The Real War on Drugs in Ontario and Canada – Editorial – Jamie Gilcig – Cornwall Ontario – April 18, 2010

Cornwall ON – The Real War on drugs takes place each and every day.

It’s not cocaine; it’s not Mary Jane as one of our radio guests call it.

It’s pharmaceuticals and the pressures from big drug companies on Medicare.

Recently Ontario slashed the prices pharmacies are allowed to charge for generic drugs and cut off kick backs from drug companies.

The led to howls of protest from pharmacies predicting an end to services from free delivery to the very basics of services and suggestions of closings.

Essentially what that means is that we in Ontario, and the other provinces follow Ontario, have all been paying billions of tax dollars for nothing.   Excess to big corporations for no reason other than they have the ear of our governments.

A recent ARTICLE in The National Post discusses points made in a Fraser Institute report.

The ODB should reimburse consumers directly and require consumers to pay a portion of the cost of their prescription drugs (25% for example). ODB recipients would become sensitive to price and they would be motivated to shop around, creating incentives for pharmacy retailers to compete on prices.

Now there lies the slipperiest of slopes.  I can tell you this thesis does nothing, but help big pharma again.    We have a medical system that more and more relies on the prescription pad instead of treatment.

I’ll use another example, because this drug policy is the tip of the iceberg, and these practices go on in about every area of medicine.    I have Sleep Apnea and require the use of a CPAP machine.   Here in Ontario,  in Cornwall in fact, if you go to the four providers they all have the same price point because it’s legislated by Ontario.    (The fact there are four providers in a city of less than 50,000 people says something to the financial rewards alone)

We are required to pay 25%, but what they don’t tell you is that without any favours you can buy the EXACT same machine retail in the US for about half the price.

The taxpayer thus is being robbed and of course we the users get robbed again by having to pay the 25% fee.  If we purchase the equipment in the US; IE not from an approved source, we don’t get our 75% paid for.

This is short of organized crime; except it’s being done systematically to all of us in Ontario, and in Canada.  It’s not a partisan issue too as all governments seem to be allowing it for one reason or another.

I agree with the Fraser Institute about market pressures.  We as the people of Ontario or Canada buy an awful lot of products and services.  We should be getting the best deals out there, not the worst, and not padding big pharma.

Our Medicare system doesn’t need more money.  It needs to radically reform how it spends our money.

Jamie Gilcig – Editor – The Cornwall Free News

(Comments and opinions of Editorials, Letters to the Editor, and comments from readers are purely their own and don’t necessarily reflect those of the owners of the Cornwall Free News, their staff, or sponsors.)

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10 Comments

  1. I’m alot disappointed about the the cut backs that the government wants to implement to community pharmacies.The independent pharmacies will be the one’s that are most affected.I can’t tell you how many times I’ve used the community pharmacy for advice.I’m a mother to 4 children,three of those being premature triplet boys.I cannot count how many times I’ve called them for advice.I’ve called them for advice on feeds,constipation,.colds,when to give oral fever liquid again due to one of my children throwing up.They are more convenient than my family doctor and more reliable than telehealth! I remember all of my triplets being sick when H1N1 was so high in the community.It was the weekend and I didn’t want to take 3 sick babies to a walk in clinic.I was scared they would get H1N1 on top of their already coughs.I called my community pharmacist and she gave me the greatest advice.She assured me my kids were fine and what to watch for and when to seek medical advice.These pharmacists deal with medications and situations everyday.They are more knowlegeable with otc’s and side effects than family doctors.They deal with these circumstances everyday.It saddens me to think that the government finds these community pharmacies not worthy of their time and services.

    Sherri Behie

  2. Hi Sherri,

    Do you work for a Pharmacy?

  3. It’s ridiculous the excessive costs that are tossed down to the end user in this country for medical care. There are plenty of devices that if purchased on their own, from perhaps the US, we save on huge by comparison to buying them here in Canada. It is a sign of the times unfortunately, and I agree, our whole medicare system needs to drastically change its spending policy. But at the same time, control has to be reigned in on these Pharmaceutical companies.

