Patients in Canada should have access to meds. 100%. Every pharmacist agrees with this.

But we need to talk about the dirty details of universal single payor #pharmacare in Canada.
1/🧵

cbc.ca/news/politics/… Profit is a dirty dirty word in healthcare. But I can’t pay my staff with goodwill alone. I can’t keep the lights on. And I can’t provide good patient care just for fun.

In Ontario, it costs $13 to dispense a prescription.

2/

Gather-round. Another #CommunityPharmacy story time - Why are we so heated about preferred pharmacy networks and lack of patient choice? B/c community pharmacy is patient care.
New Rx. Patient has very low renal function. Dose is too high. No problem, I know this pt, can
1/ adjust the dose. Pt also on conflicting medication. Now I want to connect with MD. Call MD. MD didn't see patient, is Rx basing off C&S but can't help me with the vitals I need to decide about conflict. No problem. I know this pt. We can manage. Call the pt. They use
2/

Ok buckle up. It's happening in live time.

My patient can't access a med. Med was prescribed by specialist THREE WEEKS AGO. Prescriber sent Rx to "specialty" Pharmacy.

I've dispensed this med before. Nothing "special" except the price.

Called the "case manager" -
1/ No, I need to call the Pharmacy.
Called the Pharmacy. Pressed the button to speak with staff. Straight to voicemail. Called again and pressed the button that I was a prescriber. Straight to voicemail. Called again and pressed the button that I needed a repeat. STRAIGHT TO
2/

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:
🧵1/ 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.
2/

In ONtario ##CommunityPharmacy may give 2nd dose pediatric vaccines at 21+ days as long as there is informed consent.

This means fully vaccinated by NYE for the first round kids.

I was on the fence about this but have decided to have my kids get their second dose next week.. 🧵 When we thought these were a two dose series the spacing was ideal for optimal immunity. Now with a booster I’m less worried about that interval knowing long term immunity is planned for. Additionally we are seeing a case rate increase. A new variant. Schools as major drivers
2/

The Ontario Human Rights Commission has commented on mandatory vaccination.

Buckle up. It’s glorious.

🧵/8 “Receiving a COVID-19 vaccine is voluntary. At the same time, the OHRC’s position is that a person who chooses not to be vaccinated based on personal preference does not have the right to accommodation under the Code.”
2/

Estimates are that 80-90% of unvaccinated Ontarians will contract COVID-19 in the next 6-12 months. You are literally choosing between the vaccine and the disease. Choose wisely. 💉 💉 💉 Math: 12 423 000 people over 12. 84% partially or fully vaccinated = 1 987 680 people unvaccinated. 1.7% case fatality in Canada. So conservatively, at 80% =
1 590 144 illnesses in unvaccinated and 27 032 deaths.
Holy. Crap. We’ve had 27 000 ☠️ in 🇨🇦 so far. This is just Ontario.