Edmonton pharmacist warns budget cuts put patients at greater risk

An Edmonton pharmacist is warning that cuts to dispensing fees could lead to fewer Albertans receiving flu shots, and increase risk to patients who struggle with addiction, decreased mental capacity or suicidal thoughts.

Moatasem Samara says flu vaccination rates will drop, risk to addicts and suicidal patients will rise

Pharmacist Moatasem Samara warns that cuts to dispensing fees could put suicidal and addicted patients at greater risk. (Moatasem Samara)

An Edmonton pharmacist is warning that budgetary cuts to dispensing fees could lead to fewer Albertans receiving flu shots, and increased risk to patients who struggle with addiction, decreased mental capacity or suicidal thoughts.

A new funding framework between the Alberta government and the Alberta Pharmacists' Association aims to reduce spending on government-sponsored drug programs by $150 million over the next two years.

According to Alberta Health, pharmacy compensation which was forecast to rise 12.3 per cent over the next two years wasn't sustainable. The province has capped the growth in spending at 4.3 per cent.

Among the changes, dispensing fees paid to pharmacists who give flu shots and other publicly-funded vaccines will drop from $20 to $13 as of May 17.

"But with these cuts, it's a service we have to do on the side," said Moatasem Samara, who owns four pharmacies in Edmonton. "We cannot dedicate resources to do it. And therefore the vaccination rates will go down."

Samara said it costs the province about four times more for the injection and clinic fee when a doctor administers a flu shot.

According to Alberta Health Services, during the most recent flu season pharmacists provided 615,711 of the province's overall 1,223,109 vaccinations. Physicians provided 102,529 doses.

Samara also expressed concern about the impact on patients caused by changes to the dispensing fees for drugs that are dispensed frequently.

Under the old system, pharmacists were compensated each time they dispensed medication, based on clinical assessments involving physicians, he said.

But effective May 17, a limit on the number of frequent dispensing fees will be introduced. Opioid dependency treatments will be excluded, the government says.

For drugs dispensed daily, pharmacists will be limited to a maximum of three dispensing fees per day per patient. If a patient is on more than three daily-dispensed drugs, the pharmacist will not be able to charge dispensing fees for the others.

For drugs dispensed every two to 27 days, pharmacists will be limited to two dispensing fees per drug every 28 days.

Samara said that could lead to more suicides, overdoses or mistaken overdoses among patients with decreased mental capacity, suicidal ideation or drug addiction.

"So the government tells us that an addict would need to be on daily dispense, for example, or they can get their medication every two weeks," said Samara. "There is no grey area and that is not how healthcare works."

Overall dispensing fees will also cut by 15 cents to $12.15 under the new framework. Samara said he understands some are cuts needed but said profit margins are small and the province should tackle fraud and abuse of the system instead.

Higher compensation for pharmacists

In a statement, Health Minister Sarah Hoffman said Alberta pharmacists "continue to be compensated at higher rates than their counterparts in other provinces."

She said the governments' work with the Alberta Pharmacists' Association will help save Alberta $150 million over the next two years.

Hoffman's department provided figures showing the province's new dispensing fee for flu shots will still be higher than B.C., Manitoba and Ontario

The pharmacists' association said it's the best deal it could get but described it as disappointing.

The Alberta College of Pharmacists said changes could result in longer wait times at pharmacies and diminish the amount of time pharmacists can spend with patients with complex needs.

Pharmacists plan to protest in Edmonton, Calgary and other cities on April 19.

With files from Jennifer Lee and CBC Calgary