The Mortar & Pestle Highlights: April 1, 2014 Prescription Pricing Changes

Here is the current issue of The Mortar & Pestle (Volume 5, Issue 4, April 2014) and all previous month’s are found in the archives.  The importance of this topic deserves some additional focus on these historical changes to the pricing formula that pharmacies will used.  This represents the first major change to the pricing of prescriptions since 1994.

 

The Mortar & Pestle

Volume 5 Issue 4 (April 2014)

 

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.

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. Dispensing fees have been consolidated from a three tiered structure to a single maximum dispensing fee of $12.30.

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.

CONSUMER ADVISORY:

Compounded Prescriptions and Your Drug Coverage Insurance

 Effective Date: April 1, 2014

Dear Valued Patient,
This letter is to advise you that beginning April 1, 2014 we will no longer submit compounded prescriptions for electronic submission on your behalf.
Exceptions to this rule are:

  •  Topical anti-inflammatory products (i.e. diclofenac creams) for those with Alberta Seniors Blue Cross Coverage or Group 1 Coverage
  • Those with Alberta Family and Social Services Coverage where the drug is a benefit
  • Those with Non-Insured Health Benefits for First Nations and Inuit where the drug is a benefit

This is a result of changes made to online submission rules for coverage of these compounds made by the Alberta Government. Therefore as of April 1st, 2014, we will provide the same service, the same high quality finished preparation, just as your physician has prescribed and you have learned to expect from us.

Now, once the compounded medication has been prepared, you will be required to pay our pharmacy the full prescription price and using the official prescription receipt we provide, submit this receipt to your insurance company for reimbursement. You can obtain claim forms from your company’s human resources office or from your employer. We are in the process of making claim forms available and also providing links to the forms on our website as this information is shared with us by our clients.

We regret this inconvenience but have discovered that this will result in the best outcome for both patients and pharmacy. Patients, who have already chosen to submit their receipts to their insurance company, have reported the turnaround time for reimbursement to be very reasonable and payment to date has been complete. We will continue to monitor the situation and will advise you of any other changes. In the meantime if you have any questions about submitting your claims to your insurance company, if you have any difficulty in obtaining reimbursement or require any additional information for the claim process, please speak with one of our technicians or pharmacists.

This change will allow us to focus on what we do best and that is to prepare a high quality custom dosage form and to continue our research into new and innovative drug delivery systems. This inevitably will allow us to invest the resources necessary to bring you newer and improved custom drug therapies.

We thank you for your continued support, patronage and understanding regarding this matter.

Sincerely,

The Pharmacy Team
Stafford Pharmacy & Home Healthcare

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