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....
This blog is dedicated to discussing Independent Pharmacy Issues in Newfoundland and Labrador. The Council of Independent Community Pharmacy Owners invites the public we serve to ask questions and make comments.
Showing posts with label panl. Show all posts
Showing posts with label panl. Show all posts
Friday, January 18, 2013
Monday, April 16, 2012
Notice to Editors
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”.
-30-
Friday, March 30, 2012
Newfoundland and Labrador Govt. delivering for Shoppers Drug Mart
Shoppers CEO predicts DOOM for Independents
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.
Monday, March 5, 2012
Nova Scotia - Take Heed Newfoundland and Labrador
Let's
see if the Government of Newfoundland and Labrador follows the lead of
provinces such as Ontario and closer to home Nova Scotia.
Generic price caps blamed for closure of Nova Scotia village pharmacy
(Carol Moreira - CanadianHealthcareNetwork)
The only pharmacy in the Nova Scotia village of Lawrencetown will close this summer and critics are blaming the cap on the price of generic drugs, introduced last year.
Pharmacy co-owner Rob Perry told the Chronicle-Herald that lower generic prices played a role in the store's closure, although rising costs and falling income also contributed.
"Economically, it's just not feasible. It's more expensive to run a business than it was two years ago," Perry said. The Lawrencetown Pharmasave opened in 1955 and will close on June 30th.
Allison Bodnar, executive director of the Pharmacy Association of Nova Scotia said the Lawrencetown Pharmasave is the first closure, but many pharmacies are suffering because of the cap on the price of generics sold to Pharmacare recipients.
"Reduced hours, staff layoffs, reduced services and even further closures can be expected as the final legislated price cuts take effect this summer," Bodnar said.
Generic price caps blamed for closure of Nova Scotia village pharmacy
(Carol Moreira - CanadianHealthcareNetwork)
The only pharmacy in the Nova Scotia village of Lawrencetown will close this summer and critics are blaming the cap on the price of generic drugs, introduced last year.
Pharmacy co-owner Rob Perry told the Chronicle-Herald that lower generic prices played a role in the store's closure, although rising costs and falling income also contributed.
"Economically, it's just not feasible. It's more expensive to run a business than it was two years ago," Perry said. The Lawrencetown Pharmasave opened in 1955 and will close on June 30th.
Allison Bodnar, executive director of the Pharmacy Association of Nova Scotia said the Lawrencetown Pharmasave is the first closure, but many pharmacies are suffering because of the cap on the price of generics sold to Pharmacare recipients.
"Reduced hours, staff layoffs, reduced services and even further closures can be expected as the final legislated price cuts take effect this summer," Bodnar said.
Challenges and Recognition - Pharmacists - your Health
NEWS RELEASE
March 4-10 2012 PHARMACISTS’ AWARENESS WEEK – CHALLENGES
AND RECOGNITION
For Immediate Release –
St. John’s 02/03 2012
The Council
of Independent Community Pharmacy Owners is pleased to support Pharmacists’
Awareness Week with our valued employees.
Each of our
member corporations recognizes the valued contribution of pharmacists in our
society. Through progressive and supportive employee and employer relationships
our businesses are proud of the services we provide to people, neighbourhoods
and communities.
The
pharmacist continues to be one of the most trusted professions and independent
pharmacy one of the most trusted businesses. This week celebrates the work a
pharmacist does whether as an employee of government, the University,
hospitals, Centre for Health Information, or of the private sector. Our
corporate members will continue to work toward providing a stable workplace for
our professional staff. Our members companies continue to lobby government for
medication management programs that allow our communities to avail of
preventative and stabilization consults that our employees are fully qualified
to do.
Executive Director,
Sue Kelland-Dyer says, “The scope of
practice of Newfoundland and Labrador pharmacists is lagging behind many other
provinces in Canada. The CICPO encourages the Newfoundland and Labrador
Pharmacy Board (NLPB) and the employee representative – the Pharmacists’
Association of Newfoundland and Labrador (PANL) to work diligently to correct
this inequity being experienced by our employees.”
The CICPO
also encourages the Government of Newfoundland and Labrador to use this week to
reflect on policy choices which may diminish significantly the salaries and
benefits for this profession and eliminate the opportunities found in the
private sector to deliver additional and advanced medication programs that help
to ensure compliance, best use of prescription drugs, and best patient
outcomes.
“The demographics of our province
show that chronic disease management will become a real budgetary challenge
over the coming decade. One of the only real ways to curb the anticipated
explosion of prescription drug use is through an expanded scope of practice for
pharmacists employed by private sector community pharmacies” adds Kelland-Dyer
The Council
is concerned that significant cuts to pharmacy revenues will achieve several
undesirable outcomes; a reduction in employment opportunities for these
professionals, a reduction in a pharmacist’s wages, a reduction in hours of
operation, and the elimination of all non-essential services.
Evidence is
available in other provinces - where pharmacy revenues have been reduced – that
these unanticipated consequences are already occurring. The splintered
representation of pharmacists through Allied Health, MUNFA, and PANL may be inadvertently
acting to thwart the protection of these essential employees and against
finding an equitable solution.
The CICPO is
willing to work with other employers such as government, hospital boards, and
the university to achieve an equitable benefits and salary package and further
willing to work with government to maximize the services our corporations can
deliver to the people of Newfoundland and Labrador.
The CICPO
also encourages the government to review plans to examine emergency room
wait-times. Kelland-Dyer states, “Minister
Susan Sullivan missed a very important component in the announced study – the
Minister missed pharmacists and pharmacies. It is well established that between
10-20 per cent of emergency room visits are due to drug interactions,
medication compliance, and the inability for patients to get the drugs they are
prescribed in a timely fashion.”
Kelland-Dyer
concludes, “Our businesses employ a
large number of the pharmacists practicing in our province and want to take
this opportunity to recognize their service and assure them that as employers
we are fighting to protect not only the workplace but also their jobs and the
services they deliver to our customers.”
-30-
Tuesday, February 14, 2012
The Stock Market or Your Health - Pharmacy Models
Below is a pharmacy story from Oregon.
It is interesting to note that the some of the same insurance companies are driving the changes in Canada.
The question remains are we going to follow the crowd (other provinces) who have been heavily lobbied by brand drug companies, insurance companies, and chain drugstores?
This is not the model we need for an aging population - we need more of the services offered by independent stores - not less.
We need to make sure that Newfoundland and Labrador keeps the best network of pharmacies and professionals found anywhere. We need to make sure that all our neighbourhoods and communities have reasonable access to equitable services.
Ontario is the province driving these negative and regressive pharmacy remuneration models and the rest of the provinces are following.
The American system is about 5 years ahead of Ontario - look at the results.
If the stock market is going to be the driver of your health outcomes - then what should you expect?
View full sizePatrick
Bowman opened Tualatin Pharmacy 11 months ago and says his business is
building. Pharmacy runs in Bowman's family; his father, sister and he
once operated seven stores. Before opening his store in Tualatin, Bowman
worked in large chain stores. The experience, he says, was not good.
A
retired Paisley minister experiences sudden Parkinson’s disease
symptoms, so severe he believes death is imminent — only to learn it’s
due to the wrong medication.
A pharmacy technician in Hillsboro sells an Ativan prescription to the wrong man, who gets pulled over for driving erratically.
An Astoria woman suffers a cardiac arrest, and later learns her pharmacy for months had overdosed her with thyroid medication.
These are among the estimated hundreds of pharmacy errors reported in the last few years, either to state agencies or in lawsuits. And some pharmacists say errors are happening more than ever.
A recent survey by the Oregon Board of Pharmacy reported that more than 350 chain pharmacists — more than half of those responding — said their working conditions don’t promote safe and effective patient care.
Many complained it is getting worse. “I feel that we are operating on the edge of disaster,” wrote one. “It is a danger zone for us and our patients.”
