Independent Pharmacies served another Blow by Dunderdale Govt.

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....

Bad Prescription for the People

The Government gets its Way and YOU PAY

Outside of the spectacle most PC MHA's displayed in the House of Assembly last week - regarding the change in generic drug pricing - we have a much more serious problem.

That session of comedy revealed an underlying weakness in our political leadership.

I will let the reader decide if stupidity, corruption, indifference, or vindictiveness is the cause.

First let's agree on a few things.

The following are the essentials of life for people in our province:

1. Food
2. Shelter/Housing
3. Energy
4. Transportation
5. Health Care - including Prescription Medications

Today we will deal with number 1.

The price of food is of primary concern to the vulnerable people of our society. Individuals and families living on fixed low incomes are challenged every day to eat - let alone eat healthy.

Every week when one shops at the supermarket one notices the increase in the price of food. 

Food prices rose 4.1% on a year-over-year basis in February, following a 4.2% increase in January.

What is the response of the Government of Newfoundland and Labrador? Nothing! They rely on provincial food banks to hold people over from week to week.

Supermarkets receive rebates for purchases and particular shelf space so there is money in the system to reduce the price of food.

Considering that government (taxpayers) help low to no income people and families through income assistance - in part to buy food - then one would think government would direct food manufacturers to lower the price of generic food. Example - a tin of Carnation milk (brand) compared to a tin of Our Compliments milk (generic). Price of Carnation milk $1.50 and Price of Our Compliments $1.25. Therefore the generic tin milk is priced at 83% of brand. So if the Government of Newfoundland and Labrador lowered the price to 45% of brand then the generic tin of milk would cost 68 cents. Now we're talking.

Then if Dunderdale continued on and lowered the generic milk price to 35% of brand then the price would be 53 cents a tin.

Now if a person or child does not react well to the generic milk and finds that Carnation is the only one they can consume then a special authorization would be needed from government so that they can get enough money to pay for Carnation milk.

While the special authorization is approved - Mr. Sobey could give the customer the milk until the person is approved in 4 weeks. In either case Mr. Sobey would have to wait a week to be paid for the generic milk.

The question is will Tom Marshall, Kathy Dunderdale, and Susan Sullivan ask Mr. Sobey to sharpen his pencil?

For those of you not on any form of income assistance - your price would be lowered too. The Government of Newfoundland and Labrador when regulating prices - apply that price reduction to all citizens.

Do you think the supermarkets can afford to lower their prices?

For many medical conditions - a proper and healthy diet is essential. If the person is a diabetic - incorrect food choices could mean the difference between $1500 dollars worth of drugs a year and $15,000 dollars to keep the disease in check - including otherwise unnecessary stays in the hospital or by a worsening of the disease.

So the biggest problem in Newfoundland and Labrador today is the small independent pharmacy - the same people who day after day ensure people do not go without medications? The pharmacies that have a rotating credit for customers at about $20,000 per pharmacy - the pharmacies that are there whenever they are needed. The pharmacies who have provided free essential services to the people under their care.

Meanwhile the price of generic drugs are going down through competition and are reducing the price of drugs government pays for by replacing brands.

I watched a group of MHA's who were elected to represent people - stand up an speak about something they knew nothing about. The ignorance was incredible. Unfortunately - this means the decisions made are not going to bring the stated desired result.

The government chose this time not to listen to Dr. Wade Locke or the people who are experts in pharmacy services. This time they listened to unknown sources of information but were lobbied by brand companies.

Make no mistake - the money - if any - saved on the generic price changes will be gobbled up by oil and gas giants, mass retail and grocer corporations, and brand drug houses.

Make sure you have the number for your MHA handy as changes occur. It is he or she that has caused the problem.

Changing the face of pharmacy - is not the prescription you need.

Independent Pharmacy Identifies More Savings for Government

How about $800,000 a month? Next Up Crestor - Where's the Minister?

It is now widely believed that the generic version of Crestor (another cholesterol drug) will be available for the market by April 2012. Great for the health care budget.

Crestor was the the most costly drug in Canada last year coming it at $875,000,000.

Newfoundland and Labrador's portion of this was over $19 million.

When the generic is released it will cost approximately half of this amount or over $800,000 a month savings.

If we continue down the same path used for introducing new generics - we will waste over 3 million dollars.

Just imagine the savings.

Now this is a heads-up to the Minister of Health, the Minister of Finance, and the government.

