Finance Minister Marshall misleads public on Pharmacy again!

Minister Tom Marshall appeared on Open-Line Friday of last week. The purpose of the call was to attack through innuendo, misrepresentations, threats, and misinformation - the independent pharmacy owners in the province.

The irony was that he called to correct something Randy Simms (host) said in his preamble.

Quote by Marshall:

Randy, we're negotiating now. There's a chair at the table for CICPO. CICPO refused to show up. Randy, Premier Dunderdale wants lower electricity costs for the people in this province. She wants lower drug costs for the people of this province. People have no choice. If the doctor says they got to have drugs, they got to have them, Randy. And the cost of generic drugs in this country are higher than they are in the US and higher than they are in other OECD countries. And there's got to be a reason for that. And we've looked into it and other provinces have looked into it. And British Columbia and Alberta and Saskatchewan and Ontario and Quebec and Nova Scotia have all taken an approach to reduce the cost of generic drugs to their citizens, to their taxpayers.

First - if the Premier wants to lower drug costs in the province - the first line of attack would be the brand drugs that are increasing in cost every year. The fact is brand name drugs which represent over 70% of the costs of all drugs prescribed and dispensed are going up in costs year over year. The generic drugs which are currently the target of this PC government are going down every year. Further the generic partnership with pharmacy has what has been keeping dispensing fees low and allowing pharmacies particularly small independent rural dispensaries to offer essential extra services.

Making matters worse is that the Dunderdale government is hiding its intent relative to a trade deal between the EU and Canada which would see our province have to pay an additional 50 million dollars for essential medications - by agreeing to extend the patent protection for the brand drug companies. Canada and the EU are set to go back to the table just after our provincial election and this term forms part of what a proposed deal will include.

The end result of the PC government move is:

1. The price of drugs will actually go up for citizens and taxpayers.

2. Dispensing fees for most people will have to double or the pharmacies will close.

3. Delivery to seniors and those without transportation will cease or there will be a cost for such delivery.

4. Independent pharmacies will have to stop credit programs for prescription drugs - thereby causing people not to buy and take their medications in a timely manner. This non-compliance will cause the emergency rooms of hospitals to experience unsustainable traffic, re admissions to hospital, or worse.

5. The government drug card clients will have to call their MHA or social worker to have the necessary forms completed for continuity of their prescription drug cards, or to complete their annual tax returns (in order to qualify for the card).

6. It will cause independent pharmacies to cease filling "special authorization" drugs until the approval has been given by government. In that instance the patient will have to return to their doctor to have a prescription changed, go without their medication for up to one month until approval for payment has been achieved, or have to return to the hospital.

7. Prescribing errors made by physicians will have to be handled in a different manner. Currently our independent pharmacies are dealing with between 5 to 25 prescribing errors a day. When the mistake is caught by the pharmacist - the patient will then have to return to the doctor or hospital to have the correction made. If the patient wants the pharmacist to deal with the error for them - they will have to pay a fee based on the amount of time it takes for a pharmacy to contact the doctor, achieve contact with that doctor, the faxing of a new prescription, and the paper work required for the government for a change in prescription. Usually this takes the pharmacy between half an hour to 8 hours to achieve.

8. The pharmacy will have to charge for special packaging for patients who take multiple drugs for chronic illnesses.

9. The hours and availability of pharmacies will be reduced to make the necessary savings on human resources and other expenses.

10. Services such as reprinting of receipts for income tax purposes, transferring of files, supplying hospitals with drug reviews for patients (where the hospital already has the records) or communication with the drug card program for patients will have to be additionally charged.

These are but a few of the changes that will be experienced by patients under the government's plan. The most negative result will be the out and out closure of some pharmacies.

Tom Marshall is not telling the truth or he is completely incompetent on this file.

The government including Premier Dunderdale is hiding the truth from the people and the media need to call them out on the Comprehensive Economic Trade Deal (CETA) with the EU.

Marshall goes on to say the following:

We understand that in terms of the true cost of the drug that's been passed on by the pharmacy to the customer, it has markups on it running from 140 percent to 619 percent. They're very high markups. Now that's before you take their cost into, their expenses of operation into consideration. So what happened - this all started, Randy when the pharmacies announced they weren't going to honour the drug card anymore. They were going to make people pre-pay for their drugs and have to seek reimbursement from the government, which was totally unacceptable because people didn't have the money.

First the Minister talks about markups on drugs running from 140 to 619 percent. Where is the evidence of this? Pharmacy cannot change the price of drugs as the provincial government sets them under the provincial formulary. Further Minister Tom Marshall will not address the Dr. Wade Locke report completed on pharmacy - using actual financial data from pharmacies. This is a government who only a few days ago were holding Dr. Locke's opinion and study regarding Muskrat Falls as gospel - yet when it comes to a comprehensive Activity Based Costing study on pharmacy the Minister of Finance deliberately avoids it. This is a lie by omission.

