July 9, 2010
Top Line Messages
- Funding cuts to frontline healthcare will affect pharmacy services you have come to rely on
- We are changing the way we serve you, our patients
Discussion points
- Did you know that the Ontario government has cut funding to pharmacies and the services we provide?
- There is a large funding gap between what it costs to provide pharmacy care and what the government pays pharmacies
- It costs me approximately $14 to dispense a medicine. This covers pharmacist and staff wages, rent, utilities, and everything else
- But the Ontario Drug Benefit plan sets my dispensing fee at only $7 – and they don’t pay pharmacies anything at all for the rest of the services I provide to patients
- So under the Ontario drug plan, I’m actually losing money every time I dispense a medicine
- These funding cuts have hit my pharmacy hard. The government has downloaded a significant portion of pharmacy funding, and as a result we’ve been forced to re-assess how we do business. (give examples)
- Pharmacy and pharmacists are asking the government to reinvest the cuts into expanded pharmacy services which help improve the health of Ontarians, and often help save expensive and needless emergency room visits
- Your help in telling the government and our MPP that maintaining a viable community pharmacy is important to you, and that you support the reinvestment of funds saved into expanded pharmacy services would be appreciated
July 9, 2010
POS A - Black and White – Bag Stuffer – 8′x 4′
Click here to download
POS A - Colour – Bag Stuffer – 8′x 4′
Click here to download
POS A - Black and White - Desk Topper - 8.5′ x 11′
Click here to download
POS A - Colour - Desk Topper - 8.5′ x 11′
Click here to download
POS A - Black and White - Poster- 24′ x 30′
Click here to download
POS A - Colour - Poster- 24′ x 30′
Click here to download
POS B - Black and White - Bag Stuffer- 4′ x 8′
Click here to download
POS B - Colour - Bag Stuffer- 4′ x 8′
Click here to download
POS B - Black and White - Desk Topper – 8.5′ x 11′
Click here to download
POS B - Colour - Desk Topper – 8.5′ x 11′
Click here to download
POS B - Black and White - Poster – 24′ x 30′
Click here to download
POS B - Colour - Poster – 24′ x 30′
Click here to download
July 9, 2010
To whom it may concern,
It has been ten months since the Ontario’s Community Pharmacies Coalition campaign was launched. During that time we stood up for pharmacy and for community health care and we thank all of you who participated for your dedicated and ongoing effort, time, and support.
The Coalition’s campaign was focused on a majority government that was determined to achieve specific endpoints dating back to 2006, and despite our best efforts, and loud united voice, they implemented drastic changes.
The pharmacists and pharmacy organizations that played a role in the campaign should be recognized for their many achievements, including:
• a unified voice for pharmacy and patients
• tremendous grassroots activism and political engagement
• the establishment of community pharmacy as a critical stakeholder with government
Not only were these efforts successful in delaying changes originally slated to be implemented in the fall of 2009, they also resulted in a transition approach on the private portion of pharmacy business and a transition fee that will initially help to soften the blow. Unfortunately, this transition fee helps only modestly and for a short time, as the financial picture for pharmacy in Ontario definitely darkens beginning in April 2011.
As a result, pharmacy operators are now assessing their businesses to determine what they need to change to remain economically viable. It is likely that these changes will include looking at a number of options to reduce costs, streamline operations to find efficiencies, change hours and modes of operation, increase sales, adjust prices, and/or charge for services.
These matters are all the individual decisions of operators, and clearly the pharmacy market is beginning to show signs of change. We know these changes will continue to unfold over the coming days, months and years.
Where do we go from here?
While a defined, structured and funded campaign did end with the passing of the regulations, there is still much work to be done. We stood up for pharmacy and our patients to try to effect change in a particular way, but it is now time to adjust our course.
Before we talk about the future, however, we wish to thank all those who worked tirelessly on the campaign. You met with MPPs (often more than once). You rallied and organized rallies. You talked to your patients and other customers and held public information sessions in your pharmacies. You delivered a million petition signatures. You were spokespeople for the media. You travelled the province – some on a bus – delivering our common message. And you did so much more. To each of you who contributed, in any way small or large, we thank you and the entire pharmacy community owes you a debt of gratitude.
Some of our members spent incredible amounts of time away from their regular jobs and their families to form and lead the Coalition. For many of them the time has come to re-focus on tasks within their individual organizations. As a result, and based on current funding and resources, we will be changing the Coalition activity steering process. One thing, however, will not change: OPA, IPO, and CACDS will continue to work together into the future on our issues of common interest.
