• 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

POS A - Black and White – Bag Stuffer – 8′x 4′

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POS A - Colour – Bag Stuffer – 8′x 4′

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POS A - Black and White - Desk Topper - 8.5′ x 11′

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 POS A - Colour - Desk Topper - 8.5′ x 11′

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POS A - Black and White - Poster- 24′ x 30′

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POS A - Colour - Poster- 24′ x 30′

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POS B - Black and White - Bag Stuffer- 4′  x 8′

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POS B - Colour - Bag Stuffer- 4′  x 8′

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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

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.

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.

View the letter here.

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.