Will they now deal with this problem?

Will the media or Opposition parties ask the questions?

CICPO sounds Alarm on wasted $$ in Health Care

More $$$$ lost from Health Care - Secret Committee

Another half million dollars down the tube as Newfoundland and Labrador takes 40 days longer to list new generic.

In this case Lipitor - a brand drug to help control cholesterol - came off patent protection in May 2010 - and should have been on our formulary by July 1 of 2010. Atorvastatin the generic version did not make our formulary until August 11 2010. This 41 day delay cost us close to half a million dollars.

More interesting in this case - it may very well have been delayed until December of 2010 - if the Council of Independent Community Pharmacy Owners did not directly advise the Department of Finance of this problem.

That would have cost close to 2 million dollars.

Since that time the situation has not been corrected and we continue to lose millions of dollars.

This is the second example of wastage.

Where are the questions?

Where is the media?

These numbers can be independently verified.

Why are drugs available in our hospitals but not available at the retail pharmacy?

Here is another half million for surgeries to remove excess skin or quicker MRI's. 

Will Dunderdale Government protect you from this?

As you are aware the Council of Independent Community Pharmacy Owners has been advising the public and media that changes occurring in Pharmacy Policies throughout Canada may be detrimental to you - the patient.

Recently in Ontario, the College of Pharmacists licensed a mail order pharmacy. This pharmacy located in one physical location - Express Scripts Canada Pharmacy - is promoting the transfer of your prescription from the local pharmacy to them. The medications they are interested in are "maintenance" medications for ongoing chronic conditions.

They promote the advantage of home delivery and say "you will have no need for monthly trips to the retail pharmacy" - and "free" delivery my mail.

They are pleased to advise you to have a 30 day supply on hand before you convert to them - presumably from your local pharmacy.

See the Video Here

Now consider for a moment that all patients of a local pharmacy convert to a mail in pharmacy - what happens to the local pharmacy? I think we can all be wary that your local pharmacy would not survive. Then when you need medications which are not "maintenance" such as anti-biotics or a supply of life saving medications after just having been released from a hospital - where do you go?

If you do not have an insurer or cannot have access to the mail-in pharmacy where do you go?

In the event of a change in medication to take affect immediately - where do you go?

If you want to consult with your pharmacist in person - where do you go?

Perhaps you live in the city and a big chain store is near by - no problem for you right? Well who knows? What if you live in a community where there is only one independent pharmacy what will you do?

The video compares shopping online and banking online to prescriptions online - that is irresponsible. This is your health. This is your health care professional and access.

If you are a cash paying customer or one that is on income assistance where do you go?

If the weather is bad - delayed delivery - where do you go?

This American headquartered company wants all the constant prescriptions without having to deal face to face with you the patients. They also do not want the medications that are once only or infrequent prescriptions. They want to suck all the profits they can away from your community, your province and your neighbourhoods.

What does this have to do with you in Newfoundland and Labrador. The answer to that is two-fold.

1. When contacting the mail order pharmacy by phone - the person on the phone says they expect to be able to deliver services in Newfoundland and Labrador (eastern provinces) by March or May.

2. This is the same company that is attempting to negotiate a contract with independent pharmacies in Newfoundland and Labrador for the acceptance of the Desjardins Card. Obviously they are in a conflict and we now have to deal with that. By the way that would be all provincial government employees.

Now to see what the American Version of the video shows: Press HERE

Here they talk about the accuracy and numbers of prescriptions they fill. How would we know that? Is that going to be allowed in Canada?

One thing is for sure - we must stand up for community and neighbourhood based pharmacies before it is too late.

A final note: they claim you MAY save money. What we will do is keep funneling health care dollars out of our communities and province along with direct personal access to health care professionals. That saves nobody money - but can destroy a very exceptional pharmacy network.

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.

Government’s Small Business Week Message - Meaningless to Independent Pharmacy

News Release CICPO

18/10/11

Government’s Small Business Week Message - Meaningless

The Council of Independent Community Pharmacy Owners is shocked at the rhetorical statements made by Minister of Business Derrick Dalley and Minister of Innovation Trade and Rural Development Susan Sullivan – in celebration of Small Business Week. 

Power Up Your Business. Invest. Innovate. Grow – is the theme for this year’s recognition.

Robert Doyle Vice President of CICPO says, “It is ironic that over sixty local businesses located in all regions of our province – that want to do exactly what the theme suggests – are met with disinterest, disrespect, and threats by the Government of Newfoundland and Labrador".