    You know what’s extra sad, how many people did the flu shot actually help? I didn’t hear much about this oh so deadly swine flu that we absolutely had to get a flu shot for at all costs… blah blah blah… all another ploy again for the big pharma companies to make a huge profit off the masses. And our government helped to make it all happen.

  4. First of all, this is not about big pharma, it’s about all the little guys, the small, independently owned, family-run pharmacies. My father is a senior citizen, but unfortunately, because he is a pharmacist and decided 30 years ago that he wanted to use his entrepreneur calling to open up his own pharmacy and assume all the risks that undertaking ANY business involves, he still has to work 65-70 hours a WEEK in order to keep his pharmacy afloat. When funding gets cut, he will have to increase his own hours (from 70 to what???), charge for the deliveries him and my mother do for free (yes, they are the delivery guys), and the pharmacy will still have to cut employees hours if the store is going to survive, after 30 years of operation. Why? Because these so-called “kickbacks” are actually professional allowances that the government implemented to have generic companies fund the difference between what the government was paying for pharmacy services, and what it actually cost. In 20 years, the professional fee that the government has paid pharmacies has increased by just $0.56!! The government was fine putting the burden on generic companies to compensate pharmacy services so they didn’t have to. But suddenly they claim this is what is inflating your generic prices. No – this is what allows a small pharmacy that relies solely on professional services (and not selling a variety of other products from appliances to groceries) to survive. Ask your government why they haven’t addressed the more expensive BRAND named products that get introduced so easily into the government’s medication formulary. The Brand name drugs are what cost you the most, but because of the confidential agreements and true kickbacks the GOVERNMENT gets from BRAND name companies, they haven’t mentioned anything about combating those prices. Think about it. And by the way, we also pay more for clothes, car, food, and almost anything else compared to people in the US. Does that mean the whole manufacturing industry in Canada is in this “short of organised crime” ring?

  5. @Sherri: I am a community pharmacist and stories like this makes me believe in what I do and what I am fighting for against this legislation. Me and my colleagues support reform and we have been the most cooperative when the Ontario government approach us 9 months ago. We provided our time and ideas to help this government save money. Guess who wants us out in our communities and attacked our integrity as professionals to win the PR war? While Mr McGuinty wants the “Big Pharma” out, really they will be the only wants left after this cuts. We will be like the US where no independent pharmacies operate, pharmacists are behind bullet proof glass and asking people to sign a paper if they refused to be counselled. Because of the financial mess of this government through E-Health scandal and other money wasting ways, they want to “balance” the budget and deficit by cutting the most convenient health care access we have. It is interesting that they want to cut the alleged “kickbacks” by pharmacy industry but do they tell the public where it goes now? (Yes, what you are thinking is right, we have documents to prove that.) These “kickbacks” support all along the pharmacy industry and make ends meet while all this time gov’t really have not increased funding or not even adjusted to inflation the costs for pharmacy operations. Everyday I hear the gov’t open their mouths (and articles like this one here), my stomach would just turn and just disgusted about what they “think” they know what they are saying. I thought this McGuinty land wants to boost the economy, well I hope you have made Employment Insurance more accessible now than it was before, Mr. McGuinty this industry you are about to kill will need it.
    @Jamie: My guess is you have been healthy and have not accessed your local pharmacy services. Well when you are 70 years old, fixed income, 20 medications to manage and physically challenged, I hope that the services now that are free and available will be there for you when you get there. Or I will see you behind a bullet proof glass, in line up and asking you if you want to counsel on your medications but will need to pay for that service.

  6. “And by the way, we also pay more for clothes, car, food, and almost anything else compared to people in the US. Does that mean the whole manufacturing industry in Canada is in this “short of organised crime” ring?”

    Yes. And its been this way a long time, and its getting worse!