This statement also points to pharmacy and says - they were going to have people unable to get their essential prescription drugs - this is absolutely false and further is exactly the opposite of what is true. It is the government everyday that prevents people from getting medications. Patients are released from hospital with prescriptions they cannot fill because the government prevents retail pharmacies from determining the validity of a special authorization - so instead it goes into government pharmacists in a bureaucratic setting. This in turn causes delays - up to one month - where people who on income assistance or fixed incomes such as seniors - cannot get their medications because the government has not approved them. In this case local independent pharmacies put it on account for the individual so that they can take their medications immediately thereby preventing re admissions into hospital or a trip to the emergency room. Our pharmacies never let patients leave without their drugs for reasons of inability to pay. This is one significant difference between the large corporate chains and our members.

Next the Minister uses this line:

They want to go to court, I think that's wonderful. Go to court and let it come out what the proper margins out, okay let it come out what the rebates are, let it come out why the true cost of the drugs are not being passed on and while the true cost of the drug to the pharmacy is not being passed on, we want to sit down with the pharmacists and we have sat down with the pharmacists and what we're trying to do is come up with an agreement. 

So the Minister of Finance thinks its wonderful that the CICPO wants to go to court. Well that's a mouthful in and of itself. Yes anything instead of meeting, talking, collaborating, and developing a superior policy. Then Minister Marshall - a lawyer - pretends that the issue being brought to court has something to do with generic drug pricing. The court case deals with two issues: a) whether or not the government had the right to alter a provider agreement unilaterally and second whether the "object" of PANL legislatively is valid. So once again he lies to or misleads the people regarding this very serious issue. Further the information he is seeking above is already available to him from the Dr. Wade Locke report. He once again says they are negotiating with pharmacists not pharmacies. This continued misrepresentation does not negate the fact that government signs provider agreements with corporations (legal entities) not pharmacists. If that is not the case then Wal-Mart, Shopper's Drug Mart, Lawton's and Costco could not be doing business with government.


Minister Marshall then takes the public down another twisted version of the facts:

And we've looked into it and other provinces have looked into it. And British Columbia and Alberta and Saskatchewan and Ontario and Quebec and Nova Scotia have all taken an approach to reduce the cost of generic drugs to their citizens, to their taxpayers.

Let's start with the fact that all provinces are using different models for remuneration and different approaches on the restructuring of generic drug costs. Ontario, which is what is law in Newfoundland and Labrador as it relates to generic pricing is the worst. It has caused the most damage to rural independent pharmacies and where ATM's are replacing the community pharmacy - in some cases now it will be LPN's. In Ontario now three independent pharmacy owners are running for the PC Party of Ontario in large part because of what the Liberal Ontario government has done with pharmacy and health issues generally. And here we have the PC government adopting failed Liberal policy out of Ontario.

Further in Ontario - consultations were had with the Ontario Pharmacists Association, the Canadian Association of Chain Drug Stores (CACDS) the Independent Pharmacists Association of Ontario and the Ontario Community Pharmacies Coalition. That is hardly a comparative for our province where the Premier and her Minister's keep saying we will only talk to PANL.


Then let's talk about British Columbia where a deal was struck between the Government, the BC Pharmacy Association and the Canadian Association of Chain Drug Stores. Once again broader consultation was held and a different remuneration formula was reached. Unfortunately - in BC as in Newfoundland and Labrador - the chains were pandered to while independent pharmacy was left behind. Lastly, at least the Government of BC acknowledges that no agreement reached with either the Pharmacy Association or the CACDS is binding on any individual business.

Then take the most ridiculous of Minister Marshall's comparisons - Quebec. In Quebec a pharmacy can only be owned by a pharmacist. This negates the concerns of independent owners as the government can only negotiate with them - large corporate interests are not permitted to own the dispensary. If Minister Marshall would like to entertain this idea - we would be more than happy to deal with that.

In Saskatchewan the government also reached an agreement between the Pharmacists' Association of Saskatchewan and the Canadian Association of Chain Drug Stores - once again admitting that the strong lobby by the giant retailers and chains is unduly influencing policy development. But at least they admit it. In Newfoundland and Labrador they will not admit to the discussions with CACDS because to do so would mean the CICPO would have a rightful place to put it's arguments forward separately.

In Canada the chain drug stores and mass retailers are dictating provincial policy and it is leading to reduced and inferior services in rural communities. In our province with our geography and relatively small population - this means destruction to our rural communites and inner-city neighbourhoods. Minister Marshall and Premier Dunderdale had the chance to make a difference and derive policy based on local business and rural communities - instead they have chosen to follow the mess found in other Canadian provinces. This is not leadership - and there are not enough lies in the world to cover this up.

Finally Minister Marshall refers to the following:

Okay, they had a meeting set up with Minister Kennedy. Minister Kennedy was in the House. They walked out. They left about five minutes before Minister Kennedy came in. So don't give me that. 

The truth about this meeting will be addressed by those attending this meeting. Minister Marshall and I were not there so we cannot speak directly to it. Those who were in attendance will publicly discuss what happened to this meeting and why it did not occur. safe bet though that with pharmacy owners travelling anywhere from 1 km to 800 km's to attend the meeting did not leave under the circumstances the Minister has described. Either the Minister is misinformed or is lying.