Minister Sullivan said, “While they may be termed small, their contributions and the role they play in society is anything but small. They are creating jobs and opportunities, strengthening and building communities and fortifying the provincial economy. Small Business Week recognizes the vision, passion and ingenuity of those who answer the entrepreneurial call.”

“This government does not recognize our passion, and certainly not our vision and ingenuity as they continue to look outside the province for pharmacy policy”, adds Doyle. He says, “As we head to court in early December to simply exercise our rights as small business owners and further to make government live up to written contracts – all we feel is weary and distrustful.”

The Council’s members represent over 100 million dollars of investment in our province – particularly in rural communities and quite often are the core business and health service providers.

“Government treats our private sector businesses as an extension of the public system and our owners as employees of the Department of Health. This means they have no idea as to the importance of our investments and the risks we take”, comments Doyle.

Minister Dalley suggested “Through the continued focus on the elimination of red tape along with the marketing of the province as an ideal place to live, work and invest, the Department of Business continues to help small businesses thrive.”

Independent pharmacy and the connected health clinics in rural communities offer essential services for families who live in regions and people who are looking to move into them.

The Vice President of the Council concludes, “The refusal of the Dunderdale government to meet with our members does not demonstrate the words that the Ministers utter. We look forward to a time when we as business owners can communicate with government. While we celebrate other small business owners and the contributions they make – we do not accept the meaningless words of the Dunderdale administration whose actions are entirely contrary.”

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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.

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.

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.

CICPO speaking out to Protect the Rights of Seniors

Story below as appears in the Grand Falls-Windsor Advertiser by journalist Renell LeGrow.

Group concerned over contracts

The Council of Independent Community Pharmacy Owners is crying foul over contracts being signed between personal care homes and big chain pharmacies for exclusive rights to pharmaceutical needs for residents.

Published on September 8, 2011

Personal care homes signing deals with big chain pharmacies

It's a fight the Council of Independent Community Pharmacy Owners is ready to fight - but where do they take it?

The Advertiser has learned a number of personal care homes in the region have signed contracts with some big chain pharmacies for exclusive rights to pharmaceutical needs for residents.
CICPO Executive Director Sue Kelland-Dyer said they're hearing the stories province-wide.

"Here's what appears to be going on," she said. "Number one, the big chain stores that are involved in this thing are both Shoppers Drug Mart and Lawton's. There is no evidence of others involved, those would be the two, and the predominant player in that would be Lawton's Drugs. What we're hearing essentially is that they go into the homes, and they cut a cheque, so much per bed, and what they receive in return is exclusivity of the people or residents of the home."

When contacted by the Advertiser, the homes in Grand Falls-Windsor declined comment, however Ms. Kelland-Dyer said it is happening.

"Quite often too they come in from outside the community, which is also a problem," she said. "So in Grand Falls-Windsor's case, I think the couple of cases that are there, one is a Lawton's and one is a Shopper's, but neither of them is operating in the community. They're operating their services to the home from outside the community. One from Gander, and the other from Bishop's Falls."
Ms. Kelland-Dyer said the complaints are pouring into CICPO of upset seniors and families, wanting to keep their long-time family pharmacist.

"What they're being told is that if you do not transfer over and go to another pharmacist and another pharmacy, basically we will not give you your medication," she said. "These people have been with their pharmacy for years. We've had reports of seniors crying, really upset, didn't know what to do, and the most difficult part is because they've been waiting to get into a home, or probably just getting in, they're not comfortable with rocking the boat."

Ms. Kelland-Dyer called the situation a real mess.

"To the people who have called our pharmacies, and its not just Grand Falls-Windsor... what do we say for these seniors?" she said. "Somehow this is continuing to fall on deaf ears and at some point it's going to break."

Ms. Kelland-Dyer cited a letter she was forwarded from a resident of Golden Years Estate in Grand Falls-Windsor.

"Dear Resident of the Golden Years Estate, It is the commitment of the Golden Years Estate to provide it's residents with the ultimate care and service, which is why beginning on Monday, Feb 1, we will be switching all pharmaceutical requirements and needs to Lawton's Drugs. The Golden Years Estate and Lawton's Drugs ensure that there will be no disruption in medications or prescription service and delivery, and that residents will enjoy enhanced customer service and satisfaction. We appreciate you're understanding and co-operation regarding this decision, and we look forward to a prosperous new year filled with good health and happiness."

