As complicated as the pharmaceutical business is - there are some very simple concepts.
Unlike Doctors who have a billing code a pharmacist does not.
The pharmacy - the business - has the billing code for community pharmacy services.
The government is one of many insurers that offers its clients a card to use at a pharmacy.
A pharmacy can choose to accept or reject any insurance card.
The pharmacist does not decide that administrative and business decision.
CICPO is a duly incorporated not-for-profit trade organization that represents its member companies.
As such the CICPO negotiates on behalf of its businesses with insurance companies.
When a tentative agreement has been reached - the members of the CICPO vote on the agreement.
If a majority of members vote in favour of the tentative deal - then each corporation must separately sign an agreement with the insurer. This is a tariff agreement which outlines the amounts that will be paid to the pharmacy for acceptance of that particular drug card. Amounts include a dispensing fee, any specialty fees, mark-ups etc.
At all times the agreement reached is between the insurer and corporation - not a pharmacist.
In Newfoundland and Labrador you DO NOT have to be a pharmacist to own a pharmacy. Wal-Mart, Lawton's, Shoppers, and independent pharmacies can be owned by shareholders who are not pharmacists.
A pharmacy must employ a pharmacist as part of a staff in order that the pharmacy can conduct business.
A Pharmacy has the following expenditures:
1. salaries; CPP - EI - Workers Compensation - Benefits Package,
2. mortgage, lease payments, building maintenance,
3. light and power, Oil, or other energy,
4. taxation - federal, provincial, municipal,
5. security systems,
6. refrigeration,
7.specialized computers - software,
8. consumables such as pill bottles, special packaging, paper,
9. communications, telephone, facsimile, and other,
10. shipping - delivery costs,
11. inventory - medications - both prescription and over the counter drugs,
12. accounting - legal - professional services,
13. snow clearing, paving, property external maintenance,
14. carrying costs (significant when you accept an insurance card and wait up to two weeks for payment),
15. working capital,
16. operating licences,
17. garbage storage and removal,
18. delivery - vehicle maintenance - gas,
19. banking fees,
20. and other normal expenditures of businesses in the service and retail sector.
Not one of the above is the responsibility of a pharmacist.
The pharmacist is an employee of the pharmacy.
If a pharmacist is not working in a pharmacy, they work for Universities, Governments, Hospitals, insurance companies and pharmaceutical manufacturers.
The pharmacist is an employee.
The government of Newfoundland and Labrador wants pharmacies in the province to administer the provincial drug card. It like all other insurers is asking that their clients have the convenience of simply presenting an insurance card for payment of prescriptions drugs.
The pharmacy has the right to accept that card for payment or to reject it - in preference to immediate payment by the customer. This is the same for all businesses - including other essential goods such as groceries, furnace oil, light and power, or telephone.
The government of Newfoundland and Labrador chooses to negotiate with the Pharmacists Association of Newfoundland and Labrador - an organization that is responsible to represent all pharmacists - regardless of where they are employed. The organization is NOT a trade body and pharmacists not pharmacies are the only entities eligible to vote.
Therefore the government of Newfoundland and Labrador is negotiating with employees not the corporations it wishes to conduct trade with.
The CICPO members - all corporate - are not willing to have employee pharmacists negotiate a corporate contract on behalf of the company. The CEO's of the corporations represent the business interests - not the pharmacists - not the employees.
Making matters worse the vast majority of pharmacists in PANL do not have a shareholder interest in private sector pharmacies be they publicly traded or private.
The vast majority of voting members of PANL are employees and have nothing whatsoever to do with running a business or any responsibility for paying the bills of a corporation.
Pharmacists receive a paycheck and benefits from their employer - the pharmacy.
How can this professional organization (PANL) that has the mandate to represent pharmacists as employees also represent the employer - the corporation? How can this same organization claim to represent business when the business has not given express written permission to negotiate anything on the companys' behalf?
Is PANL going to go to the bank for these corporations and seek an interest rate for borrowing? Are they going to negotiate with wholesalers and manufacturers on their behalf? No they cannot and do not. Why then does this organization continue to claim to represent business? That is ethically wrong. It is materially wrong. PANL can say that government is negotiating with them - but PANL cannot claim to be negotiating for any business without the express written permission from the corporation.
The Government chooses to negotiate with PANL - when they have no authority to make decisions on behalf of the business. PANL does not bind a corporation.
Even under the farcical negotiation process with PANL - a "deal" was reached with government which is not binding on pharmacy - and not one corporation was asked to ratify such a "deal".
The CICPO pharmacies were not satisfied with a process which could bankrupt them - without a say - without any control - so they sent a formal notice to the Minister of Health that they would no longer accept the drug card for payment. This is a normal right of all businesses.
The notice was filed in accordance with the Provider Agreement between each pharmacy and government. All insurance companies and pharmacies operate under a "provider agreement" which outlines the rights and responsibilities of both parties.
The provider agreement between government and pharmacies required a 30 day notice for withdrawal of acceptance of the "card" as payment.
Upon that proper notification which was signed and delivered by over 60 individual corporations - the government decided to change the rules. The Government unilaterally changed the 30 day notice to 120 days and also added a condition that all patients that have been in the pharmacy within the past year were to be notified in writing - individually.
Further our members were threatened with disciplinary action and summary convictions if the "new" "immediate" changes to law were not followed.
We remain in the courts with that issue.
Now let's take the absurdity a step further - PANL which is supposed to represent pharmacists as a profession regardless of where they are employed do not actually negotiate any contracts for pharmacists!
The hospital pharmacists are represented by their union.
The University pharmacists are represented by MUNFA.
The government pharmacists are represented by their union.
Private sector pharmacists negotiate with their employer - the private pharmacy, drug manufacturer, insurance company etc.
