500 million in savings from the pharmacy sector, which continues to struggle with changes in the reimbursement that pharmacies receive for the medications they provide. Pharmacists provide services to seniors and other recipients of the provincial public drug program related to the more than 100 million Ontario Drug Benefit prescriptions dispensed and managed annually.
The passage of Bill 179 in December 2009 set the stage for an increased scope of pharmacy practice, pending the passage of regulations, OPA explained. The regulations would enable pharmacists to extend prescriptions for chronic medications, adjust dosage and forms of medications if necessary, independently prescribe some medications for smoking cessation treatment and potentially for minor ailments, order and receive lab tests to help patients manage chronic diseases and avoid side effects, and provide immunizations and routine injections.
By being able to offer such services, OPA said, Ontario's pharmacists could provide hundreds of millions of dollars in health system savings annually by alleviating pressures on doctors and nurse practitioners, helping avoid emergency room visits related to medication problems, and boosting vaccination rates for seasonal influenza by making it easier for people to get immunized. The association also noted that Ontarians would have increased access to many new services on their own time, in turn increasing workplace productivity and decreasing absenteeism.
"Enabling pharmacists to use their skills to deliver more health care services to Ontarians and achieve the long-term objectives of a more efficient system could save much more than the proposed $55 million from generic drug price cuts and would avoid the significant strain such cuts place on drug supply and pharmacy operations," Moore stated. "This is a much more strategic approach than announcing an unwarranted cut to generic drug prices only three days before the budget vote."
OPA added that there's broad support among the public and experts in health care for the introduction of the new pharmacist services. Increased use of pharmacists as primary care providers already is occurring other provinces, including British Columbia, Alberta and Nova Scotia, the association said.