  7. I totally disagree with the cuts that the government is proposing, this will only cost the consumer more, maybe just in different ways. When has the government ever lowered the price on anything to help the consumer. This is going to hurt the small independent pharmacies the most and some will be forced to close. The doctors are still going to writing the same number of prescriptions and there will be less pharmacies to get them filled at. So the pharmacist and the pharmacy technicians will be a lot busier, because there will have to be layoffs to help offset the cost. The government very generously is going to increase the dispensing fee they pay up $1.00 which is still short $6.00 from what it costs to fill a prescription. So the scenario is we have less staff and pharmacists more prescriptions and (my opinion only) a lot of upset customers that have to wait longer for their medication, so they may want to have it delivered and they are told we can do that but there will be a charge for that, and it will not be just one chain charging because it will be necessary for any of them to continue with the delivery service which is an invaluable service to people who can not get out. When someone comes in to ask the pharmacist about an over the counter medication, the pharmacist will just not have enough time to answer the questions in person or over the phone. So in the end we will have more unemployment because of pharmacy closures and layoffs. Emergency Department wait times will increase because people will have to go to Emerg. or to their doctor if they have a doctor and just times that by thousands because you are looking at the entire province of Ontario. Please just visit http://www.stopcuts.ca to view the facts before you decide. I know it sounds good when they say they are going to save you money but it is up to each and everyone of us to investigate and get the facts.

  8. Jamie Gilcig’s article about Pharmacy funding shows that he does not understand the issues.

    First, the price of his CPAC machine has nothing to do with the current issues affecting pharmacy. Besides, has he noticed everything in Canada is more expensive… cars, gas, electronics…everything. That is because it is very expensive doing business in Canada…import taxes, business taxes, personal taxes, etc. He should bring this issue up with the government.

    As far as the issues with pharmacy, professional allowances were created by the McGuinty government to help subsidize pharmacy care. The government currently pays only $7 per prescription, which has only increased 57 cents in 20 years. It currently costs over $14 to fill a prescription in Canada. The difference is funded by professional allowances. Without this funding pharmacies would not be able to provide the professional services currently offered for free to Ontario residents.
    It would be helpful if you did some more research before writing an article about something you clearly don’t understand.
    I would recommend going to http://WWW.STOPCUTS.CA to learn more about the issues.
    Sincerely,
    Scott.
    Pharmacist

  9. Hi Scott,

    First I’d like to welcome you to The Cornwall Free News. Second, it’s CPAP, not CPAC, and it has nothing to do with Pharmacists; but is indicative of how funding works in the Medicare system we live with.

    I want to commend you for clearly stating that you’re a pharmacist and in any Democracy people should be able to share their opinions. I’ll stand by my story. I don’t think Drug Companies should be kicking back to pharmacies or doctors. While I understand that anything that impacts a business’ bottom line is important to the business it should not be done blindly on the backs of the public coffers.

    While I’m sure the topic could be discussed and debated from all angles the bottom line is that more people need to know more about how our health dollars are being spent and become more involved in making sure the people they vote for take heed of their desires.

    We need better care and services; not healthier bottom lines for Generic drug makers. All parties should be at the table and try and figure out the best way to deliver services to residents of Ontario and Canada at the best possible prices; especially in days of hospital bed cuts as we’re seeing here in Cornwall Ontario.

    Hopefully solutions will evolve that take into consideration the needs of the patients, the government, and the people that serve them.

    Jamie Gilcig

  10. I agree that generic pricing must come down , Professional Allowances must end.
    However the dispensing fee has only increased from 6.47 [1989] to 7.00 2009
    .53 cents …less than 10% in 20 yrs…while minimum wage has gone from 5.40 to 10.25 ..
    Pharmacies have relied on PA’s to fund that gap.Th egovt created , regulated and monitored that system since 2006.As a pharmacist and small busines owner i want to be paid a fair fee for what i provide to public . Plain , simple .

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