Last summer, the state board hosted an online survey for roughly 5,700 licensed pharmacists licensed in Oregon. The results were gratifying and disturbing, says board member Ann Zweber. She hadn’t expected so many to respond — more than 1,300; unfortunately, many responded by reporting safety concerns.
“People had a lot to say,” she says. “It concerns me greatly.”
The survey results describe a profession in transition. Independent pharmacies, which once dominated Oregon, now number just 214 out of about 750 retail pharmacies, according to state records. As independents give way to large chains and mail-order operations, increased competition is inserting a bottom-line mentality into the way people get their pills.
Only 25.9 percent of chain store pharmacists agreed working conditions promoted safe and effective patient care — compared to 76 percent of pharmacists at independent pharmacies.
Not only that, more than 200 hundred chain pharmacists commented about workload and safety.
The survey data isn’t perfect. It’s anonymous and pharmacists were allowed to self-report their type of workplace. But the board believes the survey is credible, Zweber said.
Many complained of having to fill more prescriptions each day with fewer staff; of 12-hour shifts with scant breaks; and constant distractions, such as administering immunization shots to augment profits.
One reported quitting a chain job because of feeling “like I’m going to jeopardize the patients every time I stepped into that pharmacy.” Another said because of lack of staff, “we have seen a huge increase in errors. We used to have a couple per month, now we have a couple per week and sometimes more than one in a day!”
Blake Rice, a pharmacist who used to sit on the state board, thinks many errors are caught internally by improved safety procedures. But he agrees chain stores don’t protect the public, giving drugs “the same lack of oversight as the sale of bread and milk or canned beans.”
Several chain store representatives disagreed.
Chrissy Kopple, spokeswoman for the National Association of Chain Drug Stores, said the survey does not reflect chains’ commitment to quality. “NACDS and individual chains will continue to work with the Oregon Board of Pharmacy to maximize patient safety and health.”
“We have a strong safety record because of our on-going education and training for pharmacy associates as well as our continued investment in technology for our pharmacies to maximize accuracy and patient safety,” said Rite Aid spokeswoman Ashley Flower.
There is no data to definitively show more pharmacy errors are occurring, or that they happen more often in chains. Pharmacies do not have to report errors to any public agency. The pharmacy board considers roughly 80 cases a year involving reporting errors. The Oregon Patient Safety Commission encourages voluntary reporting, but only 94 pharmacies have signed up.
The Institute for Safe Medication Practices solicits confidential reports of pharmacy errors from consumers and pharmacists. The group is seeing a steady increase in such reports nationwide, said Michael Cohen, a pharmacist who heads the group.
He said the group is sending its own survey. “It’s hard for the pharmacists who work at these chains to complain too loudly to their manager or go public because they work there and they don’t want to undergo any type of job issue,” Cohen said.
Joseph Lassiter, a Pacific University pharmacy professor who sits on the Oregon Patient Safety Commission, said the Oregon survey results are disturbing. “This survey is a signal for us that there’s something going on.”
The board of pharmacy is considering rules to keep an eye on working conditions. The rules do not set strict workload levels, but allows the board to fine or suspend a pharmacy license over safety issues.
Oregon is not the first to take on the issue, said Carmen Catizone of the National Association of Boards of Pharmacy. Iowa and North Carolina adopted stringent standards, with a workload review of every reported error where a customer was harmed. He said state pharmacy boards have to strike a balance between public safety and workplace interference.
Zweber says the Oregon board seeks the same balance. “I don’t think we’re going to be that specific,” she said.
Patrick Bowman, owner of Tualatin Pharmacy, says he’s not surprised at the survey. He founded his business 11 months ago after working in chains.
“I don’t have headaches anymore. I don’t have trouble sleeping anymore,” he said. “People come to me because they’re not a number.”
It is interesting to note that the some of the same insurance companies are driving the changes in Canada.
The question remains are we going to follow the crowd (other provinces) who have been heavily lobbied by brand drug companies, insurance companies, and chain drugstores?
This is not the model we need for an aging population - we need more of the services offered by independent stores - not less.
We need to make sure that Newfoundland and Labrador keeps the best network of pharmacies and professionals found anywhere. We need to make sure that all our neighbourhoods and communities have reasonable access to equitable services.
Ontario is the province driving these negative and regressive pharmacy remuneration models and the rest of the provinces are following.
The American system is about 5 years ahead of Ontario - look at the results.
If the stock market is going to be the driver of your health outcomes - then what should you expect?
Workloads, chain stores add to safety risks, Oregon pharmacist survey says
Published: Sunday, February 12, 2012, 10:15 PM Updated: Monday, February 13, 2012, 12:13 PM
View full sizePatrick
Bowman opened Tualatin Pharmacy 11 months ago and says his business is
building. Pharmacy runs in Bowman's family; his father, sister and he
once operated seven stores. Before opening his store in Tualatin, Bowman
worked in large chain stores. The experience, he says, was not good. A pharmacy technician in Hillsboro sells an Ativan prescription to the wrong man, who gets pulled over for driving erratically.
An Astoria woman suffers a cardiac arrest, and later learns her pharmacy for months had overdosed her with thyroid medication.
These are among the estimated hundreds of pharmacy errors reported in the last few years, either to state agencies or in lawsuits. And some pharmacists say errors are happening more than ever.
A recent survey by the Oregon Board of Pharmacy reported that more than 350 chain pharmacists — more than half of those responding — said their working conditions don’t promote safe and effective patient care.
Many complained it is getting worse. “I feel that we are operating on the edge of disaster,” wrote one. “It is a danger zone for us and our patients.”
Last summer, the state board hosted an online survey for roughly 5,700 licensed pharmacists licensed in Oregon. The results were gratifying and disturbing, says board member Ann Zweber. She hadn’t expected so many to respond — more than 1,300; unfortunately, many responded by reporting safety concerns.
“People had a lot to say,” she says. “It concerns me greatly.”
The survey results describe a profession in transition. Independent pharmacies, which once dominated Oregon, now number just 214 out of about 750 retail pharmacies, according to state records. As independents give way to large chains and mail-order operations, increased competition is inserting a bottom-line mentality into the way people get their pills.
Only 25.9 percent of chain store pharmacists agreed working conditions promoted safe and effective patient care — compared to 76 percent of pharmacists at independent pharmacies.
Not only that, more than 200 hundred chain pharmacists commented about workload and safety.
The survey data isn’t perfect. It’s anonymous and pharmacists were allowed to self-report their type of workplace. But the board believes the survey is credible, Zweber said.
Many complained of having to fill more prescriptions each day with fewer staff; of 12-hour shifts with scant breaks; and constant distractions, such as administering immunization shots to augment profits.
One reported quitting a chain job because of feeling “like I’m going to jeopardize the patients every time I stepped into that pharmacy.” Another said because of lack of staff, “we have seen a huge increase in errors. We used to have a couple per month, now we have a couple per week and sometimes more than one in a day!”
Blake Rice, a pharmacist who used to sit on the state board, thinks many errors are caught internally by improved safety procedures. But he agrees chain stores don’t protect the public, giving drugs “the same lack of oversight as the sale of bread and milk or canned beans.”
Several chain store representatives disagreed.
Chrissy Kopple, spokeswoman for the National Association of Chain Drug Stores, said the survey does not reflect chains’ commitment to quality. “NACDS and individual chains will continue to work with the Oregon Board of Pharmacy to maximize patient safety and health.”
“We have a strong safety record because of our on-going education and training for pharmacy associates as well as our continued investment in technology for our pharmacies to maximize accuracy and patient safety,” said Rite Aid spokeswoman Ashley Flower.
There is no data to definitively show more pharmacy errors are occurring, or that they happen more often in chains. Pharmacies do not have to report errors to any public agency. The pharmacy board considers roughly 80 cases a year involving reporting errors. The Oregon Patient Safety Commission encourages voluntary reporting, but only 94 pharmacies have signed up.