All of the above pharmacists are voting members of PANL who are then trying to negotiate on behalf of private sector corporations!
We have a total conflict of interest. We have employees through PANL negotiating on behalf of businesses - most of whom have no risk whatsoever.
If a pharmacist has a problem with their working conditions or scope of practice or workplace health and safety - PANL is their representative. How then does PANL represent the employer?
There are no examples of this in any other sector.
The government is simply trying to force business to administer their social program at whatever they deem fit to pay for that administration. They can in fact put the business out of business without the private corporation having any control of their investment.
The government uses PANL as the path of least resistance knowing full well this is not would not be acceptable to any other corporation the government does business with.
When the government used Danny's old law firm to participate in the lawsuit against tobacco companies - the law society did not determine what the firm had to do the work for. Legal aid lawyers do not decide what hourly rate is charged by the law firm Minister Jerome Kennedy used to be a partner in. Tom Marshall did not allow government or a professional association to set his private legal rates.
Their law firms are not FORCED to do legal work for government at whatever rate of pay the government deems fit.
This is a pure deception - and the larger chain drugstores and mass retailers who have the individual ear of government when they employ lobbyists are happy enough to let their competition be slaughtered by government policy - when they publicly state they will be there to pick up the scripts when the more "vulnerable" independents fail. As for rural areas? They would be happy enough to mail the drugs if the local pharmacy disappears. Who cares about urgency, snowstorms, equal access, and rural communities? Good question.
The bottom line is government chooses it's people to sit at a table and then proceeds to dictate who sits on the other side. This is deception. This is dealing in bad faith with the corporations they want to do business with. Most importantly they are placing in jeopardy the equitable delivery of necessary medications to the most vulnerable in our society.
Showing posts with label panl. Show all posts
Showing posts with label panl. Show all posts
Thursday, May 09, 2013
Friday, January 18, 2013
Dunderdale Govt. Eroding Health Care
Please follow at The NL Pharmacy Blog - your community and health care services are being eroded.
New Drug pricing policy for April of 2013 will continue to erode the viability of independent pharmacies in Newfoundland and Labrador.
These changes are subsequent to the (non)negotiations held last year with provincially chosen pharmacy groups - resulting in an imposed contract. The remuneration was supposed to reflect that generic drug prices would be reduced to 35% of brand.
The Dunderdale government has now signed on to a reduction for 6 generic drugs to a price of 18% of brand. These drugs represent approximately 20% of the pharmaceutical dispensing. Therefore the "contract" reached last year ties pharmacies to dispensing fees that will not in any way offset these additional reductions.
Further pharmacies, physicians, and other health care advocates are already warning that drug shortages are impacting patient care. This new reduction in price will increase the likelihood that drug shortages will become more acute.
The CICPO is holding its AGM this weekend - after which a News Release will be distributed. This year's Annual General Meeting will focus on results presented by Dr. Wade Locke regarding the future viability of the independent pharmacy model. Dr. Locke has completed the in depth study over the past 6 months - and it will be made public by month's end.
The future for independent pharmacy both in rural communities and inner-city neighbourhoods will in large part depend on the willingness of government to realize the value and potential of these businesses and primary health providers.
More to follow....
New Drug pricing policy for April of 2013 will continue to erode the viability of independent pharmacies in Newfoundland and Labrador.
These changes are subsequent to the (non)negotiations held last year with provincially chosen pharmacy groups - resulting in an imposed contract. The remuneration was supposed to reflect that generic drug prices would be reduced to 35% of brand.
The Dunderdale government has now signed on to a reduction for 6 generic drugs to a price of 18% of brand. These drugs represent approximately 20% of the pharmaceutical dispensing. Therefore the "contract" reached last year ties pharmacies to dispensing fees that will not in any way offset these additional reductions.
Further pharmacies, physicians, and other health care advocates are already warning that drug shortages are impacting patient care. This new reduction in price will increase the likelihood that drug shortages will become more acute.
The CICPO is holding its AGM this weekend - after which a News Release will be distributed. This year's Annual General Meeting will focus on results presented by Dr. Wade Locke regarding the future viability of the independent pharmacy model. Dr. Locke has completed the in depth study over the past 6 months - and it will be made public by month's end.
The future for independent pharmacy both in rural communities and inner-city neighbourhoods will in large part depend on the willingness of government to realize the value and potential of these businesses and primary health providers.
More to follow....
Tuesday, April 24, 2012
Dunderdale Government using Hakapik on Local Business
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| Fisheries Minister Darin King says the PR war between governments and anti-sealing activists is changing. In recent weeks, King has had ”very positive” meetings with two different animal rights groups. — Photo by Joe Gibbons/The Telegram |
Monday, April 16, 2012
Government Imposed Contract will Harm Independent Pharmacy - CICPO
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| CICPO Release |
Notice to Editors: 16/04/2012
Please be
advised that the Council of Independent Community Pharmacy Owners is preparing
information for a News Conference on Thursday or Friday of this week.
This
conference will outline the catastrophic losses to independent pharmacy from
both the agreement imposed by government and the changes to generic prices
forced by legislation.
Please note
that an amending agreement was executed on April 14-2012 and delivered to
pharmacies yesterday afternoon.
There is no
tentative agreement and there is no ratification process for pharmacies.
Initially
government stated it was making changes to generic drug pricing and would
reinvest in pharmacies. The government has since made further changes in an
imposed amending agreement that will see negative changes to the reimbursement
of dispensing fees.
Currently
there is a “proposal” in place regarding “underserviced” areas regarding an
annual reimbursement for qualifying pharmacies. Today there is no agreement on
the terms and conditions of such reimbursement.
Further the
administration for pharmacies respecting the change in their computer systems
to reflect the imposed agreement could not be completed between yesterday
afternoon and this morning at opening. This is causing significant confusion as
patients fill their prescriptions today.
