A dispute between pharmacists and Health Canada may force some First Nations people in the North to pay up-front for their prescription medications.

At least one pharmacy in the Yukon has warned First Nations members in their region that they will have to pay for their medications as of Sept. 1.

Northern pharmacies and Health Canada are at loggerheads over changes to prescription drug service for aboriginal people.

The program, called the Non-Insured Health Benefits program, pays for medication for about 750,000 aboriginal Canadians. In 2003/04 Ottawa spent $736.9 million covering prescription costs for Canada's First Nations and Inuit.

But Ottawa has decided to impose a new formula on pharmacies to cover dispensing fees and drug profits — and pharmacists aren't happy.

"At this point in time we're still optimistic that we'll be able to continue with these negotiations and reach a mutually satisfactory agreement," said Jim Lindsay, a Whitehorse pharmacist who sits on a national committee negotiating a new deal.

"I think it's very important to pharmacies in the North. Perhaps 30 per cent of their business is First Nations clients that are affected directly by this program."

Lindsay says the formula is too low for pharmacists in the Yukon and N.W.T.

Pharmacy ready to opt out

At least one pharmacy, Parhelion Medical Services in Watson Lake, Yukon, is already telling aboriginal people it is opting out of the NIHB, and they'll have to pay out of their own pockets for drugs starting on Sept. 1.

Pharmacy manager Shelly Dalziel says Ottawa's imposed offer represents a huge pay cut — she guesses around 50 per cent. She says that's a fee reduction Parhelion can't afford to take, so it has posted notices warning its hundreds of native clients about the change.

Dalziel says the impact will be huge on First Nations people from Watson Lake, Ross River, Lower Post, B.C. and other nearby communities. She says many clients are worried.

Health Canada sent a letter last week to Yukon health providers, stating native clients who don't pay up front can contact a pharmacy in Manitoba with a toll-free number which will mail their prescriptions under the NIHB.

Lindsay says no other pharmacies in the Yukon or N.W.T. have opted out yet, and there's still hope a better deal can be reached.

Federal officials were unavailable for comment.