Manitoba couple could pay extra $1,500 a month for medication after funding changes

A Winnipeg couple in their 70s are worried they will have to dip into their savings to pay for medication following an upcoming change in how Manitoba Health covers the preparation of some prescription medications.

George Shallcross, 74, has end-stage Parkinson's disease and takes medication 25 times a day.

"Right now it's all freeit's totally free," said George's wife, Susan Shallcross.

However, that will change on Aug.18, when a cap on pharmacy dispensing fees for provincial drug programs comes into effecta change Health Minister Kelvin Goertzen saidin a statement is expected to save about $11 million a year.

George can no longer swallow or talk because of the pain from his illness. All of the medication he takes to manage that pain is compounded a pharmaceutical term for altering a medication to meet a user's needs. In George's case, that means liquefying the medication and putting it into a syringe. He then injects the medication into the feeding tube in his stomach.

Susan said it's the process of turning his medication into liquid and filling the syringes that will soon cost extra.

"I thought this program was bulletproof," she said.

The couple received aletter from their pharmacy informing themthe cost of filling the syringes will no longer be coveredby Manitoba Health. The process of compoundingthe medication will only be covered up to a certain amount.

With Georgetaking 175 syringes a week, hispharmacist estimates the change will cost the couple $1,200 to $1,500 a month.

"They're robbing Peter to pay Paul here. It just doesn't make sense," Susan said. "Half of the time, the people who make these decisions, they haven't even asked patients what they want, what they need."

Her husband lives at home and not in a palliative care unit because, for the most part, he can still care for himself. He makes her a cup of tea every morning andadministers all of his own medication, she said.

"My husband is home here because we want to be here with him at home," she said. "He wants to see his children whenever, he wants to see his grandchild whenever."

No consultation, pharmacist says

Tache Pharmacy, which is the largest compounding pharmacy in Manitoba, said it was not consulted about the funding change.

Assistant manager Scott Groen said the pharmacy does not want to pass on the added costs for making up these more complicated and time-consuming prescriptions to its patients, but has no other choice.

"Time, unfortunately, does equal money," he said.

"Change was probably inevitable with this system, but one of the things that is lacking in it is an appeal process," he said.

"There is always going to be exceptionpatients that are out there that are requiring different services that ManitobaHealthdoesn'tknow about."

Groen is encouraging all of the pharmacy's clients to reach out to Manitoba Health or the health ministerto voice their concerns.

The province confirmed as of Aug. 18, pharmacy dispensing fees will be capped at $30 for "non-sterile preparations" and $60 for "sterile preparations."

"There are no changes to the coverage of the ingredient drug costs," said a provincial spokesperson.

"If a particular pharmacy charges [dispensing] fees beyond those amounts, that is their prerogative, and patients are encouraged to compare services and prices across pharmacies."

The cost of preparing medications varies depending on the type, he said.

"Patients are encouraged to speak with their pharmacist about the costs associated with dispensing and they may need to find a pharmacy that provides the service they need at a cost they are willing to pay if it exceeds the amount covered through one of the provincial drug programs."

The province said in the 2016-17 fiscal year, about 26,000 prescriptions with a dispensing fee were covered by a provincial drug program. Of those, about four per cent (1,040) had a fee "higher thanwhat the new policy will cover."