That's a senior's rights issue, according to Ms. Kelland-Dyer.
"You and I can pick whoever our pharmacist is, whoever our doctor is, we can change if we want or stay there if we want, but it's our choice," she said. "This has come down to seniors not having a choice. And I tell you, there's a lot of upset. We've been trying to get to the bottom of this, how do we put this complaint together, who do we lodge the complaint to, but clearly there has to be some action taken because you have people who, I know, are in tears."
Ms. Kelland-Dyer feels the government should step in.

"I know our pharmacies in Grand Falls-Windsor were supplying the homes, but there was no force," she said. "If a resident wanted to go to Roy Green, or one wanted to go to Wayne Morris, or one wanted to go to Ken Dicks, they just did. There was no blocking them."

The biggest concern for CICPO is the relationship between patient and pharmacist. Ms. Kelland-Dyer said with any luck, the pharmacist becomes a life-long health care provider, much like a family physician.

"Particularly as it involves chronic illness like heart conditions, high and low blood pressure, diabetes, asthma and that sort of thing," she said. "There's an ongoing need for medications, compliance with those medications and ongoing discussions back and forth between the doctor and the pharmacist as to what perhaps would be the best approach from a medication perspective."
Ms. Kelland-Dyer said families need to be able to speak on behalf of their loved ones.

"We had one instance where a person was getting ready to leave their home and go into the personal care home," she explained. "Before they went into the home they said they were going to keep their same pharmacist. They were told it wouldn't be a problem. And then, the day they went to check into the home, they told her she had to sign the document or she wasn't going to be admitted. What do you do? We have other instances here in St. John's, where local pharmacists weren't able to treat their own parents or grandparents. It's something that's really weird, it came out of nowhere... it's not a happy picture."

Ms. Kelland-Dyer said CICPO is ready to fight this.
"Something has to give," she said. "You can't treat seniors any different than me or you."
The Advertiser placed calls to Shoppers Drug Mart in Bishop's Falls but they were not returned, prior to deadline.

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.

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: 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.

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.

Three Independent Pharmacy Owners in Ontario running for PC's - Why?

News Flash

"Frustrated by cuts to pharmacy funding, three pharmacists are running as Ontario PC Party candidates in this fall's provincial election. Meet one nominee: Jeff Yurek, a second generation pharmacist and co-owner of Yurek Pharmacy in St. Thomas. Yurek is campaigning with a key message: Enough is enough with the cuts."

Why is the PC government in Newfoundland and Labrador adopting a failed Liberal policy in Ontario - while the PC's in Ontario believe it is a failed policy?

Something is up - and it will hurt Newfoundland and Labrador.




What is Kennedy Hiding? Quite a bit!

Catering to the big guys - that is what Ministers Jerome Kennedy and Tom Marshall are doing. They are running with the flow of central Canada and attempting to adopt a failed health-care policy.

Minister Marshall - almost gushing at the announcement of a rebate on oil costs for the vulnerable in our society. Should we do this? Absolutely - as an established democratic - socially conscious province - we don't do enough.

Here's the problem - Minister Marshall is not taking on the oil companies and asking them to lower prices in Newfoundland and Labrador to match other provinces in the country - no he will not go after the astronomical profits of big oil. Then there is food - the province/taxpayers pay so much in each and every income assistance cheque to pay for nutrition for the vulnerable in our society. Minister Marshall however will NOT ask that the giant food retailers like Sobeys and Dominion cut their rebates - or go to their suppliers and products and say we want you to lower the price of food coming into our province to equal other provinces in Canada.

The only thing that Minister Marshall is willing to do is go after the livelihood and viability of rural independent pharmacies. This is an absolute kick at rural communities and local businesses. This is a disgrace.

So what if the province used food cards as they use drug cards for those receiving assistance? Would Sobeys and Dominion put in place the technology to accept theses cards and then wait for 2 weeks to get paid? Would they help the person fill out forms monthly to keep their food card? Would they allow dietitians employed by the province to set a price they could charge for food? Would they let their competitors decide? Would they accept and do whatever the government says when it says regarding a food card? NO

Perhaps the government should try this - they don't need a drug card just as they feel they do not need a food card - they should simply provide funds to the person to pick up their prescription drugs. Perhaps they should ask the large food retailers to install a system to keep track of what people are eating and then provide that information to a nutritionist to determine if more money is needed for a family on assistance to achieve a balanced and nutritious diet. We must all remember that the best chance for good health relies heavily on ones diet and access to healthy meals. If this were achieved the government would see a significant reduction in costs to the drug program. People would be healthier.

