I work in an addiction treatment clinic. Some days I think there is little that would shock me, but then there is always the pharmacy industry.
Recently we had a patient transfer to our clinic. Unlike most of our patients he was a “private pay” patient with insurance. Also, unlike most of our patients he was taking a new drug, buprenorphine, or suboxone, to help treat his addiction.
We continued his drug treatment and found him a pharmacy close to his home in a small town near Kingston. A couple of days after starting treatment he called to see if there was anything we could do about his dispensing fees. He was going broke paying for his medication.
A call to the pharmacy established that he was paying $26.31 a day of his own money in dispensing fees for the one drug. On top of that the pharmacy was collecting a further $9.98 from the insurance company for a total income to the pharmacy of $36.29 per day. The cost of the drug is paid separately to the pharmacy and covered by insurance.
Put a bit more grossly, the pharmacy was collecting $13,245.85 a year to dispense this one drug to one patient. Think about the member of patients and number of prescriptions and this is an even more jaw-dropping figure: but one backed up by patient receipts and phone call discussion with the pharmacy.
For the patient, 26.31 dollars a day is nine thousand six hundred and three dollars a year to treat his addiction. Even if he was working, which he is not, this would be completely untenable, precluding any possibility of treatment.
With this one example it is easy to see how pharmacies, not just big pharmaceutical manufacturers, are “cash cows” lusted after by large corporate conglomerates. Indeed most community drugs in Ontario are dispensed by large chain pharmacies and we increasingly use these for-profit corporations to provide more essential health services, such as, immunizations and prescription renewals.
How is this barrier to access for a medical treatment permitted in our health care system? The pharmacy in question is a Shoppers Drug Mart; part of chain currently owned by the multibillion dollar corporation, Loblaw. Maybe it is time to put pharmacists on salary and prohibit large corporate ownership of pharmacies, or, simply have all medications dispensed from public non-profit community pharmacies building on the expertise and supply chain already available in our hospital system.
Failing these solutions, this person’s troubles accessing needed drugs is a strong argument for a universal pharmacare program.