New Brunswick

N.B. government eliminates 30-day cap on prescription refills

The 30-day limit on prescription drugs has been eliminated, Premier Blaine Higgs announced at the daily news briefing on Thursday. 

College of Pharmacists accused government of ignoring their advice

A pharmacist counts prescription drugs in this file photo. (Chris Wattie/Reuters)

The 30-day limit on prescription drugs has been eliminated, Premier Blaine Higgs announced at the government's daily news briefing on Thursday. 

Higgs said it was a unanimous decision of cabinet and was sparked by concerns over additional dispensing fees and co-payments. 

"We realize this is a difficult decision, but in light of the unprecedented circumstances we are in, we strongly believe this is the right one," Higgs said. "We are taking this action to ensure that our vulnerable population is not put in a position where they have to choose among paying for their medication, buying groceries, or paying their rent." 

Higgs said the government will create a working group to address potential shortages of specific drugs, "rather than have a sweeping model."

It's so good to know that the voices of vulnerable people hurt by this policy have finally been heard.- Kathleen Finlay, Center for Patient Protection

He said anyone who paid the extra fees over the last few weeks will not be reimbursed. 

On March 16, the New Brunswick College of Pharmacists directed that all refills be capped at a 30-day supply, instead of every 90 days as most doctors prescribe for maintenance-type drugs. 

The regulatory body said the move was necessary "to protect the drug supply for the greater good of all patients in the face of unprecedented conditions due to the pandemic. This is a temporary measure designed to enable pharmacies to help ensure all New Brunswickers continue to have access to medications at this challenging time."

Since pharmacies were still charging the same dispensing fees for each prescription, patients were paying the fees three times as often.

Dispensing fees can range from about $4 to $15 per prescription. 

Pharmacists argued that they were doing three times the work and therefore were justified in collecting three times the fees. 

Dennis Driscoll worried about how he would pay for the extra fees on the 20 medications he and his wife usually refill every 90 days. The province has now dropped the 30-day limit on refills. (CBC)

Higgs went out of his way to praise pharmacists in the province. 

"During this difficult time, pharmacists have played an important role in our communities as essential front-line workers," he said. "Our government understands that pharmacists want to ensure residents have the medications they need. We share the same concerns, and that is why we will create this working group to keep a close eye on the drug supply, and to identify any anticipated drug shortages." 

Others were not so pleased with pharmacists. 

"They're saying their workload has tripled, but it's a self-imposed workload," said Dennis Driscoll, who had been left trying to figure out how to pay an additional $420 every three months because of the 30-day policy.

Kathleen Finlay of the Center for Patient Protection is calling for all provincial governments to stop the 30-day blanket cap on prescription refills. (Kathleen Finlay)

The Saint John senior said the governing body of pharmacists should not have been allowed to make such a directive, given that pharmacists are the ones who benefit from it.

The head of a national patient advocates group praised the New  Brunswick government's move to lift the restriction.

"It's so good to know that the voices of vulnerable people hurt by this policy have finally been heard," said Kathleen Finlay from the Center for Patient Protection.

Finlay believes New Brunswick is the first province in Canada to do so and hopes that other provinces will now follow suit.

She said it never seemed right that provincial colleges were able to impose limits to refills, while collecting more dispensing fees. 

"I don't think the optics of it look very good," she said.  

Cecile Cassista, of the Coalition for Seniors and Nursing Home Residents' Rights, is very pleased that the government lifted the 30-day restriction on drug refills. (Wayne Chase Photography)

The people hurt most by the cap were seniors who tend to have more medications than most people, said Finlay. 

"Seniors can have 10, maybe 15 prescriptions that they need to get filled at a time. It adds up terribly," said Finlay, who feared seniors would start cutting pills in half or stop filling prescriptions altogether. 

Plus, she said, the extra trips to the pharmacy increase concerns about exposure to COVID-19, especially in such a vulnerable age group — all while governments are ordering people to stay at home. 

Finlay said it is "very prudent" of the provincial government to address potential problems on a drug-by-drug basis. 

Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents' Rights, is also pleased at the government's move.

"I am very pleased that they overrode the pharmacists," she said. 

"I'm very happy for seniors because this would have been money out of their pocket," said Cassista, adding that some seniors were looking at an additional cost of $1,200 per year. 

In a response issued late Thursday evening, the New Brunswick College of Pharmacists accused the government of ignoring their advice and concerns, said registrar Sam Lanctin.

"We are gravely disappointed in this decision," Mr. Lanctin said.

"Ignoring the significant supply chain warnings, information and alerts from the manufacturers and distributors will not make the problem go away. We believed — and still believe — that doing our part to stabilize already shaky international supply chains is the right thing to do. Preventing new shortages and helping to ensure current shortages don't get worse was what we were aiming to do. Unfortunately, the government has decided to simply leave this up to fate."

He said the decision "may have severe ramifications down the road."

"It doesn't take much to disrupt a supply chain — and limiting supplies in the short term was — and still is — the right thing to do. We are especially concerned with ongoing issues in India and China, where many of the ingredients for medications are sourced."

Lanctin encouraged New Brunswickers to voluntarily opt for 30-day refills. 

"New Brunswickers can help drug supplies by resisting the urge to hoard medications and to maintain 30-day refills for the time being if this is a valid option for them," he said. 

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