Now the real issue - the ONLY thing in this province which is going down is the price of generic prescription drugs. Over the past 5 years it has gone down year over year and that will continue. Can we say the same for electricity, oil/gas, and food? Why then is the government focusing on the price of generic drugs?

On the other side of the spectrum - the price of brand name drugs is going up year over year. These prices are set by a federal body and the provinces are doing nothing to change this policy. They are also doing nothing on a proposed EU trade agreement that would see an increased patent protection for these pharmaceutical giants. Once again the government of Newfoundland and Labrador is not telling the people the truth - they are not telling the people that the price of patented drugs will stay high for an additional 3 or 4 years from their inaction.

Why would the government of this province allow this to happen? It affects everybody - it drives prices up for everybody! The only reason possible for such a regressive policy to get the thumbs up from Marshall and Kennedy is because the feds are holding them hostage on something they want. We all know what that is.

One has to ask why these Ministers are showing such utter disrespect to these local business owners and disregard for the health-care services of rural communities? That is a very important and yet unanswered question.

ATMs to deliver health care in Rural Communites? Ask Minister Kennedy!

Is this what Minister of Health - Jerome Kennedy wants rural pharmacy to look like?

 Will these machines deliver to Seniors? Will they write down a prescription until a cheque comes in? Will they fill out forms and submit them to government so a Senior can get their card renewed? Is this a real practice of pharmacy? Can these machines make mistakes? Will they call your Doctor? Will they sort out a seniors special authorization for a prescription necessary for life?

Will this be satisfactory for your community? Will this machine pay municipal taxes? Will this machine support a safe grad, an arena project, a music festival, a community project? Will this machine serve as a volunteer firefighter or a municipal council member?

This is not our future Minister Kennedy regardless of what other provinces are doing. Our rural communities matter and deserve equitable access and service - particularly when it comes to front-line health care?

What's next? Will a new machine be able to check you out and issue a prescription? Will these also replace Doctors?

This is the vision of a Liberal government in Ontario - and now Minister Kennedy wants to make it the vision of a PC government in Newfoundland and Labrador.

Minister Jerome Kennedy is allowing Seniors to be used as Pawns for Chain Drugstores

The continued attitude of the Minister of Health, Jerome Kennedy risks the survival of rural communities by continuing to downgrade services both access and quality.

The Minister's attempt to diminish the rightful position of the Council of Independent Community Pharmacy Owners to negotiate with government - is simply to avoid dealing with the truth.

The Minister says the law means government must use PANL for negotiations - that is not true. The government has an ability to negotiate with any group - they will however seek the path of least resistance.

You will notice that Shopper's Drug Mart is quietly working behind the scenes with full access to government and without having to go through the PANL.

This Minister and his officials are more favourable to the large multi-national chains than to longstanding Newfoundland and Labrador business.

Further the government has no problem signing a big deal with Lawton's Drugs to service the prescription needs of seniors in personal and long-term care homes. This too did not require the PANL. No they had and have full access to the health care authority.

One of the issues the CICPO has to deal with is the removal of basic rights from seniors. This is being done without a word from Minister Kennedy - a lawyer - and prides himself with defending one without a voice. What happened to that Jerome Kennedy? Where has he gone?

A pharmacist in a community pharmacy - particularly in independent pharmacies are life-long professionals. In fact most experts will tell you that keeping your same pharmacist as well as your family physician is a real step one can take to maximize ones health.

Pharmacists are experts in disease and medication management and in our rural communities and inner-city pharmacies - they provide personal and varied social and health services.

Currently in our province there is a disgraceful practice taking place by chain drugstores that is causing the separation between patient and pharmacist. In rural communities where the independent is the only pharmacy - chain drugstores are walking into personal care homes and offering tens of thousands if not hundreds of thousands of dollars to buy the seniors in beds. To be more direct they sign contracts with the home owners to provide exclusive access to provide all prescriptions to residents. They then deliver these drugs from a regional hub - not from the community itself. In this way they do not have to invest in the community or set up a pharmacy and pay tax in another community - all they have to do is deliver drugs. Then in a couple of cases they have asked the local independent pharmacy that has lost all the business to the chain - to fill in for them if the weather is bad or other circumstances occur.

