Province gives 10-day 'washout' period to pharmacists as generic drug policy changes loom Times & Transcript May 26, 2012

NBers struggle with drug prices

Province gives 10-day 'washout' period to pharmacists as generic drug policy changes loom



While the provincial government's new generic drug policy has been touted as an effective way for the province and for New Brunswickers to save money, there are still many people falling through the cracks, struggling with the cost of medication.

Insurance companies and various groups in the province applauded the new policy, first announced in March, but they acknowledge there is much left to do to make health care more affordable for New Brunswickers.

'We recognize the changes as a big step forward to try to reduce the costs for prescription drugs to make it more affordable,' said Miguel Le-Blanc, executive director of the New Brunswick Association of Social Workers.

'It is moving towards the right direction. There is still work to be done, but we're encouraged by the first steps.' The generic drug policy, coming into effect June 1, sets maximum allowable prices for generic drugs that pharmacies can charge, reducing prices to 40 per cent of the brand price by June 1 and then to 35 per cent by December. Currently, generic drugs in New Brunswick are as high


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as 70 per cent of the brand name price.

The province expects to save roughly $16 million over the next 10 months and roughly $20 million in each full year afterward compared to current spending.

While the majority of New Brunswickers have drug coverage through private drug plans or through publicly-funded drug programs like the New Brunswick Prescription Drug Program, about 200,000 New Brunswickers, 25 to 30 per cent of the population, have no drug coverage and must pay for prescriptions out of their own pocket.

'So how can we provide access to all New Brunswickers to gain access to vital pharmaceuticals?' LeBlanc asked.

He noted that the province is hosting consultations on potential ways to help New Brunswickers who don't have medical coverage.

A Department of Health spokesperson said consultations on this topic are ongoing. The province's Economic and Social Inclusion Corporation Advisory Committee on Health Benefits has targeted fall to have its recommendations to government.

Cécile Cassista, executive director of the Coalition for Seniors and Nursing Homes Residents Rights, said the generic drug price changes are long overdue, but there is still much work to be done.

She said there are many seniors in the province who sit just above the low-income mark and thus don't qualify for assistance.

A low-income senior is a person living on $17,198 or less a year or a couple living on $26,955 or less.

Cassista said it's not fair that seniors who make only a few dollars more than that don't qualify for assistance. Those seniors find themselves in a situation where they have to decide where to spend their limited income.

'They do without other things in order to meet the needs to get their prescriptions,' she said.

And those seniors who do qualify for the provincial drug plan are now paying more than they used to. Earlier this year, the Tory government increased the co-pay for prescription drugs for low-income seniors from an annual maximum of $250 to $500 per person.

Cassista said there are about 55,000 low-income seniors in the province affected by that change.

'They have to pay out of their pocket until they hit that cap,' she said.

A Richibucto woman told the Times & Transcript recently that she doesn't expect to see much benefit from the generic drug price changes. Susan Maillet, 55, has been on disability for more than 15 years.

She suffers from a degenerative disc disease, osteoarthritis and fibromyalgia.

She requires pain medication, anti-depressants, muscle relaxers, blood pressure medication and a heart rhythm pill, plus additional medication to help with the stomach ulcers she gets due to the amount of drugs she requires.

She spends hundreds of dollars a month on prescriptions, some of which don't have a generic alternative.

'There's months that I can't afford to buy certain medications,' she said.

She can't get medical insurance, but Maillet and her husband, a carpenter, also don't qualify for provincial assistance. She is creative in finding ways to save money on prescriptions, such as paying a friend to drive to Moncton to pick up prescriptions just so she can save a bit on dispensing fees.

'They're so widely varied that it's incredible,' she said, noting that it pays to shop around.

Maillet said one can also save on dispensing fees if they can get their doctor to issue a prescription that will cover a longer period of time.

While some New Brunswickers might find savings on generic drugs, other pharmacy-related expenses may be going up.

George Murray, pharmacist and owner of Tantramar Pharmacy in Sackville, told the Times & Transcript this week that with generic drug prices being slashed, the loss in revenue he faces will force him to start charging clients for services that had been free.

'I have a guy who comes in every week to get his blood pressure checked,' Murray said. 'We're going to have to start charging for that.' The pharmacy will also start charging for glucose checks, travel medication reviews, prescription delivery and prescription re-orders.

'It's not a decision I take lightly but I feel like I don't have any other options because I just can't continue to lose money on every prescription I fill for the province,' he said.

'Unfortunately, those people who can least afford it - like seniors, low-income patients and those with serious health concerns - will be the most impacted.' Paul Blanchard, executive director of the New Brunswick Pharmacists' Association, said Murray likely won't be the only pharmacist charging for services in the future.

'The financial impact of the change that the government is bringing is such that pharmacies are either going to be cutting staff or hours of service and so on or charging from now on for services where previously there was no charge,' he said.

The province will reinvest some of the money it will save from the generic drug policy - $6.2 million annually - into pharmacy services to offset some of the revenue losses that will be felt, but pharmacists say it isn't enough.

The government will also allow pharmacies to increase dispensing fees per drug by one dollar, from $9.40 to $10.40, but Murray said dispensing drugs can cost up to $15 per prescription. Pharmacies will also be able to mark up generic drug costs by as much as four per cent up to $50 per drug.

Yesterday, the province announced that pharmacies will be allowed a 10-day transition period to help them adjust to the new generic drug pricing policy. This means that pharmacies who paid a higher price for drugs purchased prior to June 1 will have an additional 10 days where the province will reimburse them at the higher rates.

'Our government recognizes that reducing generic drug prices will impact pharmacy revenues,' said Health Minister Madeleine Dubé. 'In response to the concerns expressed by pharmacy owners, a 10-day transition period will be implemented to allow pharmacies to further reduce inventory purchased at higher prices.' The NBPA had asked for a 30-day 'washout' period, and Alistair Bursey, president of the association, said 10 days is not enough.

'Pharmacies can't turn their inventory that fast and my members are still going to lose a significant amount of money,' he said.

Dubé also announced a plan to engage pharmacies by establishing a working group which includes representatives from the Department of Health and the New Brunswick Pharmacists' Association.

The group will monitor the savings achieved by the generic drug policy in the first year and will discuss opportunities related to the role of pharmacists in the health-care system and as well as potential reinvestment should savings be higher than projected.