Confusion about how Saskatchewan pharmacists get paid for a federal methadone program was largely Health Canada's fault, an official with the department says.
Some Saskatchewan pharmacists were upset after getting a June newsletter from Health Canada's Non-Insured Health Benefits (NIHB) program that said, effectively, some of them could expect less money from now on.
Specifically, it told them that for each of their methadone clients, who typically receive a dose every day, they could bill for only one prescription a week, with the pharmacist's fee capped at $36.17. Methadone is a drug used to wean addicts off heroin.
Some pharmacists had previously understood they could submit up to three subscriptions a week and receive higher fees. The argument was that in some cases, three different strengths of methadone solutions have to be prepared, so there should be payment for three prescriptions.
But that's wrong, according to Doug Booker, director of NIHB's program analysis division. The Saskatchewan pharmacists were given inaccurate information last October, and the source of the information was Health Canada itself, Booker said. That information has now been corrected, he said.
Although Health Canada says there was never any change in its policy on the dispensing of methadone or payment for the service — just a clarification — some pharmacists were up in arms and threatened to pull out of the program.
Saskatoon pharmacist Shelly Woloshyn said that even before getting the June notice, she barely broke even providing clients with methadone.
In addition to dispensing the drug, the program requires pharmacists to witness the client taking it. Some feel it's more trouble than it's worth.
The one-prescription-a-week rule could mean Woloshyn will pull out of methadone dispensing completely, she said.
The federal program is used by about 2,000 First Nations people across Canada.
Woloshyn said if she can't provide service to First Nations people, she won't provide service to others in other methadone programs.
"It puts us in a very difficult position, because how do we say we won't accept one person as a client because their program is paid differently from another client," she said. "That could be considered discriminatory."
Brett Filson, the executive director of the Pharmacists' Association of Saskatchewan, said it's already almost impossible to get pharmacists to provide methadone now.
Filson said he can't understand why Ottawa would proceed with the prescription cap.
"The only rationale I've been given is that they believe their responsibility is to protect the public purse, they have to make sure that money is spent appropriately, so they're cutting this program," he said.
Booker said Health Canada will continue to talk to Saskatchewan pharmacists to make sure everyone understands the rules.
He said he hasn't heard directly from any pharmacists planning to pull out of the program.
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