The Council
will advise editors of the time and place of the conference and the attendees
for interview.
At this
point the only comment from the Council is:
Phil O’Keefe
Director of Third Party Relations CICPO
“Our worst
fears have materialized; independent pharmacy and the people they serve have
been dealt a crippling blow. We are incensed that an agreement was reached
without ratification of the businesses it will impact; and in fact was signed
by the President of the Pharmacists’ Association of Newfoundland and Labrador,
Sandra Carey, who does not own or operate a pharmacy in Newfoundland and
Labrador. The government has imposed an agreement which will allow the chain
drugstores and mass retailers to survive while inequitably harming independent
pharmacy”.
Friday, March 30, 2012
Lobbyists and Dunderdale - Who Pays the Price?
What the Generic Giveth the Brand Taketh Away
On the heels of the Dunderdale's government decision to lower prices of generic drugs - two brand houses are reaching in and taking that money back.
As of April 02-12 Pfizer (Brand Company) has raised the prices of 40 some drugs.
As of April 01-12 Merck Canada (Brand Company) has done the same with about the same number.
Joining them in price increases on April 01-12 are: Brand Companies - Novartis, Purdue, Abbott, Axcan, NovoNordisk, Jannsen-Ortho and Astra.
Many of the Pfizer drugs that will go up in price next week are drugs commonly needed by seniors and others with chronic illness.
With money to spare in the provinces treasury anticipated by changes to generic pricing - the Brand Drugs are taking advantage and getting more cash.
Unfortunately the Brand Houses do not fund independent pharmacies through rebates so now we lose money and have nothing going back into community health services.
The brand drug companies are the strongest lobbyists in the country and yes they lobby our government.
This is a direct attack on local independent companies by our government and a gift for Shoppers Drug Mart and Brand companies.
On the heels of the Dunderdale's government decision to lower prices of generic drugs - two brand houses are reaching in and taking that money back.
As of April 02-12 Pfizer (Brand Company) has raised the prices of 40 some drugs.
As of April 01-12 Merck Canada (Brand Company) has done the same with about the same number.
Joining them in price increases on April 01-12 are: Brand Companies - Novartis, Purdue, Abbott, Axcan, NovoNordisk, Jannsen-Ortho and Astra.
Many of the Pfizer drugs that will go up in price next week are drugs commonly needed by seniors and others with chronic illness.
With money to spare in the provinces treasury anticipated by changes to generic pricing - the Brand Drugs are taking advantage and getting more cash.
Unfortunately the Brand Houses do not fund independent pharmacies through rebates so now we lose money and have nothing going back into community health services.
The brand drug companies are the strongest lobbyists in the country and yes they lobby our government.
This is a direct attack on local independent companies by our government and a gift for Shoppers Drug Mart and Brand companies.
Shoppers CEO predicts DOOM for Independents
The Newfoundland and Labrador government is about to serve a central Canadian company - local businesses on a platter.
With 100 million local dollars invested in the provincial economy - independent pharmacies have been told by their government that they don't matter.
As witnessed in the House of Assembly - PC Cabinet members and backbenchers chided these local owners with calls to show their T-4's and state where they take vacations.
The general assertion of government is that independents are filling their pockets with rebates.
Despite the lies and misleading statements by these politicians - Shoppers Drug Mart's CEO is backing up what the independent stores have been warning against.
In the Globe and Mail yesterday Domenic Pilla spells it out clearly for all to see.
With 100 million local dollars invested in the provincial economy - independent pharmacies have been told by their government that they don't matter.
As witnessed in the House of Assembly - PC Cabinet members and backbenchers chided these local owners with calls to show their T-4's and state where they take vacations.
The general assertion of government is that independents are filling their pockets with rebates.
Despite the lies and misleading statements by these politicians - Shoppers Drug Mart's CEO is backing up what the independent stores have been warning against.
In the Globe and Mail yesterday Domenic Pilla spells it out clearly for all to see.
“We are facing the
single worst commercial environment that the drug sector has ever faced … But
who is in the absolute best position in Canada to weather that – in some cases
to take advantage of that? It’s Shoppers Drug Mart.”
He said that as
the country’s largest drugstore chain, Shoppers is best positioned to navigate
the road ahead, with economies of scale to help it lower its costs.
And he wants to
buy competitors as reduced government reimbursements start to squeeze smaller
rivals, he said. “That’s a freight train accident waiting to happen. How it
will happen and how quickly it will happen ... is something that is still to be
told.”
His estimated that
Shoppers pharmacies probably could add another 30 per cent more prescription
files without having to invest in fixed costs. “That would make acquisitions
for us very accretive.”
Newfoundland and Labrador's Minister of Innovation, Business and Rural Development might want to look long and hard in the mirror today - as he personally participated in the likely destruction of local investors.
As Shoppers talks about chewing up local businesses - it does so while saying they don't have to invest a cent in fixed assets. The government of Newfoundland and Labrador is clearly stating their position on local business and investment.
To top it all off the monies lost to the treasury - particularly monies needed for health - will far outweigh any potential savings to the government from their new generic drug pricing model.
Further the services provided by these independents - that will be lost from the policy will cost the government tens of millions more.
Particularly puzzling is the government's insistence that these independents sit at a table with Shoppers employees and come to a common position. What might that be? We the independents agree to turn over our investments to you as cheaply as we can?
The buffoonery in the House of Assembly underscores the actual ignorance or complicit behavior that will in the end ruin local business, diminish front-line health services, and drive the costs of those services through the roof.
Bravo - why not stand in your place and take a bow.
Tuesday, February 14, 2012
Will the Stock Market govern your Pharmacy Care?
Please take the time to visit the Pharmacy Blog to read the latest on pharmacy.
Today's story deals with what could happen when chain drugstores and mass retailers control pharmacy.