Pharmacies are making choices now — some of them are very difficult ones. However, we know that we are at our best when we are working together. We are at our best when we speak with a common voice. Our objective will always be to provide the highest level of pharmacy care for the people of Ontario.
We understand that we are a long way from that goal and there is critically important work to be done to ensure that pharmacy professional services funding is structured properly so that the best health care outcomes can be achieved. To do so, we must continue to work together.
A key area of our focus over the coming months will be the collection of data on the impact of the reforms. We will continue to measure the economic state of pharmacies in Ontario and how this affects patient access to frontline health care. We will use this data to build and support our case and solutions in future discussions with the government and public.
While this work unfolds over the summer, the Associations that are the backbone of the Coalition will focus on working with you to collect this data. The data from our research, which will be handled confidentially through a third party, will help inform our public positioning, and updates will be provided periodically via the Coalition website.
Thank You.
June 30, 2010
The Coalition continues to review and assess the potential impact of the final regulations announced by the Ontario government. Notwithstanding the introduction of a transition fee that phases out over 3 years, a typical Ontario pharmacy will lose $200K in the first year, almost $300K in the second year and losses in subsequent years are expected to exceed $400K.
KEY FACTS
Reducing generic prices for both the provincial and private sectors to the regulated levels, will remove more than $900M in indirect funding from pharmacy in 2011-12
- Changes to generic drug pricing will also reduce direct funding, specifically mark-up, by over $100 million
Proposed government reinvestments through increased dispensing fees and professional services funding are inadequate
- ODB dispensing fee increase, transition allowance and regional pharmacy fee increase only reinvests approximately $200 million
- Additional professional services funding will have even less impact given the time and cost to administer professional service programs
In response to these funding changes, pharmacies must cut costs by streamlining operations,eliminating uncompensated services and exploring new funding opportunities in the private sector
- The viability of pharmacies who are unable to significantly cut operating costs or produce new revenue are at high-risk
Join the TELEFORUM on Thursday, July 24 at 8:50 pm for up-to-date information, and visit the http://ontario.communitypharmacies.ca website for new POS materials.
June 22, 2010
The Coalition sent a letter to the Ministry of Health and Long-Term Care Tuesday, highlighting the concerns of pharmacists and asking for clarity on some transition issues and more information about the implementation of the new regulations.
View the letter here.
June 21, 2010
On Wednesday, June 16 Coalition members met with Helen Stevenson and Pamela MacDonald of the MOHLTC to discuss transitional issues arising from the new regulations.
Following are the highlights of that discussion:
• The Ministry currently has no plan for a washout period for existing inventory, but are providing a 10-day notice period of price change. We asked the Ministry to consider the financial penalty to pharmacies of this decision, and reconsider a 30-day period for washout — including markup. The Ministry agreed to provide an update by end of next week.
• Transition fees will be paid automatically and manually as a separate line item in the normal OPDP payment record, based upon scripts filled. Methadone, LTC or equivalent, and pre-Trillium claims are not eligible.
• Variable Dispensing Fees — Pharmacies eligible to receive more than the $8/script dispensing fee will be notified by the MOHLTC as soon as this week. The Ministry has completed its analysis of eligibility. If we are in disagreement with their analysis we can appeal the decision on the fee. The Ministry indicated that stores will receive these letters ONLY if they are eligible to receive more than $8/script. All other stores will just automatically receive the $8 fee if submitted on July 1st.
• Professional Services Funding beyond the $75 Million to be covered by transition fees, $25 Million will focus on, but not necessarily be exclusively for, rural pharmacy services. An ad hoc committee will be formed in July/August to put together a plan for payment for services. Coalition Representatives will participate on this committee.
• MedsCheck Accessibility, there will be consideration made for MedsCheck ‘at home’ in rural locations to be eligible for some kind of mileage/time fee because of distance. Program will be expanded to include diabetic patients not otherwise covered and will be at the pharmacists professional discretion. There will be consideration for payment for additional counseling at the same time (diet, exercise, foot care). It appears that MedsCheck (Home, LTC and Diabetes) may be priced differently than the $60 fee. A complete Q&A document from the Ministry on these services is to be sent out next week. Follow up MedsChecks remain at $25.
•Generic Pricing (including exceptions) will be announced in the upcoming formulary notice of changes, expected 10 days before implementation. All Generic vendors have been asked to submit their exception lists (non 25% pricing) to the MOHLTC this week.
Other Issues:
• Appeal Process — When opening a new pharmacy, the dispensing fee is automatically set at $8. MOHLTC will assess the category of the new pharmacy and re-set the fee. This could take a few days. Retroactive payment would be made available. Likewise when a store category changes (a pharmacy closes in the town, etc.), the Ministry will only re-set the categories annually. Once again, retroactive payment will be allowed in this case.
