Friday, October 15, 2010

I've hit the big time baby!

So, my last post suggested I'm going solo.

And I've done that, so I've been preoccupied.

But now, I've clearly made the big time with a shout out in the October 2010 issue of Drugstore Canada magazine.

I guess my little blog was getting more attention than I thought (which is why I stopped blogging for a while).

When I have more time, I will put up another post.

Tuesday, June 22, 2010

I'm going solo.

That's right.

There's been a lot of talk (and crying) in Ontario about how the retail pharmacy industry is in trouble thanks to the new drug reform It's true, the drug reform will hurt the retail pharmacy industry. But let's be serious, does a company like Shoppers Drug Mart or Rexall really need more money? I mean these guys have more money than some small countries!

So, while all the pharmacy owners out there have been crying foul about how their bottom lines will be hit hard with the implementation of these changes, I've been quietly taking notes and figuring out how I can take advantage of this new shape of the industry.

And, I'm confident that opening up an independent pharmacy in the immediate future is the right move to make from a professional and business perspective.

There is still lots of dollars in the industry to be had. I know I won't be making billions like SDM, but even if I can take a small percentage of what one of their stores makes, then I will be doing just fine. My overhead and expenses will be lower because it will be just me, and I know for certain that I can out-customer-service a Shoppers or Pharma Plus Rexall with my eyes closed and hands tied behind my back any day of the week.

Don't get me wrong, this isn't going to be easy, I know. But the bottom line is that all these changes were inevitable...and this isn't the last major change to the industry in my lifetime. But it was now or never.

So here I go, wish me luck.

Thursday, April 29, 2010

Small pharmacy is really screwed, but that doesn't mean I can't be only a little screwed.

So, it's been a while since I last posted.

What's happened since then? Well, I've had some excitement in my personal life, but this is not the forum for that.

And in my professional life, well, all has gone to hell, as they say. The Ontario Government has decided they aren't happy with how well the retail pharmacy industry is doing these days, so they've decided to slit our wrists, give us a bandaid, and let us all bleed out slowly. And by "us" I mean pharmacists in Ontario. Go to or for more info. Educate yourself, but in the meantime, here's my take.

The government has announced they will be eliminating all forms of professional allowances to pharmacies from generic drug companies (which is about 750 million bucks/year), while slashing the allowed cost of generic drugs to 25% of the brand name price. They did, however, agree to increase the Ontario Drug Benefit (ODB) reimbursed dispensing fee from $7 to $8 - which is very nice since they've only increased it by $0.56 over the past 21 years. Hrmmmmm....maybe its cus they knew the funding model for drugs in Ontario was screwed up and they were okay with letting pharmacies and generic drug companies work out their own deals. So now the government wants a piece of the action...or probably is thinking, "if we can't have a piece of the action, no one can". They did agree (but haven't given specifics yet) to fund pharmacists for the provision of certain professional services. Who knows what that will be and how much it will pay or even when it will take effect.

Bottom line is this: they are removing about $750 million from the industry and only giving back $250 million....where the heck is the difference coming from? The answer is the public. The innocent bystander who hears from their elected government that they will be saving money on drugs. But if pharmacies are going to lose money on every prescription they fill, either someone will pay, or pharmacies will start cutting back and going out of business.

It's happening already. People are getting laid off. Hours are harder to come by. Previously free services are being charged for (eg, $5 per delivery of a prescription). And the smaller pharmacies who aren't 17,000 square feet with 5000 square feet of high end cosmetics (and aren't receiving kickbacks to stock those cosmetics, by the way), will get hit the hardest. The independent pharmacy. Not the large/public corporations like Shoppers Drug Mart or Rexall Pharma Plus (Katz Group).

