New fee deal with pharmacists will save province $150M over two years

By Gillian Slade on March 1, 2018.

gslade@medicinehatnews.com  @MHNGillianSlade

Changes to the fee schedule agreement with Alberta’s pharmacists will save $150 million over the next two years, Alberta Health announced Wednesday.

Without the new agreement, pharmacy compensation was expected to increase by 12.3 per cent in the next two years. The new schedule reduces growth to 4.3 per cent over two years to accommodate population and volume growth.

“This funding framework will not only help us manage the province’s financial pressures responsibly, it will save Albertans money,” said Health Minister Sarah Hoffman.

There is no feedback available yet from pharmacists because they were not informed of the changes ahead of time.

“We’ve been under a non-disclosure agreement with government so we’ve not been able to inform them,” said Margaret Wing, CEO Alberta Pharmacists’ Association. “We are not expecting a positive response from pharmacists.”

The 12.3 per cent increase reflects the increased range of services pharmacists have been providing since July 2012. At that stage there was a move away from being “product-focused” to “patient-focused” services, with pharmacists using the full scope of their knowledge and training, said Wing.

“It only stands to reason we saw substantial growth over the last five years around a whole new funding model,” said Wing.

Under the new agreement, to come into effect May 17, the fee for dispensing a prescription will be reduced from $12.30 to $12.15.

Pharmacists administering a publicly-funded vaccine, such as the influenza vaccine, will receive $13 per shot rather than the current $20.

When pharmacists provide patients with a comprehensive annual care plan, Alberta Health will pay $100 rather than $125 that pharmacists with prescribing authority are currently entitled to. Follow-ups to the care plan will be $20, and only 12 will be covered per year per patient.

Providing a patient with a medication management assessment will qualify for $60 rather than $75, which those with prescribing authority can currently claim.

The News requested information from Alberta Health on the total number of “comprehensive annual care plans” and “medication management assessments” paid for in the province in the past year. This information was not provided by deadline.

“This (the new agreement) is a reflection of the current government’s fiscal challenges they’re facing — their budgetary constraints,” said Wing.

For patients who have medications dispensed daily, the pharmacist will only be able to bill the government for three fees per patient per day and monthly dispensing fees will be limited to two per drug per patient within a 28-day period. Opioid dependency treatment will be excluded.

Wing says any other dispensing beyond these limits would be provided by the pharmacist without being able to bill Alberta Health any additional amount. This applies mainly to people with substances abuse issues who require daily dispensing – the doses for that day only, said Wing.

It may also affect seniors in seniors’ residences receiving their medication prepackaged on a weekly basis.

“Those pharmacies will only receive two dispensing fees a month for those medications,” said Wing.

A new item on the schedule is a $20 fee pharmacists can claim for an assessment in the event of a “declaration of a state of emergency.”

In the second year of the agreement a new “risk-sharing” component will take effect, April 1, 2019, to ensure budget targets are met.

“At least 10 per cent of government funding to pharmacies will be withheld each quarter to be used to address any budget shortfall. That percentage can increase, if required, to meet budget targets. If expenditures are less than budget, the holdback will be redistributed to pharmacies,” says the Alberta Health website.

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