The Institute for Safe Medication Practices solicits confidential reports of pharmacy errors from consumers and pharmacists. The group is seeing a steady increase in such reports nationwide, said Michael Cohen, a pharmacist who heads the group.
He said the group is sending its own survey. “It’s hard for the pharmacists who work at these chains to complain too loudly to their manager or go public because they work there and they don’t want to undergo any type of job issue,” Cohen said.
Joseph Lassiter, a Pacific University pharmacy professor who sits on the Oregon Patient Safety Commission, said the Oregon survey results are disturbing. “This survey is a signal for us that there’s something going on.”
The board of pharmacy is considering rules to keep an eye on working conditions. The rules do not set strict workload levels, but allows the board to fine or suspend a pharmacy license over safety issues.
Oregon is not the first to take on the issue, said Carmen Catizone of the National Association of Boards of Pharmacy. Iowa and North Carolina adopted stringent standards, with a workload review of every reported error where a customer was harmed. He said state pharmacy boards have to strike a balance between public safety and workplace interference.
Zweber says the Oregon board seeks the same balance. “I don’t think we’re going to be that specific,” she said.
Patrick Bowman, owner of Tualatin Pharmacy, says he’s not surprised at the survey. He founded his business 11 months ago after working in chains.
“I don’t have headaches anymore. I don’t have trouble sleeping anymore,” he said. “People come to me because they’re not a number.”
Friday, December 2, 2011
Judge orders Government to Pay costs over delay in Case
Judge orders government to pay costs over delay in case
 |
| The Telegram |
Lawyers Brad Savoury (left), representing the Council of Independent Community Pharmacy Owners and Rolf Pritchard, representing the provincial government, are shown in Newfoundland Supreme Court this morning. — Photo by Deana Stokes Sullivan/The Telegram
Published on December 2, 2011
Chief Justice David Orsborn didn't seem impressed this morning that the provincial government was late filing its court documents in response to an application from the Council of Independent Community Pharmacy Owners (CICPO), challenging sections of the Newfoundland Pharmacy Act and regulations.
The case was scheduled to be heard today in Newfoundland Supreme Court, but was postponed until Feb. 2 because government was late filing its response and affidavits.
Lawyer Brad Savoury, representing the pharmacists, said he only received some of the documents this week.
Both sides appeared in Newfoundland Supreme Court Sept. 27 and were given timelines by Justice Richard LeBlanc. The council was given a deadline of Nov. 17 and government Nov. 24 to file documents with the court.
Rolf Pritchard, lawyer for the province, said there was a snowstorm on Nov. 24 and there were other complicating factors, including notice having to be given to the federal attorney general.
Orsborn noted that government had two months to file its documents. Because of the delay, he ordered that costs associated with today's proceedings will have to be paid by the provincial government.
CICPO’s application challenges a provision in the province’s Pharmacy Act that allows the Pharmacists’ Association of Newfoundland and Labrador to negotiate financial contracts with government on behalf of the independent owners and a recent amendment to the Pharmaceutical Services Administration regulations that extended the notice period from 30 to 120 days to opt out of the provincial drug program.
Monday, November 21, 2011
Has Express Scripts (ESI) crossed the Line? Conflict with Pharmacies?
Last week - Express Scripts Canada announced it had received a licence to operate a Pharmacy in Ontario.
ESI for short - is a pharmacy benefits manager 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 manager 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.
Tuesday, November 15, 2011
New Talk Show takes on the Pharmacy Issue, Saving Money while maximizing Health Outcomes
Listen to "Talk with Sue and Shannon" Newfoundland and Labrador's newest talk-show this Sunday evening at 8 pm NL time as they 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
What happened to the Ontario Community Pharmacies Coalition?
The Ontario Community Pharmacies coalition - the love in that was supposed to bridge the gap between the mighty chains and independents appears to have gone up in smoke.
If you go to their once active website HERE you will notice the page can no longer be found. The joint material is no longer available.
Here's the "Reader's Digest" so to speak - version of events.
In 2006 the Government of Ontario were rattling the cages of pharmacies by introducing changes to the law regarding the pricing of generics - similar to what the Government of Newfoundland and Labrador has regulated here.
Knowing the devastation that would be caused to independent pharmacy - particularly in rural areas and inner-city pharmacy - independent pharmacies in that province formed the Independent Pharmacy of Ontario to get the message out to the public.
The IPO headed by Ben Shenouda were beginning to make headway as their Public Relations campaign was meeting with good public support. The government was under pressure to do things differently as the people of Ontario generally trusted and agreed with their local independent pharmacies and wanted to have that model protected.
In a clever move by both the Government of Ontario officials and the Canadian Association of Chain Drug Stores - they "con"vinced the independents to come sit at the table together. The IPO dropped its PR campaign and joined with the CACDS the Ontario Pharmacists' Association to form the Ontario Community Pharmacies Coalition to speak with a "united" voice.
A new PR campaign was launched where essentially big chains and retailers were asking the public to support their significant profits and model and in the process - the real plight of the independent stores was lost. that PR campaign was a disaster and the Ontario government came in guns ablazing and hacked the revenues of the pharmacies.
That was then - this is now.
The independents are hurting if not closing, they are cutting back hours, laying off staff, and eliminating or putting a price-tag on services which were once free to the public is a desparate attempt to survive.
Meanwhile as demonstrated in our last post - the big players like Shopper's Drug Mart are out for the slaughter - the cheaper the better.
Please review the Shopper's Drug Mart positioning below:
also plans to seize the opportunity to buy out independent pharmacies that are even more vulnerable
The positive is, we firmly believe there will be a strong opportunity delivered by drug reform that will allow us in a greater way to be a consolidator of the marketplace
That does not sound like a nice group of people to be planning the future for independent owners and the people they serve right?
Well considering that just months ago - they were holding hands - to present a unified front - we went back to visit the Coalition to see how they were making out.
The web page is no longer there. The kinship appears to have been doused with very cold water - aka reality.
Rural communities that lose a pharmacy may well see a robot soon if not already, the once tremendous model of independent pharmacy is in the fight of its life, and the people of Ontario - if Shoppers and others have their way will one day soon be dealing with a monopoly of chain giants.
We probably don't need to tell you where that will go - right out of the customers pockets as the competition will have been drained away.
Of course Shoppers and the chains will not stop there - any little independent left will be forced to buy their drugs from chain competitors as they now have the right to produce and supply their own private line of generic drugs. The Government of Newfoundland and Labrador has already allowed that here and if they keep it up - your pharmacy may no longer be able to serve you in the manner which is best for you.
So much for sitting at the table with those who ultimately want to eliminate you. Should we expect they will make a deal that's good for independent pharmacies? It has not happened anywhere else. That is why CICPO is fighting hard - to ensure that we have equitable and superior pharmacy services available to all people in our province - regardless of where they live, their mobility, their age, or their insurance status. We are working equally as hard to find solutions for government that would save the monies they would like to save.
They just won't talk - and there's a reason for that - and that reason is not good for the people of Newfoundland and Labrador. Tell us what does the Pharmacists' Association of Newfoundland and Labrador have to say about the comments made this week by the CEO of Shopper's Drug Mart? The silence is deafening.
If you go to their once active website HERE you will notice the page can no longer be found. The joint material is no longer available.
Here's the "Reader's Digest" so to speak - version of events.
In 2006 the Government of Ontario were rattling the cages of pharmacies by introducing changes to the law regarding the pricing of generics - similar to what the Government of Newfoundland and Labrador has regulated here.
Knowing the devastation that would be caused to independent pharmacy - particularly in rural areas and inner-city pharmacy - independent pharmacies in that province formed the Independent Pharmacy of Ontario to get the message out to the public.
The IPO headed by Ben Shenouda were beginning to make headway as their Public Relations campaign was meeting with good public support. The government was under pressure to do things differently as the people of Ontario generally trusted and agreed with their local independent pharmacies and wanted to have that model protected.