Thanks Premier Dalton McGuinty and Health Minister Deb have officially solidified your role in Canada's history as the government that destroyed the pharmacy as we know it, and as we have known it for the past 20 years or even longer. Wait you two. One day soon you or someone you love will likely need a pharmacist... And by then these changes will have had time to have their full effect on the industry. And when you need the assistance of your pharmacist and don't get it or have to pay out of pocket or have to wait a very long time, I hope you curse yourself. I can only imagine what you would do if someone came along and said "you are not allowed to make the salary you have been getting for the past 20 years anymore, so now will earn 50% less for yet to be determined increase in workload." Ya, good luck with that.

I'm not really all that upset with making changes. Seriously, I agree we need lower drug prices. I'm just upset with how they went about doing it. The government created these "professional allowances" in was their idea!! And now they are making pharmacists look bad for using that. And they are being vague and unwilling to negotiate or discuss possible resolutions with any of the pharmacy associations/groups. They are making drastic changes to and industry they know little about. And just because they pay for the largest insurance plan in the company and want to reduce their debt, they figured that by paying less for drugs, their debt will decrease. So why not legislate lower prices? Genius they thought. Meanwhile they will screw millions of people in the coming years.

Until then, I'm not going to let you burst my bubble. I am still going to open my own pharmacy. I will modify my business model to account for your stupidity and arrogance and future inevitable stupidity. I will do whatever I can to prove myself and the services I provide to my patients are worth their time, loyalty, and business. I will let them know that the government doesn't really care about anyone but themselves. I will succeed whether you try and stop me or not.

That was my rant on the current situation in the retail/community pharmacy industry in Ontario.

Until next time,

The Canadian Pharmacist.

Monday, February 1, 2010

Hey Ontario, why can't you be more like Alberta?

The article below is cut and pasted from the Canadian Healthcare Network's website (but you may need to log in to view I inserted it below)

This is kind of what I've been talking about. Except it's a resolution that kind of makes sense for the future of pharmacies. Although it will never be like it was 10 years ago, it's better than things look....

Alberta pharmacy agreement inked
Written by Barbara Kermode-Scott on January 29, 2010

Collaboration has proven key in negotiating a good deal for Alberta’s pharmacists, pharmacies, public, patients and provincial government, argues Margaret Wing, acting CEO of the Alberta Pharmacists’ Association (RxA).

“This is a great story,” said Wing in response to the Alberta government’s January 28 announcement of a new pharmacy funding and services model agreement for the province. “We feel that the collaborative approach is what has helped us achieve this agreement… Other provinces need to learn from what Alberta did that collaboration is a great path. It’s better than fighting!”

In October, 2009, a joint Ministry-pharmacy transition team was established in Alberta to seek a common approach to addressing prescription drug costs, rising drug utilization, and the need to maintain a solid economic foundation for community pharmacies. The goal was to identify and implement a sustainable, long-term model for pharmacy services and compensation, and to address transition issues arising from phase two of the Alberta Pharmaceutical Strategy. This group included representatives from RxA, the Canadian Association of Chain Drug Stores (CACDS) and Alberta Health and Wellness. Together, RxA and CACDS memberships represent more than 90% of Alberta community pharmacies, says Wing.

Other provinces need to learn from Alberta that collaboration is a great path. It’s better than fighting!”

Phase 2 of Alberta’s provincial pharmaceutical strategy is a win-win, suggests Wing. Patients will benefit as they will have access to lower priced generic drugs and a wide array of pharmacy services. Pharmacies win as they will have stable, predictable, sustainable funding over the coming years, and the government wins as they will reduce rising prescription drug costs.

“The government showed real leadership on a challenging issue,” said CACDS chair Mark Dickson. “The need to modernize pharmacy funding and services is not unique to Alberta. But the solution and co-operative nature of our discussions show that this province understands the growing importance of community pharmacy care, and that the government wanted to build a system that would serve Albertans well over the long-term.”

On April 1, the price of currently available or existing generic drugs will be reduced from 75% to 56% of the price of comparable brand name drugs.