• Methadone scripts under capitation are not included with any fee increase at this time. These will be dealt with this fall. Suboxone would be included in this as well.
• MOHLTC indicated that they have intentions to meet with pharmacy on LTC in the upcoming months. For now the higher fee with no transition fee applies.
June 14, 2010
Click here for an overview of the provincial regulations.
June 11, 2010
The Coalition has established a list of issues and questions regarding the transition to operating under the new regulations. The highest priority issues have been submitted to the Ministry and the comprehensive list which follows is being maintained.
We’re looking for your feedback and additions to this list based on your experience and expertise. Please review the list, and e-mail your additions to info@ontariocommunitypharmacies.ca. Unfortunately, due to the volume of e-mails we are unable to respond individually to your questions or comments.
Click here for a PDF of the list.
June 8, 2010
Ontario’s Community Pharmacies to Minister: Patient Services and Care Still at Risk
Pharmacists react to new regulations and vow to fight for patient care
TORONTO, June 8 /CNW/ – Ontario’s Community Pharmacies Coalition are extremely disappointed by yesterday’s announcement by Health Minister Deb Matthews and the posting of amendments to regulations under the OBDA and DIDFA as it all but assures that Ontario patients will be less able to freely access the front-line community healthcare they have come to rely on. While pharmacists continue to support the need to lower generic drug prices and eliminate professional allowances, it is regrettable that the Minister chose not to work with pharmacists to find a solution that would preserve front-line healthcare. Pharmacists are disappointed by the complete lack of transparency in the consultation process, the failure to understand the profound risks to front-line community healthcare and the continued unwillingness by the Minister to meet with all key pharmacy stakeholders.
“Sadly, pharmacists will now be forced to make very difficult choices, as they evaluate the level of care they provide to all patients, especially seniors and the chronically ill,” said Rita Winn, RPH, BSCPhm, general manager, Lovell Drugs. “We deeply regret having to make choices that impact these patients and will resist having to do so. Unfortunately we have little choice.”
The government’s decision to expand the MedsCheck program and establish a transition fund for pharmacies are sound concepts but the funding level is woefully inadequate to help offset the impact to front-line healthcare of the massive $750 million healthcare cut. The cuts mean that patients will have less access to front-line healthcare and the final regulations indicate that the government really wasn’t interested in consultation with pharmacists and their patients to consider alternative solutions to deliver on their policy objectives.
Ms. Winn observed that, “The extended consultation period set out by the government resulted in very little consultation with all pharmacy stakeholders. In fact, one has to question the legitimacy of the entire process and why the guidance and expertise of those who lead the industry was outright ignored?”
Pharmacists maintain that the McGuinty government has, since April 7, waged a calculated campaign to continuously malign and vilify pharmacists with dishonest and misleading portrayals of the facts regarding professional allowances and their legitimate, regulated use in funding the patient care that pharmacists provide. “This is offensive to all pharmacists and a betrayal of the trust of Ontario voters,” says Winn.
Over time, patients will experience reductions in clinic services, evening and weekend pharmacy hours and direct access to pharmacists will be limited as a result of the cuts. Pharmacists deeply regret and resist having to make these kinds of cuts.
“Pharmacists refuse to accept such poor outcome for patients and will continue to advocate for continued patient care. Less healthcare for the people of Ontario is unacceptable.” said Winn.
Pharmacists are particularly concerned about the post-regulatory implementation period, which has historically been accompanied by a host of transition-related questions and unexpected practical and operational consequences that need to be resolved. The Coalition believes the new regulations under the ODBA and DIDFA, being numerous in scope, quantity and magnitude, will result in significant transition challenges.
The Minister has a real opportunity to work with all pharmacy stakeholders who bring the experience and operational knowledge that will help to ensure the best possible outcome as the new regulations take effect.
“On behalf of patients from every corner of the province, pharmacists remain committed to fighting for front-line healthcare in Ontario,” said Winn.
About Ontario’s Community Pharmacies
The Ontario’s Community Pharmacies coalition is the unified voice of community pharmacy in Ontario, representing independent owner-operated stores, “banner” groups of independently-owned stores that work together, as well as large and small pharmacy chains. The coalition is supported by the associations and organizations that represent both the profession and the neighbourhood business of pharmacy, including the Ontario Pharmacists’ Association, the Independent Pharmacists Association of Ontario, the Canadian Association of Chain Drug Stores and the Ontario Chain Drug Association.
June 8, 2010
Please use these key facts when communicating with patients, media and the public. Click here to view pdf.