In a clever move by both the Government of Ontario officials and the Canadian Association of Chain Drug Stores - they "con"vinced the independents to come sit at the table together. The IPO dropped its PR campaign and joined with the CACDS the Ontario Pharmacists' Association to form the Ontario Community Pharmacies Coalition to speak with a "united" voice.
A new PR campaign was launched where essentially big chains and retailers were asking the public to support their significant profits and model and in the process - the real plight of the independent stores was lost. that PR campaign was a disaster and the Ontario government came in guns ablazing and hacked the revenues of the pharmacies.
That was then - this is now.
The independents are hurting if not closing, they are cutting back hours, laying off staff, and eliminating or putting a price-tag on services which were once free to the public is a desparate attempt to survive.
Meanwhile as demonstrated in our last post - the big players like Shopper's Drug Mart are out for the slaughter - the cheaper the better.
Please review the Shopper's Drug Mart positioning below:
also plans to seize the opportunity to buy out independent pharmacies that are even more vulnerable
The positive is, we firmly believe there will be a strong opportunity delivered by drug reform that will allow us in a greater way to be a consolidator of the marketplace
Local druggists lamented that some would inevitably have to close down because prescription sales make up a bigger percentage of their sales mix and they wouldn't be able to absorb the hit to their profits.
And that vulnerability is where Shoppers sees opportunity in the reforms.
Pilla told analysts Shoppers plans to be "extremely active in the market" as it watches more independents forced into selling as the drug reforms work their way through their balance sheets.
That does not sound like a nice group of people to be planning the future for independent owners and the people they serve right?
Well considering that just months ago - they were holding hands - to present a unified front - we went back to visit the Coalition to see how they were making out.
The web page is no longer there. The kinship appears to have been doused with very cold water - aka reality.
Rural communities that lose a pharmacy may well see a robot soon if not already, the once tremendous model of independent pharmacy is in the fight of its life, and the people of Ontario - if Shoppers and others have their way will one day soon be dealing with a monopoly of chain giants.
We probably don't need to tell you where that will go - right out of the customers pockets as the competition will have been drained away.
Of course Shoppers and the chains will not stop there - any little independent left will be forced to buy their drugs from chain competitors as they now have the right to produce and supply their own private line of generic drugs. The Government of Newfoundland and Labrador has already allowed that here and if they keep it up - your pharmacy may no longer be able to serve you in the manner which is best for you.
So much for sitting at the table with those who ultimately want to eliminate you. Should we expect they will make a deal that's good for independent pharmacies? It has not happened anywhere else. That is why CICPO is fighting hard - to ensure that we have equitable and superior pharmacy services available to all people in our province - regardless of where they live, their mobility, their age, or their insurance status. We are working equally as hard to find solutions for government that would save the monies they would like to save.
They just won't talk - and there's a reason for that - and that reason is not good for the people of Newfoundland and Labrador. Tell us what does the Pharmacists' Association of Newfoundland and Labrador have to say about the comments made this week by the CEO of Shopper's Drug Mart? The silence is deafening.
Saturday, November 12, 2011
Canadian Pharmacists Journal - Story CICPO Court Action
Latest Story in the Canadian Pharmacists Journal by Kathie Lynas
Pharmacy owners in Newfoundland and Labrador going to court to challenge right of professional body to negotiate compensation deal “Independent pharmacies may end up refusing to take government drug-plan cards, no matter what the government signs with PANL” — Sue Kelland-Dyer, Executive Director, CICPO.
The organization representing the owners of independent community pharmacies in Newfoundland and Labrador has launched a legal challenge of parts of the provincial Pharmacy Act and will have its day in the Newfoundland Supreme Court later this year. The biggest legal issue for the Council of Independent Community Pharmacy Owners (CICPO) is the provision permitting the province’s professional association — the Pharmacists Association of Newfoundland and Labrador (PANL) — to negotiate financial contracts with government on behalf of the owners.
“An advocacy body for the profession has nothing to do with the commercial operations of businesses, and pharmacies — the individual corporations that government signs legal contracts with — are not members of PANL, nor can they vote,” says the executive director of CICPO, Sue Kelland-Dyer.
Using the pharmacist’s professional body for commercial negotiations, she adds, creates a conflict of interest because PANL is attempting to represent both the private sector employers who employ its pharmacist members, as well as the pharmacists themselves. The situation in Newfoundland and Labrador is unique in Canada, says Ms. Kelland-Dyer, noting that other provincial governments negotiate contracts with the owners’ associations as well as pharmacist bodies. “The action of separating the commercial from the profession enhances the interests of both sides. Businesses have a different agenda than the pharmacists.”
The Council has attempted to lobby government for changes to the Pharmacy Act to rectify the situation, but that hasn’t succeeded. So CICPO took legal action and the Supreme Court hearing is scheduled for December 2, 2011.
Meanwhile, PANL is in the process of negotiating a new compensation agreement with the province, in the face of government plans to reduce the price of generic drugs and eliminate the rebate system. A new pricing model for generic drugs could be devastating for independent pharmacy owners, says Ms. Kelland-Dyer. Newfoundland and Labrador, with so many rural and remote areas, has a very high percentage of independents.
“We have 54 regions in our province that only have independent pharmacies,” she says. “These stores will be in jeopardy, if not closing - reducing hours and not able to properly serve populations spread out over large areas.” In the end, the independent pharmacies may end up refusing to take government drug-plan cards in their stores, she adds. “No matter what the government signs with PANL, that signature doesn’t bind any corporation to an agreement. They may end up with 65 independent
corporations that don’t recognize it, so what have they achieved?”
252 C P J / R P C • N OV EMB E R / D E C EMB E R 2 0 1 1 • VO L 1 4 4 , N O 6
Pharmacy owners in Newfoundland and Labrador going to court to challenge right of professional body to negotiate compensation deal “Independent pharmacies may end up refusing to take government drug-plan cards, no matter what the government signs with PANL” — Sue Kelland-Dyer, Executive Director, CICPO.
The organization representing the owners of independent community pharmacies in Newfoundland and Labrador has launched a legal challenge of parts of the provincial Pharmacy Act and will have its day in the Newfoundland Supreme Court later this year. The biggest legal issue for the Council of Independent Community Pharmacy Owners (CICPO) is the provision permitting the province’s professional association — the Pharmacists Association of Newfoundland and Labrador (PANL) — to negotiate financial contracts with government on behalf of the owners.
“An advocacy body for the profession has nothing to do with the commercial operations of businesses, and pharmacies — the individual corporations that government signs legal contracts with — are not members of PANL, nor can they vote,” says the executive director of CICPO, Sue Kelland-Dyer.
Using the pharmacist’s professional body for commercial negotiations, she adds, creates a conflict of interest because PANL is attempting to represent both the private sector employers who employ its pharmacist members, as well as the pharmacists themselves. The situation in Newfoundland and Labrador is unique in Canada, says Ms. Kelland-Dyer, noting that other provincial governments negotiate contracts with the owners’ associations as well as pharmacist bodies. “The action of separating the commercial from the profession enhances the interests of both sides. Businesses have a different agenda than the pharmacists.”
The Council has attempted to lobby government for changes to the Pharmacy Act to rectify the situation, but that hasn’t succeeded. So CICPO took legal action and the Supreme Court hearing is scheduled for December 2, 2011.
Meanwhile, PANL is in the process of negotiating a new compensation agreement with the province, in the face of government plans to reduce the price of generic drugs and eliminate the rebate system. A new pricing model for generic drugs could be devastating for independent pharmacy owners, says Ms. Kelland-Dyer. Newfoundland and Labrador, with so many rural and remote areas, has a very high percentage of independents.
“We have 54 regions in our province that only have independent pharmacies,” she says. “These stores will be in jeopardy, if not closing - reducing hours and not able to properly serve populations spread out over large areas.” In the end, the independent pharmacies may end up refusing to take government drug-plan cards in their stores, she adds. “No matter what the government signs with PANL, that signature doesn’t bind any corporation to an agreement. They may end up with 65 independent
corporations that don’t recognize it, so what have they achieved?”
