Letter to the Editor

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I read with a great degree of disappointment (Huron-Bruce MPP) Carol Mitchell's letter to the editor regarding the dispute between the McGuinty government and the pharmacists of Ontario. I had held my tongue up to now, but after frequent requests for my opinion from my patients and finally realizing that Mitchell doesn't seem to have any information other than what her party has fed to her, I have decided to come forward.

My qualifications and biases are as follows: 

• I am currently a pharmacist and was previously the owner of Gordon Pharmasave, a small independent pharmacy in downtown Kincardine. 
• The store I work in will be deeply affected but will not close despite the proposed cutbacks and my job and is secure.  
• Before I bought my store, I looked into a number of other stores throughout Ontario so I have more than a passing knowledge of just how much money small-town pharmacies actually make. 
• I am also not a fan of drug manufacturers offering rebates to pharmacies. The optics are terrible and many of my colleagues feel similarly.
• I also understand that Ontario's finances are a mess, that health-care costs need to be reined in and that the business of pharmacy should bear its share of this.

While the Liberal proposals sound all well and good, I would argue so did their promises regarding: Local Health Integrated Networks or LHINS (you know "people-centred, community-focused care that responds to local population health needs," a direct quote from their bulletin of Oct. 6, 2004) and E-Health (all your health information on a single card at an affordable price).

I believe we all know how those have turned out so far. This proposal, like E-Health and LHINS, has been made with undoubtedly great intentions but has been so poorly thought out that in its present form it will, without question, impact either your health or those of an acquaintance within months. Here's how it will.

Mitchell has been told that the price of generic drugs will go down with these proposals. That is indisputable. If you pay for your drugs or a percentage of the cost, you will save some money. I am in favour of that as should all residents of Ontario.  

What Mitchell either doesn't know or hasn't informed you of, is that generics account for only 26 per cent of the money the government spends on drugs and that percentage figures to be lower for people not on the government plan.  

The lesson here: you will save some money on only some prescriptions. If you are a senior who pays $2 or $6.11 or a person with a drug plan who charges a set price or nothing at all, you will save nothing personally unless you are of the opinion that your insurance company will grant you a refund or that McGuinty (he of the Ontario Health Tax) will give you a tax break.

In return for these lower generic prices, you will pay a higher dispensing fee at many, and possibly all, pharmacies in Ontario including the chains, grocery and box-store types. This will be on all of your prescriptions and not just the generic drug ones. 

The reason for this is that the dispensing fee paid by the government has increased 50 cents in 20 years. As such, the manufacturer rebates that the government plans to eliminate have been the difference between making money and losing money for just about every small-town pharmacy in Ontario.  

So if you pay cash for a prescription, you will likely pay more on your increased fee. If your plan has a dispensing fee cap, and most do, you  may have to make up that difference or drive further to a different pharmacy that won't charge you the extra. You know how much gas and your time are worth.  

If you're a senior, drugs that are not covered by the government plan will also have these higher dispensing fees and you will have to pay them. The bottom line, these changes will hit you in the pocket if you require prescription drugs.

However, given the amount of money each pharmacy stands to lose, these increases in the dispensing fee that you may need to pay won't be enough. Many stores will be forced to charge for services such as deliveries, faxing doctors, private consultations and many others. In my experience, these services are often required by my most needy patients. 

I have heard all of the chains and independent stores talk of reducing the number of pharmacists and pharmacy assistants working at one time. For you, that means you will have to wait longer for your prescription and will be far less able to get needed advice when you really need it from a health care professional who knows who you are and what medications you take.  

That's tough in physician-underserviced areas like Bruce and Grey counties where doctors are so overburdened they don't always have time to see you when you need it most. That's also tough and expensive on already overcrowded emergency departments.  

Lastly, there will be some stores that can't make up for the loss of funds. Undoubtedly some of these stores will be in cities such as Toronto and Ottawa where I think we can all agree there are way too many pharmacies. Unfortunately, some will be in small towns in rural Ontario where they are the only store in town and they don't have the grocery and cosmetic sales to compensate.  

Ask Carol Mitchell if she's certain Chesley, Paisley, Lucknow, ... will be able to keep their pharmacies open. I'm willing to bet she doesn't have any idea.

As I said, I'm okay with your local pharmacies, pharmacists and drug manufactures making less. I'm okay with Ontario having more money to spend on covering new drugs. I just hope that Carol Mitchell and the rest of the Ontario Liberals come to their senses and revise their plan to one that makes a little more sense and doesn't jeopardize your local level of health care.   

We've had too many health-care mistakes from this party already.  Please call Mitchell, at 519-396-3011, and voice your concerns.

Sincerely,
Ron Chapleau
Pharmacist

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Monday, May 03, 2010