Alberta pharmacists face fee rollbacks as demand grows and budget soars

Pharmacists are pushing back against the Alberta government's plan to cut some of their fees, warning the move could lead to job cuts and ultimately hurt patient care.

Health Minister Adriana LaGrange notified pharmacists of the cuts in a letter on Monday.

She said Alberta's pharmacy services budget is forecasted to go $30 million over its $670-million budget for this fiscal year.

As a result, she is cutting the amount pharmacists are paid for conducting comprehensive annual care plans from $100 to $70.

And the number of followups and medication reviews they can charge for drops from 12 to four per year.

"I'm very frustrated," said Calgary pharmacist Randy Howden.

"One of my colleagues, who I talked to yesterday, was in tears"

Howden, who is past-president of the Alberta Pharmacists' Association said this impacts his work with vulnerable patients, including seniors and people with chronic diseases.

Care plans can involve education and meeting with a patient to discuss diabetes management, for example.

"To have those fees cut is pretty drastic. And then to have the number of followups cut means that if I'm following up with a senior every month, I'm only going to get paid for four months and after that I'm doing it for free," he said.

Margaret Wing worries this could lead to job cuts or pharmacists spending less time with patients.

"That does impact quality," said Wing, CEO of the Alberta Pharmacists' Association.

"If patients can't go to pharmacists and they don't have family doctors available to them, where do they go? They have to go to our hospital system, which is, I think, a challenge."

According to Wing, it's been clear for the last 18 months that pharmacy service spending was trending up.

"This was not a surprise to anyone. The reaction [from government] is a surprise to pharmacists."

She said the budget was set several years ago and demand for pharmacist services has increased since then.

"It doesn't seem to be a very responsive reaction to how much need there is right now from Albertans."

These cuts come at time when the province is struggling with a shortage of family physicians and the government has been messaging that pharmacists can play a key role in primary care.

"Up until now, all of the messages have been that your pharmacist is one source of some kinds of primary care in a hope to try and address some of the gap that Albertans are experiencing," said Fiona Clement, a professor in the department of community health sciences at the University of Calgary.

"It is surprising to then see the fees being pulled back because one might hypothesize that this will have exactly the opposite effect of more pharmacists engaging in primary care activities for patients." 

Clement agrees the pay rollbacks could lead to service reductions.

"It is a business at the end of the day … and that will likely translate into changes to the way people interact with their pharmacist."

In a statement, the health minister's office said Albertans will still have access to pharmacists for care plan assessments and followups.

"The decision to make these changes to these pharmacy services has taken into consideration the financial sustainability of both government and pharmacies, while minimizing the impact to service quality and access to primary care for Albertans," the statement said.

The spokesperson said the government has been meeting with the Alberta Pharmacists' Association to discuss how to address the budget concerns and acknowledge pharmacists have presented other cost-saving options.

"The government will continue to explore the feasibility of implementing the options proposed by the association and pharmacists during upcoming consultation meetings for a new pharmacy funding framework in early November."

The changes will be made through a ministerial order and take effect on Nov. 1.