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 (http://ontario.communitypharmacies.ca/) 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 scenes...it'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".

Huh?

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.

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 been...fun! 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% rebates...so 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 drugs...so 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.