Abstract
The British Columbia government has accepted all the recommendations of the task force that reviewed the province's PharmaCare program, including a call for negotiations with pharmacists on higher dispensing fees and compensation for professional services.
Health Minister George Abbott announced May 21, 2008, that the province would implement the recommendations of the Pharmaceutical Task Force, set up last fall to advise the government on ways to make the drug program more transparent and effective, while controlling its burgeoning costs.
The British Columbia Pharmacy Association (BCPhA) is encouraged by the task force's recognition that pharmacists can play a greater role in assuring optimal drug therapy and improved outcomes for patients.
“This was a message we took to the task force and we are very pleased it seems to have hit home,” says Marnie Mitchell, the chief executive officer of the BCPhA. “The task force has recommended negotiations between the Pharmaceutical Services Division and pharmacists for professional roles beyond dispensing and compensation for those services. This is something we will eagerly follow up with the health ministry.”
The Pharmaceutical Task Force expressed concern about the high price paid for generic drugs in Canada compared to other countries, and about the complex system of generic drug rebates and professional allowances. “It is not tenable to maintain practices which result in provincial reimbursement plans, such as PharmaCare, paying an artificially high price for generic drug products,” the report stated.
The task force also recognized that decreasing reimbursement for generic drugs could have an adverse impact on community pharmacies, unless balanced by higher dispensing fees for pharmacists and funding of other services. “If the reimbursement arrangement for generic drugs is to be substantially altered,” the report said, “it will be essential … to negotiate a new arrangement with pharmacy to ensure that high-quality patient services are sustained and where possible, improved, while also ensuring that the compensation for pharmacy … is reasonable and fair.”
Pharmacists realize the government wants to control costs, says Ms. Mitchell, so the negotiations will be challenging. However, it's reassuring to see that the task force and the province realize that generic allowances have been required to subsidize the true cost of pharmacist services.
“The task force understood that dispensing fees are currently too low — they don't cover the cost of doing the work and pharmacies rely on the allowances from generic manufacturers to make the business model work,” Ms. Mitchell says.
Although BC spends less per capita on prescription drugs than the Canadian average (based on 2006 data), the province is experiencing the highest annual growth rate in the number of new prescriptions and the third highest growth rate in the dollar value of prescriptions.
PharmaCare's budget increased by more than 50% between 2001 and 2008/09 to an annual total of more than $1 billion.