PRESS HERE
Today's story deals with what could happen when chain drugstores and mass retailers control pharmacy.
PRESS HERE
Monday, November 21, 2011
Rural Communities to have Mail-Order Pharmacy? Ask Premier Dunderdale!
Last week - Express Scripts Canada announced it had received a licence to operate a Pharmacy in Ontario.
ESI for short - is a pharmacy benefits manages and negotiates agreements and provides management services to insurance companies. In other words a middle man.
The Council of Independent Community Pharmacy Owners (CICPO) was in fact in negotiations with the company last year to reach a deal for Desjardins card holders in Newfoundland and Labrador (provincial government employees insurance card).
So the fellow who was sitting at the table across from the independent pharmacies was in fact involved with establishing a pharmacy for the the company he represented. This fellow Mark Murphy was actually gathering further information about pharmacies, costs, and services - reportedly in an effort to reach an agreement with independent pharmacies in Newfoundland and Labrador.
Express Scripts Canada is located in Missisauga Ontario with its Parent company Express Scripts Inc. is located in Missouri, USA.
As a pharmacy benefit manager - they negotiate contracts for Insurers like Desjardins and in the case of these negotiations - in direct contact with the employer - the Government of Newfoundland and Labrador.
As Express Scripts Canada have now announced they will be looking at setting up pharmacies in other provinces - we might expect that rural areas of the province may now be served by mail order - thereby eliminating the local pharmacy, business, personal service, and professional face to face contact with an essential member of your health-care team.
Is this what the Dunderdale government wanted? Is this why they passed a regulation contrary to the agreement they were under with pharmacies? Is this why they wanted extra time? Will they be seeking to eliminate direct services in rural areas and have all the money leave those communities and even our province?
There is no doubt that a conflict exists here and it is time for the Premier to speak on this matter.
ESI for short - is a pharmacy benefits manages and negotiates agreements and provides management services to insurance companies. In other words a middle man.
The Council of Independent Community Pharmacy Owners (CICPO) was in fact in negotiations with the company last year to reach a deal for Desjardins card holders in Newfoundland and Labrador (provincial government employees insurance card).
So the fellow who was sitting at the table across from the independent pharmacies was in fact involved with establishing a pharmacy for the the company he represented. This fellow Mark Murphy was actually gathering further information about pharmacies, costs, and services - reportedly in an effort to reach an agreement with independent pharmacies in Newfoundland and Labrador.
Express Scripts Canada is located in Missisauga Ontario with its Parent company Express Scripts Inc. is located in Missouri, USA.
As a pharmacy benefit manager - they negotiate contracts for Insurers like Desjardins and in the case of these negotiations - in direct contact with the employer - the Government of Newfoundland and Labrador.
As Express Scripts Canada have now announced they will be looking at setting up pharmacies in other provinces - we might expect that rural areas of the province may now be served by mail order - thereby eliminating the local pharmacy, business, personal service, and professional face to face contact with an essential member of your health-care team.
Is this what the Dunderdale government wanted? Is this why they passed a regulation contrary to the agreement they were under with pharmacies? Is this why they wanted extra time? Will they be seeking to eliminate direct services in rural areas and have all the money leave those communities and even our province?
There is no doubt that a conflict exists here and it is time for the Premier to speak on this matter.
Sunday, November 20, 2011
Talk Newfoundland and Labrador - A show with Purpose for People not Politicians
Please join Shannon Reardon and I tonight on Talk Newfoundland and Labrador. Press HERE
Tonight we talk about pharmacy.
Available during the program is Todd Squires Pharmacist and owner of St. Mary's Pharmacy.
Topics to be covered:
1. What's happening with Pharmacy in Newfoundland and Labrador and Canada.
2. Medication and disease management.
3. CETA
4. Generic versus Brand
5. What is CICPO
6. Collaborative Care
7. Wastage in the Newfoundland and Labrador system.
8. Conflicts in the system.
9. Rural and inner-city pharmacy.
10. Your questions - your concerns - your points.
Press HERE to join the show at 8 pm tonight.
Tonight we talk about pharmacy.
Available during the program is Todd Squires Pharmacist and owner of St. Mary's Pharmacy.
Topics to be covered:
1. What's happening with Pharmacy in Newfoundland and Labrador and Canada.
2. Medication and disease management.
3. CETA
4. Generic versus Brand
5. What is CICPO
6. Collaborative Care
7. Wastage in the Newfoundland and Labrador system.
8. Conflicts in the system.
9. Rural and inner-city pharmacy.
10. Your questions - your concerns - your points.
Press HERE to join the show at 8 pm tonight.
Tuesday, November 15, 2011
"Talk with Sue and Shannon" takes on Pharmacy Issue this Sunday
Listen to "Talk with Sue and Shannon" Newfoundland and Labrador's newest talk-show this Sunday evening at 8 pm NL time as we explore the pharmacy issue.
There will also be a pharmacist/owner on hand to answer questions about the independent pharmacy model, medication and disease management (diabetes, cardiac, asthma, and other chronic disease), pharmacy services, the court challenge, other provinces, generic drugs versus brand name, saving money for government and patients/customers and the role of pharmacy in the future.
Find out where there are inefficiencies in the government system that are wasting tens of millions of taxpayer dollars.
Please take the time to listen in and become involved in this area of front-line health that affects you, your family, and community.
To take in the show please PRESS HERE
There will also be a pharmacist/owner on hand to answer questions about the independent pharmacy model, medication and disease management (diabetes, cardiac, asthma, and other chronic disease), pharmacy services, the court challenge, other provinces, generic drugs versus brand name, saving money for government and patients/customers and the role of pharmacy in the future.
Find out where there are inefficiencies in the government system that are wasting tens of millions of taxpayer dollars.