The Alberta Government anticipates saving about $100 million through reduced new and existing generic drug prices as well as through other related cost saving initiatives contained in the pharmaceutical strategy.

Under the new agreement, Alberta Pharmacies will have a new remuneration model that goes beyond fee for service to compensate pharmacists for additional services they offer, such as patient consultations, medication reviews and immunizations.
The government is providing $75 million over three years to help pharmacies move to the new compensation model. Through the transitional allowance government will provide additional payments to pharmacies on top of their current $10.93 dispensing fee for prescriptions less than $75:

* $3 per prescription ($13.93) from April 1, 2010 through March 31, 2011
* $2 per prescription ($12.93) from April 1, 2011 through March 31, 2012
* $1 per prescription ($11.93) from April 1, 2012 through March 31, 2013

Rural and remote pharmacies will be eligible for additional funding based on criteria such as proximity to an urban centre and number of pharmacies in the community. The Alberta Government has established a $5 million fund for this purpose.

The new payment model will be announced later this year after a pilot project has been completed and evaluated.

More information regarding Alberta’s Pharmaceutical Strategy can be found at:

Sunday, January 31, 2010

Call To Action

In Ontario over the past several weeks, the major players in the retail pharmacy industry have banded together to deal with the current state of affairs. The big three involved are: The Canadian Association of Chain Drug Stores (CACDS), the Independent Pharmacists of Ontario (IPO), and the Ontario Pharmacists Association (OPA). They have even collaborated and formed a website ( to convey their messages and spread the word via facebook groups.

Why? Money, obviously.

And don't get me wrong, I'm all for improving the future financial situation of my profession. It's just funny how these things play out. In reality, the independent pharmacists despise the chain pharmacies, and the chain pharmacies want to wipe out independent pharmacies. Both bad mouth the other to their patients (I've seen and witnessed this on several occasions; and doing relief for both the chains and independents, I can say that confidently).

So why all this hooplah? The government is toying with the idea of getting rid of all rebates, or setting a very pathetic cap on the whole thing. This would cripple pharmacy as we know it. I won't get into the details, but trust me. You think we stay alive making $7.00 on a prescription? Umm, no. It's the rebates we get behind the's always been the rebates. It's no secret. Think about it...has the dispensing fee for ODB (ODB is the government funded drug plan) gone up in the past decade? No. Has inflation...hell yes. Does there seem to be a problem here? Yes.

So picture this. The government never raised the dispensing fee for the past 20 or something years because they knew pharmacies were getting money elsewhere (the rebates from the drug companies). Yes, the government knew all along!! And now, they're saying no more rebates, and we're not going to increase the dispensing fee to make up the difference in revenue. What will happen? Well, patients will suffer and so will pharmacies who focus on prescriptions (and not cosmetics).

So the Ontario Community Pharmacies have banded together to create awareness and try and get the government to change what they are proposing. What are they proposing exactly? Well the people who are meeting with the government won't tell us. Seriously. Even at one of the "Call to Action" meetings which are still taking place at various places across the province, there is some confusion. We are being urged to get our patients to "help us" and have them sign postcards and fax forms to send to the government to "save pharmacy". But even as all of the major players band together and urge the pharmacists of Ontario to do these things, each of the different groups has their own agenda. The meeting told pharmacists to collect signatures and send them off. But then the head office of the chain pharmacies say something different like "ignore what you heard, and do what we tell you instead".


How is anything ever going to get accomplished if the people getting together to speak on behalf of all pharmacists, will sit down at meetings, look each other in the eyes, make a plan, and then do something different?

Call to action? Ya, good luck with that.

The fate of the future of pharmacy in Ontario is in the hands of a bunch of boneheads.

Sunday, January 17, 2010

Long break...

Well happy 2010 world.