What makes all this worse - many of our pharmacies have tried to console visibly upset seniors or their families as they are told that if they do not give up the pharmacist they have had for most of their life - and change to the out of community chain drugstore - their medications would not be administered. In other words they are forced to give up their right to choose their health-care professional. Many are frightened to talk as they believe it might impact their ability to get accepted into the home or perhaps their treatment because they spoke up.

Does Minister Kennedy have an answer for this? Who is bullying and threatening seniors - or using them as "pawns"? What of the cost to government and seniors? Does their price go up? Is government going to ask the homes to give up that head tax to the government where they are the ones funding the seniors' room in the home?

That is why independents know that what Minister Kennedy is proposing is going to destroy the best pharmacy network in the country. He will also destroy the quality of care for people - especially seniors.

Government Protects the Profits of Oil Companies, Sobeys and Loblaws while attacking Rural Independent Pharmacies

The Government of Newfoundland and Labrador provides income assistance to those most vulnerable in our society.

The monies given to these individuals or families are to meet the daily necessities of life.

They include electricity, heating oil, food, and medications.

In the case of electricity the Government of Newfoundland and Labrador is not seeking to lower rates for consumers by asking Fortis to reduce its profits. Fortis is regulated by the public utilities board and that body regulates the rates for consumers. When Fortis wants to increase rates it can as a business appear before the PUB and ask for an increase based on the cost of doing business and a rate of return or profit.

In the case of food the Government of Newfoundland and Labrador is not seeking to reduce the price of food - despite the need of many families to achieve a balanced diet on insufficient funds. The Government of Newfoundland and Labrador is not demanding that Sobeys and Dominion lower prices for the public - particularly the most financially challenged so that consumers can get the same cost for food in Newfoundland and Labrador as the consumer can get in other provinces. The government is not asking Sobeys or Dominion to reduce their rebates by lowering the price of food.

In the case of oil and gas the Government of Newfoundland and Labrador is not seeking to lower the price of these heating essentials despite the astronomical profits of these oil companies.

The Government of Newfoundland and Labrador is going after local independent rural and inner-city pharmacies. They are going after Newfoundland and Labrador businesses - while walking very carefully around retail and commodity giants.

The Minister of Finance, Tom Marshall announced proudly how government and taxpayers are subsidizing heating bills for those most vulnerable. Yes that should be done - but who should be taking the hit - the taxpayers or the oil companies? Why doesn't the government demand that oil companies lower the price to equal every other province in Canada? Why should Newfoundlanders and Labradorians pay more? Well if the same Minister would have you believe that we should be paying the same as any other province in Canada for prescription drugs - then certainly the same should be true for all essentials of life that the more vulnerable in our society have to pay for.

Supermarkets receive rebates for the products they stock and the shelf space they are on. This should now be stopped - and all the value of those rebates should be used to lower prices. In this way all Newfoundlanders and Labradorians can pay the same price for food here as any other province in Canada.

Then there are Cable TV, Telephone, and Internet services. Why should anybody in Newfoundland and Labrador have to pay anything more for these essential services - than anywhere else in Canada?

Now the real kicker, the government is going after the only thing that is going DOWN in price - generic drugs. Yes that is true - over the past five years they have gone down between 15 to 20 per cent. They will go down even further through the natural competition between generic drug companies.

Further - pharmacies have taken significant decreases already to their revenue stream. Several years ago a thirty day supply was the maximum volume of prescription which could be filled. That changed to a ninety day supply - meaning the pharmacy was losing two-thirds of its revenue stream from its dispensing fee. People saved significantly on their costs as did government (or so they thought). That policy was enacted to satisfy chain drugstores and their insatiable need to wipe out competition.

The truth is the economics have not been completed on this and what many private insurers as well as the government are seeing is that significant dollars may have been lost in this exercise. A very good example - as I am sure many readers can relate to - is getting a first time prescription for a new chronic illness. As you are released from hospital and given a 90 day supply - chances are your prescription may have to be changed several times during that period. So the government or the insurance companies will have avoided three seven dollar dispensing fees but they will have thrown away 500 dollar's worth of drugs.

The CICPO has made recommendations to government to deal with this issue. We have suggested that the expenses be studied so the taxpayer, those with private insurance, and cash paying customers may save significant dollars by adopting a different approach. The government ignored that; yet they say government is looking to save money.

More to come!