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weekender january 18 1986 p3 pharmacists scapegoats public are losers cousens by lynn kelly pharmacists are the scapegoats of proposed new leg islation aimed at reducing ontar ios prescription drug prices says york centre mpp don cousens and joe public will be the loser if bills 54 and 55 which went to committee this week are pas sed without a full and open public discussion mr cousens says nothing should ever be rail roaded through the legislature thats going to have such rami fications on the public needs of the province he said in a recent in terview all i ask for and all our caucus is asking for is that the public longterm interest is protected by full discussion on it and i can say without any hesitation that the ac tion by health minister murray elston and the liberal govern ment to pursue this and to push it through without that discus sion is wrong mr cousens said he has heard from more than 50 of about 70 pharmacists who live in his con stituency which includes mar kham richmond hill and part of vaughan and at least 95 per cent of them oppose categorially the ac tion being taken by government he said adding that many feel ignored by the ministry of health moh if the legislation is causing that much concern to that many people what are another three to six months going to hurt to make sure we do it right he asked in a brochure distributed at markhams amherst dispensary the ontario pharmacists asso ciation calls the legislation the biggest pill youll ever have to swallow said opa executive director romeo franceschini we cer tainly asked for input into the drafting of the legislation so that we could be constructive and that was denied so now were going to have to go ahead and tell the world whats wrong with it mr franceschini said but moh director of drug programs and policy branch alan burrows said thats patent ly untrue in several recent meetings the opa and moh have discussed drug costs an ob vious major concern to both and the wording of the legislation mr burrows said and weve had very valuable input from the opa from the col lege of pharmacists from the bill crothers a good move manufacturing industry from public groups and this is al being assessed at the present time markham pharmacist bill crothers said the new law which he supports in principal has some technical problems hes confi dent the government will try to resolve but no surprises and almost nothing new the opas way of negotiating is this is what we want said mr crothers adding that an opa claim that government acted un ilaterally is dishonest if you say i acted unilaterally in that i introduced a piece of leg islation that the other person didnt like then you can say the act is unilaterial he said not far enough the new legislation doesnt go far enough said mr crothers a pharmacist for 22 years and inde- pendent owner of crothers ida because most clauses app ly only to multiplesource drugs those with governmentapproved generic equivalents the intent of the law is to des troy price spreading which en ables pharmacists to charge cus tomers more than the current 5 maximum dispensing fee for mul tiplesource drugs he said a government formula sets maximum retail drug prices based on what manufacturers say they will charge pharmacists he said but o volume sales or to in crease their market share of a particular drug manufacturers often reduce the cost to pharma cies and that difference the price spread effectively raises the dispensing fee which includes all get out of here claudy youre going to ruin your birthday surprise don cousens druggists scapegoats operating costs and profit under the law as drafted price spread ing is going to happen because it has happened already he said the new law will permit pharmacists to set their own dis pensing fees for multiplesource drugs but it also requires them to post maximum dispensing fees and itemize total prescription costs on receipts the fine for ex ceeding the fee is 10000 for an individual and 50000 for a cor poration pharmacists upset pharmacists myself in cluded are upset and dont parti cularly like the provision of post ing their fees but the present sys tem and the way pharmacists have used the present system de monstrates its in the public in terest that they be posted mr crothers said but larry blumenfeld mar kham manager of amherst dis pensary a sevenstore private chain argues the law will destroy competition because large chains which can afford to post lower dispensing fees will put small independent pharmacists out pf business i would think within six months if this does go through 20 per cent or even more would close up said mr blumenfeld a pharmacist for 20 years thats bull said mr crothers who claims indepen dents make three times as much money as franchise operators be cause they pay no franchise fees its a valid argument in a com petitive system he said but for 10 years there has not been com petition in the marketplace in pharmacy about 95 per cent of the profit large pharmacies make comes from the dispensary he said and reduced fees mean reduced re venue a sacrifice no one wants to make thats why big stores are so afraid of the legislation because it puts them on an even keel with the small independent guy and they dont like that prospect he said little guy scared so theyre going to scare the hell out the little guy and get the little guy to scream because the government is not going to listen to any objections from big chains but theyre going to be ex tremely sensitive if the little wee tiny independent says youre put ting me out of business because no government can afford to be por trayed as the slayer of a small businessman neil katzman independent owner of three savex drug mart stores in markham stouffville and unionville resents a new dispense as written clause re quiring pharmacists to fill entire prescription amounts unless the customer authorizes in writing a neil katzman loss of independence lesserquantity because my pro fessional judgment as a pharma cist will be taken away if somebody came into my store for six gallons of morphine according to the new legislation i would have to fill that six gallons of morphine said mr katzman a pharmacist for 25 years if the government wants to pass this legislation they dont need pharmacists all they need is technicians to pour lick and stick but mr burrows said nothing in the new law prevents pharma cists from refusing to fill entire quantities if they fear possible drug abuse and that a decision to alter prescriptions is governed by the health disciplines act he said the new law is clearly to preclude that decision from being taken for economic reasons and is neither designed nor to be interpreted as altering the professional responsibility of the pharmacist mr blumenfeld opposes provi sions that permit government- appointed inspectors to examine and remove patient records while conducting and audit because it threatens confidentiality but mr crothers stressed theres not a single bit of in formation that these inspectors can pick up of a confidential na ture that the government doesnt already have thats a red her ring and that ones used because this is the one that will catch the publics eye and make people up set and apprehensive about this access already a pharmacist and former ministry inspector mr burrows confirmed that current law already gives the college of pharmacists access to all docu mentation related to a pharma cists practice the college the professions governing body only enforces current dispensing fee legislation when fees exceed 575 said mr crothers who supports proposed new clauses that will permit the government to appoint alterna- tive inspectors a new proposal that pharma cists charge customers their actual acquisition cost for mul tiplesource drugs will erode pro fits and kill incentive to buy in volume at reduced cost argues mr katzman the result he said is smaller inventories and higher retail prices but while he agrees profits may drop mr crothers said part of the incentive to buy in volume is to pass savings to customers which few pharmacists do the pharmaceutical manufac turers associaton of canada de clined comment on the proposed legislation until it is revised at committee a provision intended to help re duce retail drug prices requires pharmacists to advise customers of all generic equivalens and their costs for every prescription filled unless the doctor stipulates no substitution mr blumenfeld said that will increase workload and minimize counselling time or i think wed get to the point where wed be charging for advice time is money people take it for granted that they can phone up and ask our advice on drugs or whatever and we give it freely where does it say that we have to give that out free the clause is a pain said mr crothers who wants it amended to exclude refills to save time signs or brochures list ing the most popular 25 drugs which account for 70 per cent of all prescriptions filled their generic equivalents and price of both could also be displayed he said touchy subject mr crothers noted its a little bit touchy in markham because the towns large population of brandname manufacturer em ployees are offended if you sug gest a generic the government will continue to reimburse pharmacists for only the lowestpriced generic equivalents of drugs dispensed under the ontario drug benefit program but mr blumenfeld said most people prefer brandname drugs because they believe they are bet ter quality as far as im con cerned theres no comparison at all i have no doubt that if my child needed an antibiotic i would give him brandname no matter what the cost was mr crothers said there is no therapeutic difference between brandname and generic equiva lents and that he would not dis pense a drug that hes not pre pared to give his children call display advertising 2942200 or lenni hull 2948244 19s flyer delivered economist sunttibune 9913600 2mw9400 metround 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