Q. I normally get 3 months worth of my medications but lately my prescriptions have been reduced to a 30 days supply. Why is that and does that mean I will have to pay each month?
A. These are very different and unprecedented times (we sure have read/heard that word often recently) and nobody could have predicted how this would have panned out.
For one, the run on toilet paper purchases since March surprised many of us. For a time, one could not find toilet paper in any store until the next shipment arrived days later. Within hours the stores were sold out of this “precious” commodity yet again leaving customers to debate the relative merits of newspapers versus old t-shirts.
This quite naturally got people to thinking that perhaps this same situation could occur with other supplies leading some to “stock up” on their medication just in case. This was a perfectly logical response to all of this uncertainty and in fact, people were initially being advised to do so by some of our governmental officials. But the reality is that our pharmaceutical supply chains were not designed to allow everyone to have a few extra months of medication. If we allowed that to happen, we might have found ourselves in the same situation that we had with the toilet paper…. that not everyone would be able to get the supply of the medication that they require.
As well, the wholesalers began to limit the quantities of our orders to prevent pharmacies from stockpiling medications (they might send two inhalers instead of the 12 we ordered) and thus even a three-month supply could not be given as there wasn’t enough medication on hand to meet everybody’s needs.
Then, on March 20th, the Ministry of Health stepped in to help resolve this situation before it could lead to its inevitable outcome; people not having access to life sustaining drugs. They made the recommendation for pharmacies to dispense no more than a 30-day supply until further notice to try and protect the supply chain. This reduction of quantities increases the amount of times you need to refill your prescriptions, which is not only inconvenient for everybody, but for many it also means more money out of their pockets.
Back in March, nobody really knew just how long this might go on. Thus, what you might have been told then is likely very different to what you might be told today and very well might change yet again in the near future. As it stands today, if you normally get a three- month supply of your medication and you pay cash for your prescriptions, you will pay the full usual and customary fee for your first 30-day supply and then a reduced $4.00 fee for the second and third refill and then back to the full fee. Note – this may be differ at pharmacies.
Some people have their medications paid for by a private insurance plan and, as it stands now, they are continuing to pay for your medication in the smaller quantities. For those individuals that are on the Ontario Drug Benefit Plan (ODB), such as anyone over 65 years old as well as anyone on social assistance, home care, Ontario Works and other programs, the government has made significant changes to help with this increased cost. The government has opted to pay for the co-payments for all medications that meet the following criteria;
· You have the ODB as a primary drug plan
· Your prescription as originally written should have been greater than a 30 days supply
· Your medication is covered under the ODB plan
As such, many of those $6.11’s and $2 deductibles are now zero, at least for the time being. For those people that have both ODB and a private insurance plan, the government has decided to also cover the co-payments during this interim to reduce the amount your private insurance will have to pay. Keep in mind however, that this unfortunately does not apply to individuals that are paying towards their deductible for the Trillium Drug Plan or the annual $100 deductible. This also does not apply to those under 25 years old who get their medications paid for by the government since there is no deductible for them to pay in the first place. These changes will continue until the supply limit from the Ministry of Health has ended or until June 30, 2020, whichever comes first.
What happens afterwards is unknown. One hopes that the government will accurately assess the situation and make the appropriate decisions as to whether to extend these rules, amend them or rescind them. Time will tell much like anything with the coronavirus is these days.
We understand that this is frustrating for many and we ask you for your patience during these different times. Due to the increased workload imposed with the 30 day limit, not only are pharmacists filling the prescriptions more often but are dealing with a substantially increased amount of phone calls, deliveries, curb-side pick ups and more counselling of patients over the phone as they seek to minimize face to face contact or a visit to the emergency department. In addition, the frequent sanitizing of counters, washrooms and equipment are also contributing to everyone’s workload.
Everyone is eagerly look forward to the day we can resume a “new” normal, whenever that might be. In the meantime, pharmacies are limited customer numbers, offer delivery and curb-side pickup. For more information on this or any other topic, contact your pharmacist.