Alberta pharmacists face fee rollbacks as demand grows and budget soars

Pharmacists are pushing back against the Alberta government’s decision to reduce some of their fees, warning that the cuts could result in job losses and negatively affect patient care.

On Monday, Health Minister Adriana LaGrange informed pharmacists of the changes through a letter, citing budget concerns.

She explained that the pharmacy services budget for this fiscal year is projected to exceed its $670 million target by $30 million. To address the shortfall, the payment for comprehensive annual care plans will drop from $100 to $70. Additionally, pharmacists will now only be able to bill for four follow-ups and medication reviews annually, down from the previous limit of 12.

Calgary pharmacist Randy Howden expressed frustration with the decision.

"One of my colleagues was in tears when I spoke to them yesterday," Howden said.

As a former president of the Alberta Pharmacists' Association, Howden emphasized that these cuts will directly impact the care pharmacists provide to vulnerable groups, such as seniors and patients with chronic conditions. He noted that care plans often include education and discussions on topics like diabetes management.

"Having these fees cut is pretty drastic," Howden said. "And reducing the number of follow-ups means if I meet with a senior every month, I’ll only get paid for the first four months, and after that, I’ll be working for free."

Margaret Wing, CEO of the Alberta Pharmacists' Association, raised concerns that the cuts could lead to job losses or force pharmacists to spend less time with patients, impacting care quality.

"If patients can’t access pharmacists and don’t have family doctors, where do they go? They’ll turn to the hospital system, which is already under pressure," Wing said.

Wing noted that pharmacy service spending has been steadily increasing over the past 18 months, and the growing demand was well known.

"This outcome wasn’t a surprise, but the government's response certainly is," she said, explaining that the budget was set years ago, but demand for pharmacy services has grown since then.

"It doesn’t seem like a responsive approach to meeting the needs of Albertans right now," Wing added.

The timing of these cuts is also raising eyebrows, as Alberta faces a shortage of family physicians, and pharmacists were expected to help fill gaps in primary care.

"Until now, the message from the government was that pharmacists could provide certain kinds of primary care to help address the shortage," said Fiona Clement, a professor in the Department of Community Health Sciences at the University of Calgary. "So it’s surprising to see fees reduced, as it could have the opposite effect—discouraging more pharmacists from engaging in primary care."

Clement warned that the pay reductions are likely to impact how pharmacists deliver services.

"At the end of the day, pharmacies are businesses, and this will likely change how people interact with their pharmacists," she said.

In a statement, the health minister's office assured that pharmacists would still offer care plan assessments and follow-ups.

"The decision to make these changes was made with both financial sustainability and service quality in mind, aiming to minimize disruptions to primary care access for Albertans," the statement read.

The government added that discussions with the Alberta Pharmacists' Association are ongoing, with the association having already suggested alternative ways to cut costs.

"The government will continue evaluating the feasibility of the association’s proposals during consultations for a new pharmacy funding framework, scheduled for early November," the spokesperson said.

The changes will be implemented through a ministerial order and will take effect on November 1.