I took some vacation time. And since you were staring, tapping your fingers, and pacing back and forth, I decided to take a little longer than necessary. ;)

So, what have I been up to? Well, I'm still thinking about, thinking about, opening my own pharmacy. Being a pharmacist and never taking a business course ever in my life, not even in high school way back, learning how to go about starting a business has! So it may take me longer to understand concepts or terms that come second nature to many business-types. But I've read a couple books on business plans, which inevitably lead me to the internet to search out definitions and further explanations of terms and concepts. Did you know that pro forma means "completely made up"? Why can't they just call it a "made up financial statement" instead of a pro forma? That would be way easier for the average person to understand.

One of the main problems I foresee in this potential venture is the future of pharmacy in Ontario. The government in the past couple years has decided to make the drug rebate side of the business "transparent". So by doing this, they also thought it wouldn't look so good if the transparency showed that pharmacies are getting 60% now pharmacies can only get 20% on drugs purchased for publicly funded people (seniors and welfare). In some cases, the reimbursement for some drugs was less, yes less, than the actual acquisition cost. WTF? This left the field wide open for the brand name that's how pharmacies have been making it up over the past couple years. Now, they're discussing capping the brand name rebates to 20% or something also! What does this mean? It means the future of pharmacy as we know it in Ontario is in jeopardy. It means only the big box stores who buy in large enough volume to make a 20% rebate worth it, and who have a large enough front shop to supplement their sales with high-end cosmetics, will survive. It's almost like the government is angry with pharmacists for making a living over the last 40 years.

The problem I see, is that dispensing fees have been the "transparent" side of how pharmacists make money. The average consumer hates the dispensing fee and thinks a $9.99 fee or (gasp) $10.99 is absurd! The reason these fees haven't gone up over the past couple decades? You got it, cus pharmacies were making money in rebates and didn't bother passing on the inflation in the cost of dispensing to the customer in the form of a fee. What happens next? Well, if you raise your fee, you upset your customers and eventually lose business. If you don't, you'll eventually go broke anyway.

So, the state of pharmacy affairs in Ontario is uncertain and grim. Do I start a pharmacy or not?
Do I risk everything I have to start something I've been dreaming about for years with a 50:50 chance of making it. And even if I "make it" will it be "worth it". I mean, I love being a pharmacist, but let's be serious, this venture would be a business decision. Is it worth it?

Who knows. 2010 just got underway. I've got a feeling this year will be a tough one, but a memorable one.

So happy 2010 world.

Thursday, December 3, 2009

Apotex Shortages Explained

Good Morning.

I woke up this morning to rain. Not snow. I guess that's okay for this time of year.

First guy that walks into the pharmacy was looking for his Oxycontin. Sorry, still too early. And tomorrow will also be too early. See you in a few weeks.

Funny how when there was a shortage of pharmacists a few years ago, the media didn't cover it like they cover the doctor shortage, eh?

Seriously, I know we're not preceived as more important, but why not at least give us some recognition for what we do for the public.

In other news, I spoke with a rep from Apotex yesterday about all the drug shortages that pharmacies all over Ontario (and probably Canada) have been experiencing. Here is basically what he told me: Apotex applied for approval of it's Canadian facilities to manufacture drugs for sale in the US. The FDA told them to change a bunch of things to get up to their standards (uh, oh). So then the rest of the world decided we want to do what the FDA does. Now, Apotex is going through major process, SOP, and QA adjustments in all of it's plants. For example, they found traces of penicillin in one of the plants that isn't supposed to have penicillin in it (big uh, oh.) And so during this whole process, they have shut down or slowed down manufacturing certain lines or drugs or whatever. End result, pharmacies can't get product they rely on, and patients are suffering.

That's all I've got on that. I guess this is good for all the other generic companies.

What else is happening in the world of health today? There's been some talk about increased incidence of infection in ICU's. They're saying infections in half of the world's ICUs!!? I have a good friend who is an ICU doctor. His nick name in Univeristy was "filthy". Coincidence?

I also got some good gossip on where various people in the industry are today (ie, job changes, etc). But, I'll save that for another day.