Please take the time to listen in and become involved in this area of front-line health that affects you, your family, and community.
To take in the show please PRESS HERE
Saturday, November 12, 2011
Canada taking Notice of Pharmacy Lawsuit by CICPO in Newfoundland and Labrador
The latest edition of the Canadian Pharmacists Journal has extensive story on the Council of Independent Community Pharmacy Owners and it`s lawsuit against the government.
Please read the full article PRESS HERE
Please read the full article PRESS HERE
Thursday, November 10, 2011
Will the Dunderdale Government allow the Shoppers Drug Mart Plan
The question for Premier Dunderdale is will she allow Shoppers Drug Mart to kill the independent pharmacies in our province? Will this government allow the "consolidation"? Will the Premier turn a blind eye to public statements of Shoppers Drug Mart's CEO?
CLICK HERE to read why Independent Pharmacy Owners cannot sit at the table with Shoppers Drug Mart and other publicly traded giants.
CLICK HERE to read why Independent Pharmacy Owners cannot sit at the table with Shoppers Drug Mart and other publicly traded giants.
Sunday, September 18, 2011
Will Minister Tom Marshall lie? Yes! Will he mislead? Yes!
Minister Tom Marshall appeared on Open-Line Friday of last week. The purpose of the call was to attack through innuendo, misrepresentations, threats, and misinformation - the independent pharmacy owners in the province.
The irony was that he called to correct something Randy Simms (host) said in his preamble.
Quote by Marshall:
Randy, we're negotiating now. There's a chair at the table for CICPO. CICPO refused to show up. Randy, Premier Dunderdale wants lower electricity costs for the people in this province. She wants lower drug costs for the people of this province. People have no choice. If the doctor says they got to have drugs, they got to have them, Randy. And the cost of generic drugs in this country are higher than they are in the US and higher than they are in other OECD countries. And there's got to be a reason for that. And we've looked into it and other provinces have looked into it. And British Columbia and Alberta and Saskatchewan and Ontario and Quebec and Nova Scotia have all taken an approach to reduce the cost of generic drugs to their citizens, to their taxpayers.
First - if the Premier wants to lower drug costs in the province - the first line of attack would be the brand drugs that are increasing in cost every year. The fact is brand name drugs which represent over 70% of the costs of all drugs prescribed and dispensed are going up in costs year over year. The generic drugs which are currently the target of this PC government are going down every year. Further the generic partnership with pharmacy has what has been keeping dispensing fees low and allowing pharmacies particularly small independent rural dispensaries to offer essential extra services.
Making matters worse is that the Dunderdale government is hiding its intent relative to a trade deal between the EU and Canada which would see our province have to pay an additional 50 million dollars for essential medications - by agreeing to extend the patent protection for the brand drug companies. Canada and the EU are set to go back to the table just after our provincial election and this term forms part of what a proposed deal will include.
The end result of the PC government move is:
1. The price of drugs will actually go up for citizens and taxpayers.
2. Dispensing fees for most people will have to double or the pharmacies will close.
3. Delivery to seniors and those without transportation will cease or there will be a cost for such delivery.
4. Independent pharmacies will have to stop credit programs for prescription drugs - thereby causing people not to buy and take their medications in a timely manner. This non-compliance will cause the emergency rooms of hospitals to experience unsustainable traffic, re admissions to hospital, or worse.
5. The government drug card clients will have to call their MHA or social worker to have the necessary forms completed for continuity of their prescription drug cards, or to complete their annual tax returns (in order to qualify for the card).
6. It will cause independent pharmacies to cease filling "special authorization" drugs until the approval has been given by government. In that instance the patient will have to return to their doctor to have a prescription changed, go without their medication for up to one month until approval for payment has been achieved, or have to return to the hospital.
7. Prescribing errors made by physicians will have to be handled in a different manner. Currently our independent pharmacies are dealing with between 5 to 25 prescribing errors a day. When the mistake is caught by the pharmacist - the patient will then have to return to the doctor or hospital to have the correction made. If the patient wants the pharmacist to deal with the error for them - they will have to pay a fee based on the amount of time it takes for a pharmacy to contact the doctor, achieve contact with that doctor, the faxing of a new prescription, and the paper work required for the government for a change in prescription. Usually this takes the pharmacy between half an hour to 8 hours to achieve.
8. The pharmacy will have to charge for special packaging for patients who take multiple drugs for chronic illnesses.
9. The hours and availability of pharmacies will be reduced to make the necessary savings on human resources and other expenses.
10. Services such as reprinting of receipts for income tax purposes, transferring of files, supplying hospitals with drug reviews for patients (where the hospital already has the records) or communication with the drug card program for patients will have to be additionally charged.
These are but a few of the changes that will be experienced by patients under the government's plan. The most negative result will be the out and out closure of some pharmacies.
Tom Marshall is not telling the truth or he is completely incompetent on this file.
The government including Premier Dunderdale is hiding the truth from the people and the media need to call them out on the Comprehensive Economic Trade Deal (CETA) with the EU.
Marshall goes on to say the following:
We understand that in terms of the true cost of the drug that's been passed on by the pharmacy to the customer, it has markups on it running from 140 percent to 619 percent. They're very high markups. Now that's before you take their cost into, their expenses of operation into consideration. So what happened - this all started, Randy when the pharmacies announced they weren't going to honour the drug card anymore. They were going to make people pre-pay for their drugs and have to seek reimbursement from the government, which was totally unacceptable because people didn't have the money.
First the Minister talks about markups on drugs running from 140 to 619 percent. Where is the evidence of this? Pharmacy cannot change the price of drugs as the provincial government sets them under the provincial formulary. Further Minister Tom Marshall will not address the Dr. Wade Locke report completed on pharmacy - using actual financial data from pharmacies. This is a government who only a few days ago were holding Dr. Locke's opinion and study regarding Muskrat Falls as gospel - yet when it comes to a comprehensive Activity Based Costing study on pharmacy the Minister of Finance deliberately avoids it. This is a lie by omission.