252 C P J / R P C • N OV EMB E R / D E C EMB E R 2 0 1 1 • VO L 1 4 4 , N O 6
Thursday, November 10, 2011
This is Why - PANL will not work for Independents.
Please read below and you will understand why sitting at a table with large chains and retailers does not make business sense to independent pharmacy owners. Perhaps the new PANL President could weigh in here and advise Shoppers Drug Mart that they cannot be so overtly aggressive toward independents.
Shoppers Drug Mart hit by drug reforms, but also sees takeover opportunities
TORONTO - Shoppers Drug Mart Corp. (TSX:SC) is bracing for a profit squeeze from more reforms to generic drug sales next year, but also plans to seize the opportunity to buy out independent pharmacies that are even more vulnerable.
"It's the company that's absolutely best positioned to take advantage of opportunities that are going to (result) from drug reform and other macro trends in the Canadian market," Domenic Pilla, the new president and CEO of Shoppers told analysts on a conference call Wednesday.
Changes in several provinces including the huge markets of Ontario, Quebec and British Columbia have reduced generic drug prices to 25 per cent of the price of patented drugs — down from 50 per cent — by cutting professional allowances that drug companies paid to pharmacies for stocking their pills.
The first phase of the reforms, which made generic drugs cheaper for patients on government-assisted plans, has taken a toll on Shoppers revenue this year. It has managed to churn out modest quarterly growth by compensating with more non-prescription sales.
The Toronto-based company reported Wednesday that third-quarter profits rose more than 11 per cent to $172 million as revenue grew a modest 2.1 per cent from the quarter in 2010, due to strong "front of store" sales.
Shoppers has long sold a range of health, beauty and other household items and expanded into grocery in recent years to supplement "back of store" pharmaceutical sales.
Brad Lukow, Shoppers chief financial officer said the full impact of drug reform on Shoppers earnings has not yet been felt.
Legislative reform has yet to take place in a number of provinces, and a second phase will be implemented in Ontario and B.C. in April.
The new changes will expand the cheaper prescription regulations to cover all patients purchasing pills, either out of pocket or using insurance plans.
"That's the negative," he explained. "The positive is, we firmly believe there will be a strong opportunity delivered by drug reform that will allow us in a greater way to be a consolidator of the marketplace."
A similar strategy is being used by Jean Coutu Group (TSX:PJC.A), Quebec's largest pharmacy chain. The two companies compete in some areas of the country but CEO Francois Coutu said recently that he wasn't concerned about facing the larger Toronto-based drug retailer.
Shoppers, which is Canada's largest drug store chain, banded together with independent pharmacies last year to stop generic drug reforms.
Shoppers said the move would cost an estimated $750-million a year in revenue, which it has been working to offset through ramping up front of store sales.
But independent pharmacists warned that in their stores, the consequences would be much more dire.
Local druggists lamented that some would inevitably have to close down because prescription sales make up a bigger percentage of their sales mix and they wouldn't be able to absorb the hit to their profits.
And that vulnerability is where Shoppers sees opportunity in the reforms.
Pilla told analysts Shoppers plans to be "extremely active in the market" as it watches more independents forced into selling as the drug reforms work their way through their balance sheets.
There has so far been no frenzy to buy up smaller chains due to the uncertainty affecting the whole industry, Pilla said.
But he expects a "kick up" in consolidation activity when the second phase of drug reforms hits, creating an "economic perfect storm" for some independent stores.
"What we are seeing is a lot more activity in the market and that augurs well for potentially having a lot more deals done in 2012."
Shoppers earned $172.4 million, or 80 cents per share in its latest quarter, up from $154.7 million, or 71 cents per share, in the quarter a year ago.
Excluding the impact of a $3-million, one-time gain due to a sale leaseback deal at some stores, earnings would have been $170 million, or 79 cents per share.
That was in line with analysts expectations for adjusted earnings, according to Thomson Reuters.
For the third quarter, analysts on average had been expecting revenue of $3.16 billion and the chain delivered.
Revenue was $3.1 billion from $3.05 billion a year ago. On a same-store basis — a key measure in the retail world — sales were up by 1.5 per cent.
Prescription sales rose by 1.5 per cent to $1.5 billion in the third quarter, as the volume of prescriptions improved by 3.6 per cent.
But the growth was largely offset by a decline in the average drug price due to the legislation reducing generic prescription reimbursement rates.
Meanwhile, generic prescriptions continued to grow. The cheaper alternatives made up 57 per cent of prescriptions in the third quarter, compared with 55 per cent a year ago.
As the company works to ramp up growth in other areas of store sales, it reduced its reliance on prescription sales slightly to 48.7 per cent from 49 per cent last year.
Front of store sales were $1.6 billion in the third quarter, up 2.6 per cent, led by strong sales in cosmetics, food and candy and other convenience categories.
The results also reflected the benefits the chain has realized from an efficiency drive to reduce costs and improve productivity.
Those benefits helped to partially offset higher operating expenses associated with its expansion strategy.
The company opened 15 stores in the third quarter and expanded eight others. At the end of the quarter, Shoppers had 1,328 stores.
Pilla, who became the Toronto-based company's chief executive effective Nov. 1, is a McGill University graduate and member of the Quebec Order of Engineers. He was president of McKesson Canada, a major player in Quebec's pharmacy business, just before his appointment.
Shoppers shares were down 36 cents to close at $42.48 Wednesday on the Toronto Stock Exchange.
Tuesday, September 27, 2011
CICPO begins the Court Process Today
From the Telegram today - with the complete story to follow in the paper tomorrow.
The Council of Independent Community Pharmacy Owners (CICPO) made its first appearance in Newfoundland Supreme Court today to begin its challenge of sections of the Pharmacy Act and regulations.
Justice Richard LeBlanc has scheduled Dec. 2 for a full-day hearing.
At issue is a provision in the act that permits the Pharmacists Association of Newfoundland and Labrador (PANL) to negotiate financial contracts with government on behalf of the independent owners.
CICPO is also challenging a recent amendment to the pharmacy regulations extending the notice pharmacists have to give to opt out of the provincial prescription drug program.
The Council of Independent Community Pharmacy Owners (CICPO) made its first appearance in Newfoundland Supreme Court today to begin its challenge of sections of the Pharmacy Act and regulations.
Justice Richard LeBlanc has scheduled Dec. 2 for a full-day hearing.
At issue is a provision in the act that permits the Pharmacists Association of Newfoundland and Labrador (PANL) to negotiate financial contracts with government on behalf of the independent owners.
CICPO is also challenging a recent amendment to the pharmacy regulations extending the notice pharmacists have to give to opt out of the provincial prescription drug program.
Thursday, September 22, 2011
No Pharmacy - No Pharmacist in the Blue Book - so much for PANL
The Pharmacists' Association of Newfoundland and Labrador (PANL) has had the net affect of zero on the Provincial Government - this despite claims by the group regarding its relationship with government. The Tory Blue Book does not even mention the word pharmacist or pharmacy.
The only thing the Blue Book talks about is the lowering of costs on medications. There is nothing about rural pharmacy or the profession.
CETA the Comprehensive Economic Trade Agreement with the European Union - which threatens to extend patents on widely used prescription drugs - no mention. The only thing mentioned are tariffs so products can compete.
This government is not committed to rural or inner-city pharmacy - has not held the profession out for medication and disease management - in fact they have not held out the profession for anything.
Rural and inner-city independent pharmacy is being forgotten - which means people and their health care do not matter to the Progressive Conservatives.
The choice for independent pharmacy is clear - the choice for rural communities and inner-city neighbourhoods is clear. The only party with a platform on pharmacy including the use of pharmacists to their full capacity is the Liberal Party.
