Pubdate: Thu, 23 Oct 2003
Source: Edmonton Journal (CN AB)
Copyright: 2003 The Edmonton Journal
Contact:  http://www.canada.com/edmonton/edmontonjournal/
Details: http://www.mapinc.org/media/134
Author: Susan Ruttan

ADDICTS AT RISK AS OTTAWA REDUCES METHADONE FEE

Pharmacists Get 43 Per Cent Less To Dispense Drug

EDMONTON  -  Downtown  pharmacist Dennis Vass has a special client who 
comes in daily for his methadone.

But the young native man's plan to wean himself off methadone has been 
put  in  jeopardy  by a Health Canada decision to cut the fees Vass is paid 
to dispense the methadone.

"It's just really frustrating," said Vass, pharmacist-manager at Value Drug 
Mart in Edmonton City Centre, in an interview Wednesday. "There's 
no  thought  for what these people (on methadone) go through. The only 
thought is for the cost of the program."

Health  Canada's  Non  Insured  Health Benefits Directorate this month 
announced  that  it  would  pay  the  same  fee  across the country to 
pharmacists who dispense methadone to status Indians. In the past, the 
federal fee varied from province to province.

The problem, says the Canadian Pharmacists Association, is that Ottawa 
picked  as  its one dispensing fee the lowest fee in the country, that of 
Saskatchewan.

The  new  fee  will  result  in  a 43-per-cent drop in the fee paid to 
Alberta pharmacists, a 50-per-cent drop in Ontario, and an 80-per-cent drop 
in British Columbia, the association says.

Many  pharmacists  are  now  thinking  of  dropping  out of dispensing 
methadone to status Indians because they'll be paid so much less, said 
association spokeswoman Debra Yearwood.

Dispensing methadone is a time-consuming and often thankless job, said 
Yearwood.  The user comes daily for his medication, and the pharmacist 
is  supposed  to  observe  him  taking  it.  A methadone clientele can 
sometimes  discourage  other  customers from coming to a pharmacy, she said.

Peggy  Berndt, spokeswoman for the Pharmacists Association of Alberta, 
said  one  Calgary  pharmacist estimates he'd lose $2,200 per year per 
client  if he continues dispensing methadone under the new federal fee 
schedule, leaving not even enough to break even.

Any  Alberta pharmacist who decides to continue with the lower federal 
fee  will  also  find  his  or her fee cut for dispensing methadone to 
seniors  and  the  poor,  people covered by Alberta Blue Cross, Berndt 
added.   Blue  Cross  has  an  agreement  with  pharmacists  that  the 
dispensing  fee  it  pays  can't  be  higher  than  that  of any other 
customer.

Pharmacists are now faced with informing these clients that they'll no 
longer  provide  methadone, said Berndt. Yet they're torn because they know 
it means the clients will be forced back onto street drugs.

Vass is now struggling with his own decision over his young client.

"Do  I reach into my own pocket and subsidize this person for whatever 
dollar  value it will take, and help this young person get this monkey out 
of his life, or not?" he asks.

His  client  has  already reduced his methadone dependence by five per 
cent,  and hoped to be totally free of it in six to eight months, said 
Vass.  The young man has a job, but doesn't earn enough to pay for the gap 
left by the federal cutback, he said.

Pharmacists  aren't  rich,  Vass said. They can't pick up the slack if the 
federal government decides to save money on methadone programs for status 
Indians.

Catherine Saunders, spokeswoman for Health Canada, said the government 
considers the new dispensing fee to be "fair and reasonable."
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MAP posted-by: Beth Wehrman