This statement also points to pharmacy and says - they were going to have people unable to get their essential prescription drugs - this is absolutely false and further is exactly the opposite of what is true. It is the government everyday that prevents people from getting medications. Patients are released from hospital with prescriptions they cannot fill because the government prevents retail pharmacies from determining the validity of a special authorization - so instead it goes into government pharmacists in a bureaucratic setting. This in turn causes delays - up to one month - where people who on income assistance or fixed incomes such as seniors - cannot get their medications because the government has not approved them. In this case local independent pharmacies put it on account for the individual so that they can take their medications immediately thereby preventing re admissions into hospital or a trip to the emergency room. Our pharmacies never let patients leave without their drugs for reasons of inability to pay. This is one significant difference between the large corporate chains and our members.
Next the Minister uses this line:
They want to go to court, I think that's wonderful. Go to court and let it come out what the proper margins out, okay let it come out what the rebates are, let it come out why the true cost of the drugs are not being passed on and while the true cost of the drug to the pharmacy is not being passed on, we want to sit down with the pharmacists and we have sat down with the pharmacists and what we're trying to do is come up with an agreement.
So the Minister of Finance thinks its wonderful that the CICPO wants to go to court. Well that's a mouthful in and of itself. Yes anything instead of meeting, talking, collaborating, and developing a superior policy. Then Minister Marshall - a lawyer - pretends that the issue being brought to court has something to do with generic drug pricing. The court case deals with two issues: a) whether or not the government had the right to alter a provider agreement unilaterally and second whether the "object" of PANL legislatively is valid. So once again he lies to or misleads the people regarding this very serious issue. Further the information he is seeking above is already available to him from the Dr. Wade Locke report. He once again says they are negotiating with pharmacists not pharmacies. This continued misrepresentation does not negate the fact that government signs provider agreements with corporations (legal entities) not pharmacists. If that is not the case then Wal-Mart, Shopper's Drug Mart, Lawton's and Costco could not be doing business with government.
Minister Marshall then takes the public down another twisted version of the facts:
And we've looked into it and other provinces have looked into it. And British Columbia and Alberta and Saskatchewan and Ontario and Quebec and Nova Scotia have all taken an approach to reduce the cost of generic drugs to their citizens, to their taxpayers.
Let's start with the fact that all provinces are using different models for remuneration and different approaches on the restructuring of generic drug costs. Ontario, which is what is law in Newfoundland and Labrador as it relates to generic pricing is the worst. It has caused the most damage to rural independent pharmacies and where ATM's are replacing the community pharmacy - in some cases now it will be LPN's. In Ontario now three independent pharmacy owners are running for the PC Party of Ontario in large part because of what the Liberal Ontario government has done with pharmacy and health issues generally. And here we have the PC government adopting failed Liberal policy out of Ontario.
Further in Ontario - consultations were had with the Ontario Pharmacists Association, the Canadian Association of Chain Drug Stores (CACDS) the Independent Pharmacists Association of Ontario and the Ontario Community Pharmacies Coalition. That is hardly a comparative for our province where the Premier and her Minister's keep saying we will only talk to PANL.
Then let's talk about British Columbia where a deal was struck between the Government, the BC Pharmacy Association and the Canadian Association of Chain Drug Stores. Once again broader consultation was held and a different remuneration formula was reached. Unfortunately - in BC as in Newfoundland and Labrador - the chains were pandered to while independent pharmacy was left behind. Lastly, at least the Government of BC acknowledges that no agreement reached with either the Pharmacy Association or the CACDS is binding on any individual business.
Then take the most ridiculous of Minister Marshall's comparisons - Quebec. In Quebec a pharmacy can only be owned by a pharmacist. This negates the concerns of independent owners as the government can only negotiate with them - large corporate interests are not permitted to own the dispensary. If Minister Marshall would like to entertain this idea - we would be more than happy to deal with that.
In Saskatchewan the government also reached an agreement between the Pharmacists' Association of Saskatchewan and the Canadian Association of Chain Drug Stores - once again admitting that the strong lobby by the giant retailers and chains is unduly influencing policy development. But at least they admit it. In Newfoundland and Labrador they will not admit to the discussions with CACDS because to do so would mean the CICPO would have a rightful place to put it's arguments forward separately.
In Canada the chain drug stores and mass retailers are dictating provincial policy and it is leading to reduced and inferior services in rural communities. In our province with our geography and relatively small population - this means destruction to our rural communites and inner-city neighbourhoods. Minister Marshall and Premier Dunderdale had the chance to make a difference and derive policy based on local business and rural communities - instead they have chosen to follow the mess found in other Canadian provinces. This is not leadership - and there are not enough lies in the world to cover this up.
Finally Minister Marshall refers to the following:
Okay, they had a meeting set up with Minister Kennedy. Minister Kennedy was in the House. They walked out. They left about five minutes before Minister Kennedy came in. So don't give me that.
The truth about this meeting will be addressed by those attending this meeting. Minister Marshall and I were not there so we cannot speak directly to it. Those who were in attendance will publicly discuss what happened to this meeting and why it did not occur. safe bet though that with pharmacy owners travelling anywhere from 1 km to 800 km's to attend the meeting did not leave under the circumstances the Minister has described. Either the Minister is misinformed or is lying.
The irony was that he called to correct something Randy Simms (host) said in his preamble.