Please stay tuned for copy of Minister Tom Marshall's transcript regarding pharmacy.
The only thing the Blue Book talks about is the lowering of costs on medications. There is nothing about rural pharmacy or the profession.
CETA the Comprehensive Economic Trade Agreement with the European Union - which threatens to extend patents on widely used prescription drugs - no mention. The only thing mentioned are tariffs so products can compete.
This government is not committed to rural or inner-city pharmacy - has not held the profession out for medication and disease management - in fact they have not held out the profession for anything.
Rural and inner-city independent pharmacy is being forgotten - which means people and their health care do not matter to the Progressive Conservatives.
The choice for independent pharmacy is clear - the choice for rural communities and inner-city neighbourhoods is clear. The only party with a platform on pharmacy including the use of pharmacists to their full capacity is the Liberal Party.
Please stay tuned for copy of Minister Tom Marshall's transcript regarding pharmacy.
Tuesday, September 13, 2011
What is happening to Pharmacy and where is the Board? Ask Minister Kennedy!
The Newfoundland and Labrador Pharmacy Board is the self-regulating body for pharmacy in our province. As you have probably heard in the news - they are the body that monitors both the profession and the operations of pharmacies and may hold disciplinary hearings and issue professional sanctions and/or remove a license of either a pharmacist or pharmacy.
By the same token they should also be there to protect their profession - in the interest of public safety and health - in the same manner the College of Physicians and Surgeons do for Physicians. But the NLPB is no match - and it is going to cost everybody in the end.
The Pharmacy Board as is the problem with the PANL is inundated with big corporate agendas - something which the College does not have to deal with. This is because you do not have to be a pharmacist to own a pharmacy. The Board is an elected body and as such staff pharmacists who work for the big conglomerates like Wal-Mart and Shopper's Drug Mart can get elected and form part of a decision making process. This is the beginning of the problem. Let's say it's in the best interests of the large companies to increase the scope of practice of a pharmacy technician - in order that they may reduce the number of pharmacists needed - and thereby reduce their costs - what will there staff have to represent in a committee meeting? That's the name of the game for publicly traded companies - lower costs - increase shareholder value. Is this however the model that best serves the public? The answer is no.
There are a number of changes going on in Canada and every one of them are causing the destruction of the profession of pharmacy including the value of these highly qualified health care experts. You see as I write today the multinational retail giants - Shoppers, Lawtons, Wal-Mart and Costco are designing, lobbying, and controlling the development of policy surrounding the profession - in order that they maximize profits. Pharmacists are being replaced by ATM's, Licensed Practical Nurses, and pharmacy technicians. In Ontario - where the generic drug pricing changes were introduced - these regressive policies are in full swing. Now where a rural pharmacy used to stand - an ATM will move in; or if a rural community no longer has access to an independent pharmacy (due to revenue loss) an LPN can now dispense, sell, and compound prescription drugs. Further where the ratio of pharmacists to pharmacy technicians was 1:2 is now becoming 1:6 if there are any limits at all. Better yet the pharmacy technicians primarily needed in large numbers by the heavy volume drugstores are now being encouraged by these chains to take control by supporting their efforts to organize and advocate. This all comes at as cost to pharmacists.
The reports are fairly common in Ontario now, pharmacy students are having a difficult time getting a placement in drugstores in order that they may graduate - and when they do the salaries now being offered are 1/3 to 1/2 what they used to be. The public relations spin by the big drugstore chains is that now pharmacists are going to be able to do more of what they are trained to do - by having techs take care of the less significant tasks. The spin goes on to say pharmacists will be paid for med-checks, injections, and counselling. The pharmacist is paid by their employer - they do not receive direct payment for their increased scope of practice - in fact they are now being paid less for doing more. Meanwhile the corporation that employs them bring in more cash with a cheaper payroll.
Any reasonably minded person would ask - if an LPN or an ATM or a pharmacy technician can do the job - what is a pharmacist for? A large corporate drugstore or retail chain will examine the human resources necessary to pump out prescription drugs and adjust their staff needs accordingly. So if a pharmacist is restricted to counselling and medication checks and if the government only pays the corporation a set fee to do those tasks - the pharmacists salaries will actually go down. The money making volume can now be completed by techs and machines.
Is this good for the public? No it is not. The pharmacist should as with all experts in health care being enjoying more stability in the workforce and expect professional salaries for the investment they made in their education. For pharmacists - sadly - the opposite is true. The large corporations in Ontario are now reportedly reducing hours, salaries, and benefits for pharmacists. Schools of Pharmacy in universities are now experiencing a difficulty in achieving placements for their students. At the rate things are going these Schools will have to downsize to adjust to the new market reality. Ironically this is happening at a time when Memorial's School of Pharmacy is looking to expand with new facilities and more seats. If one looks at the changes now occurring in Ontario and the fact the Minister Jerome Kennedy is determined to follow that model - our School of Pharmacy could actually be downsized if not eliminated altogether.
So back to the Newfoundland and Labrador Pharmacy Board - The Executive Committee is comprised of 2 pharmacists from the School of Pharmacy and 2 pharmacists from Shopper's Drug Mart. Of nine Board members only 1 is an independent pharmacy owner.
The Chair of all the Professional Practice Committee and sub-committees is Sandra Carey. Ms Carey is a pharmacist and an employee of the Health Initiative Inc. in Toronto which is an agency of McCann Healthcare Worldwide which is a subsidiary of Interpublic Inc. This conglomerate is a global provider of advertising and marketing services. At the most basic level - it's the attempted control of market share. When it comes to health care and pharmacy - who would want such control of market share? With 41,000 employess how much independent influence does Ms. Carey have?
This big corporate agenda is going after all policies related to pharmaceuticals. The bigwigs of retail pharmacy - the giant chains - are lobbying governments to achieve what's best for their shareholders - not what's best for you and I.
Are they succeeding? Well Minister Kennedy could be the poster boy for this initiative - Shopper's Drug Mart is definitely controlling the development of pharmacy policy. So far they have managed to have their own private line of prescription drugs listed on the provincial formulary, they have managed to have the Department of Health turn a blind eye to Seniors rights in personal care homes, and they have managed to keep independent pharmacy out of the Minister's office. They have lobbied directly, and indirectly at $500 a plate political dinners.
As for the Pharmacy Board - it is becoming obvious that they too are turning a blind eye when the public interest is being affected. You can bet your last dollar that the College of Physicians and Surgeons would long since have a like problem dealt with.
By the same token they should also be there to protect their profession - in the interest of public safety and health - in the same manner the College of Physicians and Surgeons do for Physicians. But the NLPB is no match - and it is going to cost everybody in the end.
The Pharmacy Board as is the problem with the PANL is inundated with big corporate agendas - something which the College does not have to deal with. This is because you do not have to be a pharmacist to own a pharmacy. The Board is an elected body and as such staff pharmacists who work for the big conglomerates like Wal-Mart and Shopper's Drug Mart can get elected and form part of a decision making process. This is the beginning of the problem. Let's say it's in the best interests of the large companies to increase the scope of practice of a pharmacy technician - in order that they may reduce the number of pharmacists needed - and thereby reduce their costs - what will there staff have to represent in a committee meeting? That's the name of the game for publicly traded companies - lower costs - increase shareholder value. Is this however the model that best serves the public? The answer is no.
There are a number of changes going on in Canada and every one of them are causing the destruction of the profession of pharmacy including the value of these highly qualified health care experts. You see as I write today the multinational retail giants - Shoppers, Lawtons, Wal-Mart and Costco are designing, lobbying, and controlling the development of policy surrounding the profession - in order that they maximize profits. Pharmacists are being replaced by ATM's, Licensed Practical Nurses, and pharmacy technicians. In Ontario - where the generic drug pricing changes were introduced - these regressive policies are in full swing. Now where a rural pharmacy used to stand - an ATM will move in; or if a rural community no longer has access to an independent pharmacy (due to revenue loss) an LPN can now dispense, sell, and compound prescription drugs. Further where the ratio of pharmacists to pharmacy technicians was 1:2 is now becoming 1:6 if there are any limits at all. Better yet the pharmacy technicians primarily needed in large numbers by the heavy volume drugstores are now being encouraged by these chains to take control by supporting their efforts to organize and advocate. This all comes at as cost to pharmacists.
