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How You Will Benefit From Ontario's Drug System Reforms

Archived Backgrounder

How You Will Benefit From Ontario's Drug System Reforms

Ministry of Health

1.

Patients

  •  You benefit because you'll get better health care.
  • Every dollar saved by lowering the price of generic drugs is going right back into the health care system to benefit all Ontarians.
  • New prescription drugs will continue to be added to the Ontario Drug Benefit Program's formulary. That means seniors and Ontarians on social assistance will have access to more drugs.
  •  Savings will also go towards initiatives like increasing the quality of our hospitals, hiring more nurses, strengthening our home care system, or reducing wait times in our emergency rooms.
  • That's why groups like the Ontario Nurses Association and the Ontario Hospital Association commended the government for taking action to reduce the cost of generic drugs.

2.

Seniors and Individuals with Ontario Drug Benefits 

  • You benefit because you'll have access to more prescription drugs.
  • The government is going to use some of the savings it achieves through these changes to expand the number of drugs on the formulary.
  • Ontario has already added over 150 new brand name and generic drugs and over 39 cancer drugs to the formulary since 2006. With these new changes, it plans to add even more.
  • That's why groups like CARP, the Canadian Cancer Society and the Heart and Stroke Foundation of Ontario think these reforms are a step in the right direction.

3.

Individuals Who Pay Out-of-Pocket

 

 

  • You benefit because you'll pay less for your generic drugs.
  •   How much less? Here's an example: A 45-year-old man who pays for Venlafaxine (a generic drug used to treat depression and anxiety) and takes a 150 mg dose once a day would save more than $330 every year once the reforms take full effect.

4.

Employees with Private Plans

  • You benefit because you may get access to a better health insurance plan or pay lower premiums for your current plan.
  •  These reforms should allow private insurers to make their drug plans more comprehensive - they may use the savings to add new drugs to their formularies or invest more money in things like health promotion and disease prevention.
  •  The reforms could also allow private insurers to lower their premiums, making your health insurance more affordable. This could have the added benefit of enabling some employers, who haven't been able to afford a health plan for their workers, to start offering their employees a health plan.
  • It's for these reasons that the following groups support the reforms:

o    Ontario Federation of Labour

o    Service Employees International Union

o    Canadian Vehicle Manufacturers' Association

o    Canadian Health and Life Insurance Association

o    The Ontario Hospital Association

o    The Ontario Teachers' Insurance Plan

5.

Pharmacists

  • You benefit because your pharmacy will be fairly compensated for the patient care you provide.
  •  The government knows that pharmacists want to use their skills to the fullest. Pharmacists are highly-trained health professionals and an integral part of the province's health care system.
  • The government is investing an additional $100 million in 2010/11 to pay for the professional services pharmacists provide to patients. While the new professional services are being introduced, pharmacies will be paid a transition fee for every prescription dispensed under Ontario's drug programs (excluding Long-term Care and Methadone):

o    $1/claim from July 2010 to March 2011

o    $0.65/claim from April 2011 to March 2012

o    $0.35/claim for April 2012 to March 2013

o    $0 as of April 1, 2013

  •  Dispensing fees will increase by $1 (from $7 to $8) for prescriptions filled through Ontario's drug programs. The increase will be higher for rural pharmacies as described below. 

6.

Rural Pharmacies

  •  You benefit from an increase in dispensing fees of up to $5 per prescription filled under Ontario's drug programs. The different dispensing fees will be paid based on the distance between pharmacies as follows:

o   Less than 5 km and more than two pharmacies in a town = will stay at new level of $8

o   5 - 10 km between pharmacies = $9

o   10 - 25 km between pharmacies = $10

o    More than 25 km between pharmacies = $12

  •  The government is doing this because it knows how important it is to ensure that the people who live in these regions have a full-service pharmacy, close to home.

7.

Taxpayers

  •  You benefit because you'll get better value for your tax dollars.
  • By eliminating so-called "professional allowances", the government is:

o    making the drug system more accountable

o    increasing direct payments to pharmacists for the valued services they provide

o    lowering the cost of generic drugs and making more prescription drugs available to Ontario's patients and seniors

o    supporting access to pharmacy services in rural communities

o    saving taxpayers millions.

 

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