Ontario #CommunityPharmacy will begin to dispense Paxlovid shortly. Great for access. Except. We are being paid the princely sum of $13.25 for this service. Which is utterly demeaning, ridiculous and unsafe. Let’s dive into why:
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Right now for dispensing publicly funded medication we are paid $8.83 each. This covers our software, the label, vial, bag, and time for clinical & technical check (plus lights, wages etc). So this new ability to dispense paxlovid nets us an additional $4.42. Wow, right?
No.
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No.
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Paxlovid is not like most meds we dispense. There are *many* drug interactions that we must manage. Many! And in rural settings it will most often be the #CommunityPharmacist who is tasked to consider, evaluate and manage these interactions. Paxlovid expert physicians who
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Work at access centres currently, indicate that it takes at least 30 minutes for these assessments, and likely 1h at the start. For $4.42??
There are some mechanisms to bill an additional $15 once we suggest a regimen change to a physician to manage the interactions. But only
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There are some mechanisms to bill an additional $15 once we suggest a regimen change to a physician to manage the interactions. But only
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After we review for them. For patients on 3+ meds we could use the #MedsCheck program ($60 if they haven’t had one this year and $25 if they have). But only if on three meds.
Paxlovid is also new, clinically, for most of us. So we are spending unpaid time right now to
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Paxlovid is also new, clinically, for most of us. So we are spending unpaid time right now to
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Prepare to get this in place.
And when this is done at a loss many Community Pharmacies will opt out. Because unfunded work is dangerous and doesn’t get the attention it deserves. Which means some of us will take on more to help people. At even bigger losses.
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And when this is done at a loss many Community Pharmacies will opt out. Because unfunded work is dangerous and doesn’t get the attention it deserves. Which means some of us will take on more to help people. At even bigger losses.
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All of this is a real insult to a group of professionals who have moved mountains to provide care, vaccines & testing to millions of Ontarians over the last two years.
We cannot continue to supplement #UniversalHealthCare out of our own pocket.
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We cannot continue to supplement #UniversalHealthCare out of our own pocket.
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Underfunded health does not improve access or outcomes for patients.
Ontarians and #CommunityPharmacy deserve better.
I’m extremely ragey about this today. What. An. Insult.
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Ontarians and #CommunityPharmacy deserve better.
I’m extremely ragey about this today. What. An. Insult.
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Adding: Community Pharmacy Is key in access. We are working with Family Med in the most rural and remote parts of the province to improve access. But can’t do it under these circumstances
Adding more: we evaluate for interactions all the time. But never under this much of a time crunch (med has a window it must be started). And rarely with this many potential interactions. It could take us 30-45 mins just to manage one interaction. For $4.42 means no extra staff
To bring on to manage this increased workload to give this the attention it deserves. We absolutely can do this but need the support to provide the support.
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