Changes to Your Alberta Health Sponsored Blue Cross Plan

Apr 29, 2014Posted By: igorUnder: Health Economics, Health News

Changes to Prescription Drug Pricing in Alberta

As of April 1, 2014, you may notice some changes in drug pricing when purchasing a prescription.

These changes may result in higher or lower co-pay or out out-of-pocket expenses depending on which medications you take and what drug plan coverage you have.

If you are a senior with drug coverage through the Coverage for Seniors program, you will continue to pay 30 per cent of the cost of your eligible prescriptions up to $25 per prescription.  You may notice a difference in the amount you are responsible for paying under the 30 per cent co-pay.

Over the last few years, Albertans have seen a significant reduction in the price they pay for drugs as the Government of Alberta has sought to lower generic drug prices.   Three years ago generic drugs to be considered for coverage on the Alberta Health sponsored Alberta Blue Cross Plans (Group 66 for Seniors and Group 1 for individuals with no group drug coverage) had to be priced at 75% of the original brandname price.   That price is now down to 25% of the original brand-name price.

As an example, if you were taking a medication, let’s call it “Reductazeen®” (no such drug – just made up the name for the example) that cost the pharmacist $100 for a bottle of 100 tablets, when the patent expired and a generic version of “Reductazeen®” was available, the price had to be no more than 75% of the original brand price, making that generic drug price $75, which is now the price paid by Alberta Blue Cross.  Today, that price is now 25% of that original brand-name price of $100, making it $25 instead of the $75 from a three years ago.  That $50 per 100 tablets is a huge savings being enjoyed by both Alberta Health and the Alberta consumer.

The new agreement between the Government of Alberta, the Alberta Pharmacists’ Association and Alberta Blue Cross has also resulted in a dispensing fee change.   This is the first change in prescription dispensing fees in the last 10 years in Alberta and represent the first substantial increase to fees since about 1994.  In that time period pharmacies saw an increase in overall fees of about 3% but 1.5% of those fees were lost as a result of some reductions in inventory holding allowances.   Dispensing fees have been consolidated from a three tiered structure to a single maximum dispensing fee of $12.30 which was determined to be the average fee based on a selection of billings to Alberta Blue Cross over a certain fixed period of time.

Should you have any questions about how the cost of your prescription may change, please talk to your pharmacist.

New services offered

You can now receive further services from your pharmacist as the new agreement has expanded the role pharmacists play in our health care system. The agreement provides Albertans with more access to primary care by increasing the services pharmacists offer. Pharmacists are paid for conducting a number of specific patient assessment services including, but not limited to:

• Adjusting and renewing your prescriptions based upon your needs,
• Helping you create a health care plan specific to conditions such as heart problems, asthma or diabetes,
• Helping you quit using tobacco, and
• Providing you with injections including the influenza vaccine.

Please talk to your pharmacist to see what services they can provide you.

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