http://www.canada.com/cityguides/toronto/story.html?id=d9e04fa0-c4f1-4d53-aa0c-58de537fbfbe&k=98830 
<http://www.canada.com/cityguides/toronto/story.html?id=d9e04fa0-c4f1-4d53-aa0c-58de537fbfbe&k=98830>
Pharmacists, patients squabble over Ont. drug changes
 
Angela Pacienza
Canadian Press

Sunday, May 28, 2006

TORONTO -- Pharmacists, patients and drug companies are set to turn up 
the heat Monday as public hearings begin to examine Ontario's 
contentious effort to change how drugs are bought and sold in the province.

The hearings come at a time when the government is under fire about 
limited access to life-saving drugs such as the breast cancer medication 
Herceptin, and for failing to pay for expensive drugs that treat rare 
diseases such as Fabry's, an enzyme disorder.

Pharmacists, too, have long complained that they're not being 
compensated for the work they do outside the basic job of filling 
prescriptions.

The sweeping changes are aimed at controlling escalating drug costs 
while improving access to medications in the province's $3.5-billion 
drug program, which includes coverage for welfare and disability 
recipients, seniors and hospitals.

The thinking is that by using Ontario's massive buying power, the 
government can pressure pharmaceutical companies into giving it 
discounted drugs.

Other proposed changes include allowing pharmacists to replace brand 
name drugs with generics when filling prescriptions.

One of the more contentious changes would halt a scheme that sees 
generic drug companies give product or financial rebates to pharmacies.

"Most people who use the program say it doesn't work. It needed 
restructuring. That's what we've done," said Helen Stevenson, the 
executive lead for the Drug System Secretariat who crafted many of the 
recommendations that ended up in the legislation, known as Bill 102.

The province estimates it can save about $289 million a year if the 
legislation is approved.

But ever since announcing the changes last month, the government has 
come under fire from critics who say the plan will create a host of new 
problems.

Among them is a coalition of pharmacists who calculate that the pharmacy 
industry stands to lose $500 million from the changes, largely a result 
of the end of the rebate system. The group also believes the changes 
would force an estimated 300 pharmacies to close shop while forcing 
others to reduce services.

"We won't be sustainable the way we are today," said Rita Winn, general 
manager of Lovell Drugs, a 10-store chain in central and eastern 
Ontario, and a member of the Coalition of Ontario Pharmacy.

"Rebates, marketing allowances are paid in every industry in this 
country. That's just free enterprise. There's nothing wrong or illegal 
about that."

The government, however, says it has done its homework and doesn't agree 
with the pharmacists' doomsday scenario.

"We've done a very, very detailed analysis of the impacts. We certainly 
do not believe that as a result of the recommendations that pharmacies 
will go out of business," said Stevenson.

"We were very thorough in our numbers."

On the patient end, there's some concern over granting pharmacists the 
ability to interchange medication.

Durhane Wong-Rieger, of the Institute for Optimizing Health Outcomes, 
said drugs are only similar to a degree and don't work the same in some 
cases.

"A patient may be well stabilized on one brand of the drug and not be 
well stabilized on the other," said Wong-Rieger, who represents anemics 
and people with rare disorders, among others.

"Under the way the bill is written now, when they talk about a similar 
active ingredient, it would allow the pharmacist to switch you to 
something that is different from what the doctor actually prescribed."

Other changes in the legislation include creating a drug program chief 
executive who would decide which drugs the province would cover, taking 
the role away from Ontario's cabinet.

The legislation also recognizes the role pharmacists play in the 
health-care system by allowing them to charge OHIP for counselling 
patients. The government said it will set aside $50 million to pay the 
new fees.

Karen Philp, executive director of public policy with the Canadian 
Diabetes Association, said she welcomes the move.

"There's a huge shortage of diabetes educators in the province," Philp 
said. "This could help fill that gap."

Philp said her organization supports the legislation because it improves 
the drug approval process by including patients on the committee which 
evaluates which drugs are funded.

"The status quo doesn't work. Ontario has the worst record in the 
country for access to drugs," she said.

"(The legislation) could significantly improve access to medications and 
therapeutic treatments for people with diabetes."

The hearings, scheduled for Monday, Tuesday and June 5, are sure to be 
spirited.

Some 99 separate presentations are scheduled from all sides of the 
debate, including brand name pharmaceutical companies, asthma patients 
and pharma research firms.

A group of pharmacists has scheduled a protest Wednesday on the front 
lawn of the legislature.

But while many in the health-care sector can't agree on the best course 
of action, few disagree that the system needs an overhaul.

"Things have been broken for a long time . . . It's not a simple 
system," said pharmacist Winn, who practices in Oshawa, Ont.

Added Wong-Rieger: "The drug plan that we have currently in Ontario does 
not work for lots of patients, for lots of reasons."
© Canadian Press 2006

-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]


To unsubscribe, send the following message in the text section -- NOT the subject header --  to [log in to unmask]
SIGNOFF SDOH

DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.

To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname

To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.

For a list of SDOH members, send a request to [log in to unmask]

To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST

To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html