Quote by Marshall:
Randy, we're negotiating now. There's a chair at the table for CICPO. CICPO refused to show up. Randy, Premier Dunderdale wants lower electricity costs for the people in this province. She wants lower drug costs for the people of this province. People have no choice. If the doctor says they got to have drugs, they got to have them, Randy. And the cost of generic drugs in this country are higher than they are in the US and higher than they are in other OECD countries. And there's got to be a reason for that. And we've looked into it and other provinces have looked into it. And British Columbia and Alberta and Saskatchewan and Ontario and Quebec and Nova Scotia have all taken an approach to reduce the cost of generic drugs to their citizens, to their taxpayers.
First - if the Premier wants to lower drug costs in the province - the first line of attack would be the brand drugs that are increasing in cost every year. The fact is brand name drugs which represent over 70% of the costs of all drugs prescribed and dispensed are going up in costs year over year. The generic drugs which are currently the target of this PC government are going down every year. Further the generic partnership with pharmacy has what has been keeping dispensing fees low and allowing pharmacies particularly small independent rural dispensaries to offer essential extra services.
Making matters worse is that the Dunderdale government is hiding its intent relative to a trade deal between the EU and Canada which would see our province have to pay an additional 50 million dollars for essential medications - by agreeing to extend the patent protection for the brand drug companies. Canada and the EU are set to go back to the table just after our provincial election and this term forms part of what a proposed deal will include.
The end result of the PC government move is:
1. The price of drugs will actually go up for citizens and taxpayers.
2. Dispensing fees for most people will have to double or the pharmacies will close.
3. Delivery to seniors and those without transportation will cease or there will be a cost for such delivery.
4. Independent pharmacies will have to stop credit programs for prescription drugs - thereby causing people not to buy and take their medications in a timely manner. This non-compliance will cause the emergency rooms of hospitals to experience unsustainable traffic, re admissions to hospital, or worse.
5. The government drug card clients will have to call their MHA or social worker to have the necessary forms completed for continuity of their prescription drug cards, or to complete their annual tax returns (in order to qualify for the card).
6. It will cause independent pharmacies to cease filling "special authorization" drugs until the approval has been given by government. In that instance the patient will have to return to their doctor to have a prescription changed, go without their medication for up to one month until approval for payment has been achieved, or have to return to the hospital.
7. Prescribing errors made by physicians will have to be handled in a different manner. Currently our independent pharmacies are dealing with between 5 to 25 prescribing errors a day. When the mistake is caught by the pharmacist - the patient will then have to return to the doctor or hospital to have the correction made. If the patient wants the pharmacist to deal with the error for them - they will have to pay a fee based on the amount of time it takes for a pharmacy to contact the doctor, achieve contact with that doctor, the faxing of a new prescription, and the paper work required for the government for a change in prescription. Usually this takes the pharmacy between half an hour to 8 hours to achieve.
8. The pharmacy will have to charge for special packaging for patients who take multiple drugs for chronic illnesses.
9. The hours and availability of pharmacies will be reduced to make the necessary savings on human resources and other expenses.
10. Services such as reprinting of receipts for income tax purposes, transferring of files, supplying hospitals with drug reviews for patients (where the hospital already has the records) or communication with the drug card program for patients will have to be additionally charged.
These are but a few of the changes that will be experienced by patients under the government's plan. The most negative result will be the out and out closure of some pharmacies.
Tom Marshall is not telling the truth or he is completely incompetent on this file.
The government including Premier Dunderdale is hiding the truth from the people and the media need to call them out on the Comprehensive Economic Trade Deal (CETA) with the EU.
Marshall goes on to say the following:
We understand that in terms of the true cost of the drug that's been passed on by the pharmacy to the customer, it has markups on it running from 140 percent to 619 percent. They're very high markups. Now that's before you take their cost into, their expenses of operation into consideration. So what happened - this all started, Randy when the pharmacies announced they weren't going to honour the drug card anymore. They were going to make people pre-pay for their drugs and have to seek reimbursement from the government, which was totally unacceptable because people didn't have the money.
First the Minister talks about markups on drugs running from 140 to 619 percent. Where is the evidence of this? Pharmacy cannot change the price of drugs as the provincial government sets them under the provincial formulary. Further Minister Tom Marshall will not address the Dr. Wade Locke report completed on pharmacy - using actual financial data from pharmacies. This is a government who only a few days ago were holding Dr. Locke's opinion and study regarding Muskrat Falls as gospel - yet when it comes to a comprehensive Activity Based Costing study on pharmacy the Minister of Finance deliberately avoids it. This is a lie by omission.
This statement also points to pharmacy and says - they were going to have people unable to get their essential prescription drugs - this is absolutely false and further is exactly the opposite of what is true. It is the government everyday that prevents people from getting medications. Patients are released from hospital with prescriptions they cannot fill because the government prevents retail pharmacies from determining the validity of a special authorization - so instead it goes into government pharmacists in a bureaucratic setting. This in turn causes delays - up to one month - where people who on income assistance or fixed incomes such as seniors - cannot get their medications because the government has not approved them. In this case local independent pharmacies put it on account for the individual so that they can take their medications immediately thereby preventing re admissions into hospital or a trip to the emergency room. Our pharmacies never let patients leave without their drugs for reasons of inability to pay. This is one significant difference between the large corporate chains and our members.
Next the Minister uses this line:
They want to go to court, I think that's wonderful. Go to court and let it come out what the proper margins out, okay let it come out what the rebates are, let it come out why the true cost of the drugs are not being passed on and while the true cost of the drug to the pharmacy is not being passed on, we want to sit down with the pharmacists and we have sat down with the pharmacists and what we're trying to do is come up with an agreement.
