Manitoba drug stores may need to advertise dispensing fees

The Manitoba government is facing pressure from supporters to get pharmacies to list dispensing fees so that consumers can shop around for the best price. (Mark Blinch/Reuters)

Manitoba is looking at becoming one of the first provinces in Canada to force pharmacies to disclose how much people have to pay to get their prescriptions filled.

The NDP government is facing pressure from supporters to get pharmacies to list their dispensing fees so consumers can shop around for the best price. A spokeswoman for Consumer Protection Minister Ron Lemieux says the government is looking into how to make the fees more transparent.

Rachel Morgan said Lemieux has been asked to look into the issue.

"We are looking … to see what role the Manitoba government can play in helping Manitobans get a clear, upfront understanding of pharmacy dispensing fees and fair prices on medications," she said in an emailed statement.

Lemieux was out of town and unavailable for comment, said Morgan, who declined to say what options the province is weighing.

No other province has forced pharmacies to advertise their dispensing fees, Morgan said. But the bylaws of the College of Ontario Pharmacists require druggists to post their fees and break out the fee if they advertise drug costs, she added.

Pressure is growing on Manitoba to do something. A survey by Royal Bank last year found the province's residents pay the highest average dispensing fees in the country — anywhere between $4.50 and $13 a prescription.

Delegates at a recent NDP policy convention in Winnipeg passed a non-binding resolution calling on the government to look at protecting consumers from "excessive fees and price gouging" by forcing pharmacies to display their dispensing fees.

The resolution also urged the province to ban filling year-long prescriptions in three-month increments, forcing consumers to repeatedly pay dispensing fees, unless there is a medical reason to do so.

Winnipeg NDP backbencher Deanne Crothers said she has been pushing for the government to do something after hearing concerns from seniors in her community. She points out that high dispensing fees can add up for anyone, especially for those with repeat — and routine — prescriptions.

"I have a six- and a four-year-old going through ear infections and strep throat. It isn't always obvious what the fee is," Crothers said.

"It's just fair that we find a way to make sure pharmacies are plainly stating how much their handling fee is, so if someone is on a limited budget, particularly someone who is dealing with a health issue … they can … make an educated choice about where to get their prescriptions filled."

Crothers said she has talked to Lemieux and is hopeful the government will do something.

Ronald Guse, registrar of the College of Pharmacists of Manitoba, said the college hasn't been consulted so far by the government on this issue. Regulations already exist which spell out how a pharmacy can advertise its fees and a pharmacy must outline the fees if asked by a patient, he said.

"We're not opposed to it, we just want to know a little more about what they have in mind and what they're trying to accomplish," Guse said. "If it is to inform the public, we want to make sure that the information the public is getting is helpful and useful for them."

Ron Schuler, consumer protection critic for the Opposition Conservatives, said the law already allows pharmacies to spell out their dispensing fees. The last prescription receipt he got clearly broke down the cost, he said.

"It's something they're doing already voluntarily," Schuler said. "I don't know what's broken that they're trying to fix."

Noralou Roos had never given much thought to dispensing fees until she took a prescription for thyroid medication she has been on since high school to a new pharmacy last year. Roos said she was told the pharmacy could not fill the year-long prescription in anything other than three-month increments.

That meant she had to pay the dispensing fee four times instead of just once.

"I was really irritated," said Roos, a professor in the Faculty of Medicine at the University of Manitoba and a founding director of the Manitoba Centre for Health Policy.

"I went home and I realized I had just paid essentially as much for the three months as I had for my previous full-year prescription, because it's a cheap medication and the prescription dispensing fee was $20."

Roos said she discovered the issue was a bit more complex after talking to some colleagues in the pharmacy department. She was told that as pharmacists are asked to take on a greater role in health care, the best way to compensate them is through dispensing fees.

"It's a big issue that nobody has figured out how to appropriately pay pharmacists."

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