The reports are fairly common in Ontario now, pharmacy students are having a difficult time getting a placement in drugstores in order that they may graduate - and when they do the salaries now being offered are 1/3 to 1/2 what they used to be. The public relations spin by the big drugstore chains is that now pharmacists are going to be able to do more of what they are trained to do - by having techs take care of the less significant tasks. The spin goes on to say pharmacists will be paid for med-checks, injections, and counselling. The pharmacist is paid by their employer - they do not receive direct payment for their increased scope of practice - in fact they are now being paid less for doing more. Meanwhile the corporation that employs them bring in more cash with a cheaper payroll.
Any reasonably minded person would ask - if an LPN or an ATM or a pharmacy technician can do the job - what is a pharmacist for? A large corporate drugstore or retail chain will examine the human resources necessary to pump out prescription drugs and adjust their staff needs accordingly. So if a pharmacist is restricted to counselling and medication checks and if the government only pays the corporation a set fee to do those tasks - the pharmacists salaries will actually go down. The money making volume can now be completed by techs and machines.
Is this good for the public? No it is not. The pharmacist should as with all experts in health care being enjoying more stability in the workforce and expect professional salaries for the investment they made in their education. For pharmacists - sadly - the opposite is true. The large corporations in Ontario are now reportedly reducing hours, salaries, and benefits for pharmacists. Schools of Pharmacy in universities are now experiencing a difficulty in achieving placements for their students. At the rate things are going these Schools will have to downsize to adjust to the new market reality. Ironically this is happening at a time when Memorial's School of Pharmacy is looking to expand with new facilities and more seats. If one looks at the changes now occurring in Ontario and the fact the Minister Jerome Kennedy is determined to follow that model - our School of Pharmacy could actually be downsized if not eliminated altogether.
So back to the Newfoundland and Labrador Pharmacy Board - The Executive Committee is comprised of 2 pharmacists from the School of Pharmacy and 2 pharmacists from Shopper's Drug Mart. Of nine Board members only 1 is an independent pharmacy owner.
The Chair of all the Professional Practice Committee and sub-committees is Sandra Carey. Ms Carey is a pharmacist and an employee of the Health Initiative Inc. in Toronto which is an agency of McCann Healthcare Worldwide which is a subsidiary of Interpublic Inc. This conglomerate is a global provider of advertising and marketing services. At the most basic level - it's the attempted control of market share. When it comes to health care and pharmacy - who would want such control of market share? With 41,000 employess how much independent influence does Ms. Carey have?
This big corporate agenda is going after all policies related to pharmaceuticals. The bigwigs of retail pharmacy - the giant chains - are lobbying governments to achieve what's best for their shareholders - not what's best for you and I.
Are they succeeding? Well Minister Kennedy could be the poster boy for this initiative - Shopper's Drug Mart is definitely controlling the development of pharmacy policy. So far they have managed to have their own private line of prescription drugs listed on the provincial formulary, they have managed to have the Department of Health turn a blind eye to Seniors rights in personal care homes, and they have managed to keep independent pharmacy out of the Minister's office. They have lobbied directly, and indirectly at $500 a plate political dinners.
As for the Pharmacy Board - it is becoming obvious that they too are turning a blind eye when the public interest is being affected. You can bet your last dollar that the College of Physicians and Surgeons would long since have a like problem dealt with.
Friday, September 2, 2011
CICPO outlines Court Action in the Telegram
Below story from the Telegram September 02-2011
Comments prompted legal action
Legal action seems only way to settle dispute: spokeswoman
The Council of Independent Community Pharmacy Owners (CICPO) is preparing to go to court to challenge the Newfoundland Pharmacy Act, with respect to a mandate given to the Pharmacists’ Association of Newfoundland and Labrador (PANL) to negotiate third-party contracts.The decision to take legal action came after comments Tuesday by Finance Minister Tom Marshall on VOCM Radio’s “Back Talk” program.
Marshall, who pointed out that he was speaking as “minister of the public service secretariat” which negotiates major contracts and labour agreements, said PANL is at the table with a committee called the government relations committee, which has a mandate from its board of directors to negotiate a contract on behalf of members “involved in the pharmacy retail business.”
The minister said there are three PANL members at the table, of which the chairman and another member are independent pharmacists. “They have advised me that they’re holding a seat available at the table for CICPO,” he added.
Marshall also said the negotiations formally began on Aug. 16 and, now that they’re underway, government will not be making any further public comments during the process.
Kelland-Dyer said the minister has made it quite clear that he either doesn’t understand this issue or he’s providing misleading information.
“We feel the only way to have this issue settled and resolved is to simply go to a court process,” she said. “The purpose behind it, obviously, is to now go to a technical process of dealing with what we’ve been attempting to talk to government about now for the past three years.”
CICPO’s position is that PANL is the professional body for pharmacists, but it shouldn’t represent independent pharmacies, which are corporations or legal entities, in negotiations regarding the province’s prescription drug program, which subsidizes the cost of medications for residents, based on financial needs assessments.
Kelland-Dyer said not all pharmacies in the province are owned by pharmacists. At least six of the 65 CICPO members are not pharmacists, she said. Some could be owned by doctors or other business people, she said. While the pharmacists they employ are PANL members, the owners are not.
“Frankly, all of our members, be they pharmacists or not, support advocacy for the profession. There’s no issue with that,” KellandDyer said, but the only trade bodies representing pharmacies are CICPO and the Canadian Association of Chain Drug Stores.
She said PANL was formed under the Pharmacy Act as a professional association, but has also been given an objective to “negotiate with third-party payers for prescription drug programs.” This is what CICPO has a problem with.
Private health insurance companies, like Medavie Blue Cross and Dejardins, negotiate directly with the business groups, Kelland-Dyer said, like CICPO or the chain drug stores association.
She said these insurance companies recognize that PANL is simply an association for the profession, similar to an employees’ professional organization and she can’t understand how that type of representation has crossed over into negotiating contracts for the actual corporations or legal entities.
“The way Tom Marshall talked about it the other day, he said we’re sitting down negotiating with pharmacists. Well, the government doesn’t pay a cheque to pharmacists, never did,” Kelland-Dyer said. “The only pharmacists they pay directly are the ones that work in the Health Sciences Complex or up in the government office. They’re employees of the government and they negotiate through the Association of Allied Health Professionals, so they don’t even negotiate with those pharmacists directly. The cheque that comes out would be to the corporation itself and the provider agreement is between each individual corporation and the government.”
The corporation signs a provider agreement to accept the provincial drug card as a method of payment, Kelland-Dyer said, and it agrees to a tariff and how it will be paid for its drugs and services.
She said there are about 660 pharmacists registered with PANL, about one-quarter of whom are employed by the government, working at places like hospitals, the prescription drug program or the Newfoundland and Labrador Centre for Health Information. Other PANL members, she said, are pharmacists employed by Memorial University, who are also represented by the MUN Faculty Association, some are employees of the provincial pharmacy board and there are staff pharmacists working in the retail sector for chain or independent stores.
Even if you take a CICPO member who is a business owner and pharmacist, Kelland-Dyer said, while that person is registered with PANL, their corporation pays them a salary and it’s that corporation or legal entity that should negotiate any business deal with government.
Opposition Leader Kevin Aylward said Thursday a Liberal government would immediately engage in discussions and negotiations with all pharmacists and pharmacy groups, including CICPO. “We recognize that to achieve a contract with community pharmacies, negotiations from time to time may require separate discussions with pharmacy owners in unique areas of practice,” Aylward said.