So the Minister of Finance thinks its wonderful that the CICPO wants to go to court. Well that's a mouthful in and of itself. Yes anything instead of meeting, talking, collaborating, and developing a superior policy. Then Minister Marshall - a lawyer - pretends that the issue being brought to court has something to do with generic drug pricing. The court case deals with two issues: a) whether or not the government had the right to alter a provider agreement unilaterally and second whether the "object" of PANL legislatively is valid. So once again he lies to or misleads the people regarding this very serious issue. Further the information he is seeking above is already available to him from the Dr. Wade Locke report. He once again says they are negotiating with pharmacists not pharmacies. This continued misrepresentation does not negate the fact that government signs provider agreements with corporations (legal entities) not pharmacists. If that is not the case then Wal-Mart, Shopper's Drug Mart, Lawton's and Costco could not be doing business with government.
Minister Marshall then takes the public down another twisted version of the facts:
And we've looked into it and other provinces have looked into it. And British Columbia and Alberta and Saskatchewan and Ontario and Quebec and Nova Scotia have all taken an approach to reduce the cost of generic drugs to their citizens, to their taxpayers.
Let's start with the fact that all provinces are using different models for remuneration and different approaches on the restructuring of generic drug costs. Ontario, which is what is law in Newfoundland and Labrador as it relates to generic pricing is the worst. It has caused the most damage to rural independent pharmacies and where ATM's are replacing the community pharmacy - in some cases now it will be LPN's. In Ontario now three independent pharmacy owners are running for the PC Party of Ontario in large part because of what the Liberal Ontario government has done with pharmacy and health issues generally. And here we have the PC government adopting failed Liberal policy out of Ontario.
Further in Ontario - consultations were had with the Ontario Pharmacists Association, the Canadian Association of Chain Drug Stores (CACDS) the Independent Pharmacists Association of Ontario and the Ontario Community Pharmacies Coalition. That is hardly a comparative for our province where the Premier and her Minister's keep saying we will only talk to PANL.
Then let's talk about British Columbia where a deal was struck between the Government, the BC Pharmacy Association and the Canadian Association of Chain Drug Stores. Once again broader consultation was held and a different remuneration formula was reached. Unfortunately - in BC as in Newfoundland and Labrador - the chains were pandered to while independent pharmacy was left behind. Lastly, at least the Government of BC acknowledges that no agreement reached with either the Pharmacy Association or the CACDS is binding on any individual business.
Then take the most ridiculous of Minister Marshall's comparisons - Quebec. In Quebec a pharmacy can only be owned by a pharmacist. This negates the concerns of independent owners as the government can only negotiate with them - large corporate interests are not permitted to own the dispensary. If Minister Marshall would like to entertain this idea - we would be more than happy to deal with that.
In Saskatchewan the government also reached an agreement between the Pharmacists' Association of Saskatchewan and the Canadian Association of Chain Drug Stores - once again admitting that the strong lobby by the giant retailers and chains is unduly influencing policy development. But at least they admit it. In Newfoundland and Labrador they will not admit to the discussions with CACDS because to do so would mean the CICPO would have a rightful place to put it's arguments forward separately.
In Canada the chain drug stores and mass retailers are dictating provincial policy and it is leading to reduced and inferior services in rural communities. In our province with our geography and relatively small population - this means destruction to our rural communites and inner-city neighbourhoods. Minister Marshall and Premier Dunderdale had the chance to make a difference and derive policy based on local business and rural communities - instead they have chosen to follow the mess found in other Canadian provinces. This is not leadership - and there are not enough lies in the world to cover this up.
Finally Minister Marshall refers to the following:
Okay, they had a meeting set up with Minister Kennedy. Minister Kennedy was in the House. They walked out. They left about five minutes before Minister Kennedy came in. So don't give me that.
The truth about this meeting will be addressed by those attending this meeting. Minister Marshall and I were not there so we cannot speak directly to it. Those who were in attendance will publicly discuss what happened to this meeting and why it did not occur. safe bet though that with pharmacy owners travelling anywhere from 1 km to 800 km's to attend the meeting did not leave under the circumstances the Minister has described. Either the Minister is misinformed or is lying.
Tuesday, September 13, 2011
How Corporations from outside the Province are controlling essential Health Policy
Read how big Corporations from outside the Province are controlling essential Health Policy. Read how it is not in YOUR best interest.
PRESS HERE
PRESS HERE
Thursday, September 08, 2011
How much does it cost to talk to Minister Kennedy?
So how much does it cost to get Minister Jerome Kennedy's attention.
Perhaps this can be answered by looking at the Contributions to Political Parties in 2010. It was not an election year - but one must not take any chances.
Shopper's Drug Mart was among the top donors again with $8500 to the PC's.
Strange though - ironic? Hardly! In this year Shopper's Drug Mart was able to get their own line of prescription drugs listed in our formulary in record time. In this year the Minister refuses to meet with the trade group that represents the majority of independent pharmacy owners in our province. After-all what's happening in Ontario should happen here right Minister?
What's happening in Ontario is killing small independent pharmacies - particularly in rural communities!
Then there is the elimination of seniors rights in personal care homes. You know where Lawton's or Shopper's give or offer a hefty check to the homeowners to guarantee access to the prescription drug purchases of residents.
More to come....
Have a look at the contributions to your PC's PRESS HERE.
Perhaps this can be answered by looking at the Contributions to Political Parties in 2010. It was not an election year - but one must not take any chances.
Shopper's Drug Mart was among the top donors again with $8500 to the PC's.
Strange though - ironic? Hardly! In this year Shopper's Drug Mart was able to get their own line of prescription drugs listed in our formulary in record time. In this year the Minister refuses to meet with the trade group that represents the majority of independent pharmacy owners in our province. After-all what's happening in Ontario should happen here right Minister?
What's happening in Ontario is killing small independent pharmacies - particularly in rural communities!
Then there is the elimination of seniors rights in personal care homes. You know where Lawton's or Shopper's give or offer a hefty check to the homeowners to guarantee access to the prescription drug purchases of residents.
More to come....
Have a look at the contributions to your PC's PRESS HERE.
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