She said PANL was formed under the Pharmacy Act as a professional association, but has also been given an objective to “negotiate with third-party payers for prescription drug programs.” This is what CICPO has a problem with.
Private health insurance companies, like Medavie Blue Cross and Dejardins, negotiate directly with the business groups, Kelland-Dyer said, like CICPO or the chain drug stores association.
She said these insurance companies recognize that PANL is simply an association for the profession, similar to an employees’ professional organization and she can’t understand how that type of representation has crossed over into negotiating contracts for the actual corporations or legal entities.
“The way Tom Marshall talked about it the other day, he said we’re sitting down negotiating with pharmacists. Well, the government doesn’t pay a cheque to pharmacists, never did,” Kelland-Dyer said. “The only pharmacists they pay directly are the ones that work in the Health Sciences Complex or up in the government office. They’re employees of the government and they negotiate through the Association of Allied Health Professionals, so they don’t even negotiate with those pharmacists directly. The cheque that comes out would be to the corporation itself and the provider agreement is between each individual corporation and the government.”
The corporation signs a provider agreement to accept the provincial drug card as a method of payment, Kelland-Dyer said, and it agrees to a tariff and how it will be paid for its drugs and services.
She said there are about 660 pharmacists registered with PANL, about one-quarter of whom are employed by the government, working at places like hospitals, the prescription drug program or the Newfoundland and Labrador Centre for Health Information. Other PANL members, she said, are pharmacists employed by Memorial University, who are also represented by the MUN Faculty Association, some are employees of the provincial pharmacy board and there are staff pharmacists working in the retail sector for chain or independent stores.
Even if you take a CICPO member who is a business owner and pharmacist, Kelland-Dyer said, while that person is registered with PANL, their corporation pays them a salary and it’s that corporation or legal entity that should negotiate any business deal with government.
Opposition Leader Kevin Aylward said Thursday a Liberal government would immediately engage in discussions and negotiations with all pharmacists and pharmacy groups, including CICPO. “We recognize that to achieve a contract with community pharmacies, negotiations from time to time may require separate discussions with pharmacy owners in unique areas of practice,” Aylward said.
Wednesday, August 31, 2011
Minister Marshall just moved Negotiations to the Court Room
As a result of the discussion found below - the CICPO will be proceeding to court.
Yesterday on Vocm's Back-Talk with Paddy Daly - Minister Tom Marshall called to discuss one subject - the pharmacy issue.
Below please find a transcript of the conversation:
PHARMACISTS NEGOTIATIONS: "Finance Minister Tom Marshall" is calling as Minister of the Public Service Secretariat to talk about negotiations with the Pharmacists Association of Newfoundland and Labrador.
Tuesday, August 30, 2011 02:19PM
VOCM - St. John's
PADDY DALY:Bye-bye.
As a result of this discourse - the CICPO is now proceeding to court to challenge the Pharmacy Act regarding the mandate of the Pharmacists Association of Newfoundland and Labrador.
The irony is that the words of the Minister could not have stated our case more clearly.
The filing is expected by early next week and will be posted here.
Yesterday on Vocm's Back-Talk with Paddy Daly - Minister Tom Marshall called to discuss one subject - the pharmacy issue.
Below please find a transcript of the conversation:
PHARMACISTS NEGOTIATIONS: "Finance Minister Tom Marshall" is calling as Minister of the Public Service Secretariat to talk about negotiations with the Pharmacists Association of Newfoundland and Labrador.
Tuesday, August 30, 2011 02:19PM
VOCM - St. John's
| PADDY DALY: Let's begin this afternoon and speak with the MHA for Humber East, the Minister of Finance, President of Treasury Board - Tom Marshall. Minister Marshall you're on the air. | |
| MINISTER TOM MARSHALL: Great. Good afternoon Paddy. | |
| PADDY DALY: Good afternoon to you sir. | |
| MINISTER TOM MARSHALL: Paddy I'm calling you in my capacity as the Minister responsible for the Public Service Secretariat. | |
| PADDY DALY: Okay. | |
| MINISTER TOM MARSHALL: The Public Service Secretariat as you know is the institution in government that negotiates major contracts you know, the labour agreements when collective bargaining comes up and also the agreement with the doctors. | |
| PADDY DALY: Right. | |
| MINISTER TOM MARSHALL: So the Public Service Secretariat is now involved with health and community services in conducting negotiations with the pharmacists, the group called PANL - the Pharmacists Association of Newfoundland and Labrador. | |
| PADDY DALY: Yes sir. | |
| MINISTER TOM MARSHALL: We want to negotiate a new agreement and PANL is at the table and they have committee called the government relations committee which has a mandate from their board of directors to negotiate a contract on behalf of members that are involved in the pharmacy retail business. | |
| PADDY DALY: Right. | |
| MINISTER TOM MARSHALL: So there are three PANL members at the table, the chair is an independent pharmacist, one of the other members is also pharmacist and the third one is a former independent pharmacist. They are there now and they have advised me that they're holding a seat available at the table for CICPO which is the Council of Independent Community Pharmacy Owners. | |
| PADDY DALY: Now CICPO will say to that Minister Marshall that that government relations committee has not teeth or say when it comes down to the final ratification or acceptance of negotiations, they bring it back to the board of PANL - a 9 person board with only one independent on it, Mr. Rick Elliott who owns a host of pharmacies so it's not considered the same small business independent that the others at CICPO will call themselves so they give no weight to those independents on that government working relations committee. | |
| MINISTER TOM MARSHALL: Well I can say that there are two independent pharmacists taking part in the discussions and the seat is being held for CICPO unfortunately CICPO has refused to participate in the process and there's nothing that I can do about that. We want to negotiate an appropriate contract and the way you do that is sit down and negotiate at the table, negotiations started on August 16th that was the first meeting there have been 2 more sessions since then and the process is continuing so it's not appropriate to negotiate in public - we're going to carry out the negotiations in private as is the normal case and therefore will make no further comment while a negotiations are ongoing. | |
| PADDY DALY: So we won't hear from the government any further on the independent pharmacy issue or the generic drug pricing? | |
| MINISTER TOM MARSHALL: We will carry out the negotiations with PANL's committee as I said, there is a seat at the table - PANL tells me they have a seat at the table for CICPO if they choose to attend but we will carry out the negotiations and will make no further comment while negotiations are ongoing. | |
| PADDY DALY: Minister Marshall, not to act privy to those negotiations but do you, yourself see the benefit in getting all the information required to make a good decision on this important policy to have a sit down with CICPO as they have obviously made no bones about it - they're not going to sit down with PANL, they have no interest in going through this process without their voice being heard as a group, a recognized group of CICPO. Do you see the benefit of sitting down with them? | |
| MINISTER TOM MARSHALL:The...we are aware of CICPO's issues; we are not negotiating with CICPO we are negotiating with PANL, there is a seat at the table for CICPO. They are refusing to take that seat. That's most unfortunate but there is nothing I can do about that. PANL is a group that government has recognized in the past we've negotiated contracts with them in the past and will continue to negotiate with them again, CICPO has a seat at the table. They have chosen not to participate. | |
| PADDY DALY:I understand that position from the government and I hear you loud and clear Minister Marshall, this is the last we'll hear from the government on the airwaves or on the newscasts regarding these negotiations. I am sure we will hear a reaction from CICPO this afternoon but we appreciate you making the government's position here on the programme today. | |
| MINISTER TOM MARSHALL:Great. Thanks Paddy for giving that opportunity. | |
| PADDY DALY:All the best, Sir. | |
| MINISTER TOM MARSHALL:Bye now. | |
As a result of this discourse - the CICPO is now proceeding to court to challenge the Pharmacy Act regarding the mandate of the Pharmacists Association of Newfoundland and Labrador.
The irony is that the words of the Minister could not have stated our case more clearly.
The filing is expected by early next week and will be posted here.
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