Monday, April 26, 2010


I fixed the wonky sock for the hubby. He's already worn them twice. I had to snatch them out of the dryer to get a picture or two...
They are now the same size:

And are being worn quite happily:

Hooray for happy feet!

Tuesday, April 20, 2010

Pharmacy Roundup

I have talked your 'ear' off about the govt funding cuts. A couple of points I don't think I made in an earlier post:

the so called 'inflated' price of generic drugs was set by the provincial govt itself, so who can they blame but themselves?

The 'kickbacks' are actually manufacturer rebates. If Walmart can get rebates from manufacturers on soup to nuts, why isn't pharmacy entitled to the same?

Now, if the govt actually goes through with this piece of ill-thought out legislation, the ones who are gonna suffer will be the smaller, independant pharmacies. Walmart will simply subsidize pharmacy sales with the sales from their shoe departement or the like.

Smaller pharmacies are going to have to makeup the revnue, often in the range of $100,000 a year. They are going to do this by charging for things that up to now were free. Such as delivery. Blisterpacking (where the pharmacy packages up a weeks worth of medication in 'blisters for the patient, So they just pop open the breakfast blister for all their morning medications etc) will now have a 'packaging fee'. Need us to fax your doctor for a refill because that's what the doctor's office wants you to do? We're going to have to charge you for that service.

Need some help picking out a cough syrup? Hope you don't mind waiting because with the staffing cuts that are going to happen, the pharmacist is going to be busy for the next 20 minutes before they can get to your question.

Is your drug plan acting up and saying you owe a deductible or just outright rejecting your card? We're going to say that YOU have to call them and get it sorted out.

Doctor didn't put the limited use code on your prescription so ODB will pay for it? You are going to have to call them to get them to fix it, we won't have time.

Obviously this is going to hurt the people with lower incomes first. The disabled, the elderly. These are exactly the vulnerable groups that NEED our help. But we won't have time, we will be busy doing things that actually get us paid.

Pharmacies are going to have to bill the way lawyers do. For EVERYTHING. How many people do you know can afford the kind of fees lawyers charge?

Stop the govt. Call your MPP. Go to this website, click on the orange button and tell the govt they are shortsighted.


Monday, April 19, 2010

Done. Well, Almost

I finished the hubbunny's socks!

Hmm, something doesn't look quite right:

Dammit! Off to unpick my toe-graft and add about an inch....

Sunday, April 18, 2010

you bought what?

For those of you who wear super low-rise jeans and don't want to show butt-crac, you can buy these sparkly buttcrack covers,

On the same note, have any of you seen that ad for Lysol Hand's Free Soap Dispenser? The theory is that the pump on your soap is teeming with germs. If you have their hands-free device, you won't get contaminated by the germs on your soap dispenser. Umm, aren't you washing your hands AFTER you touch your supposedly germy soap? So what difference does it make? Other than to Lysol's bottom line, that is

Friday, April 16, 2010

Clarifying the Dispensing Fee and Fingernail Friday!

Skip to the end for the fingernails if you wish......

Alrighty. We have covered the fact that the $7 dispensing fee that the gpvt pays is not enough as it stands right now. However, who is REALLY paying the dispensing fee? In many cases, it's NOT the government. That's right. ODB is a 2 tier system. People on lower incomes ($16 000 a year for a single person, $24 000 for a couple) pay a $2 copay. People that make more than the cutoff pay the first $100 a year then they pay $6.11 . (this is all per prescription) The $2 and the $6.11 are actually the dispensing fee. The govt pays $5 for the lower income people and $0.89 for the higher income people. So, really, the government is NOT paying the fee. Or even most of the fee in many cases. Thus all their posing is just that, posing. Now, the government claims that they are giving us a raise in the dispensing fee. Who is going to pay that? The client or the govenment? I have not heard a clear answer on that. But I bet it's NOT the government.
and now, on to the important part of the post...FINGERNAILS!

Thursday, April 15, 2010

What You Get for Your Money

What do pharmacists do to earn their paltry $7 fee?

when I get a prescription, it is entered into the computer. Hopefully, you get all your medications at one store, so I can look quickly at your file and deal with any issues. Some of the common issues:

1. Drug interactions. Some are a big deal and I have to call the doctor with other suggestions or options. Some are not a big deal and can be ignored.
2. Dosage changes that weren't really meant to be. Doctor wrote for the 100mg when last time it was 50mg. Generally I ask the patient if they are expecting a change. If not, then I call the doctor.
3. Illegible prescriptions or prescriptions printed off a computer where the doctor chose the wrong thing off the drop down menu. I have to call the doctor to clarify
4. Drug isn't covered on your plan. I call the doctor to suggest alternatives that ARE covered to save you a few bucks.
5. Drug is something called a 'limited use' drug, which requires that the doctor write a code on the prescription so we can bill your drug plan. And the doctor didn't write the code, or used the wrong code.
6. Drug is no longer made or is on back order or is something so rarely used it is a special order which won't be in till tomorrow

These are the ones that spring to mind, There are many other less common issues that crop up on a daily basis. All of the above require a call to your doctor to sort out.

Other things you pay for with your fee:
Counselling when you pick up your prescription. Advice on what over the counter medication to buy when you have a minor problem. Triage services. Basically, should you go to the emergency room or not? Pretty much anytime you talk to your pharmacist for free. It is 'free' because of the dispensing fee.

Some of the funnier questions I have had over the years:
I broke my mercury thermometer in my swimming pool. What should I do? (call a pool specialist)
I was doing some renovation work on my house and took the grate off the heating vent. My cat climbed into the hole and won't come out. What should I do? (How would a pharmacist know? Call an HVAC guy)
Do I know where the phone caller could buy jimson weed? (um, no)
I dropped my Zantac pills into the sink and tried to dry them out by putting them in my frying pan to dry off. (they actually brought those in. They were scorched black and STUNK!)

Wednesday, April 14, 2010

Tuesday, April 13, 2010

What is a Dispensing Fee?

Currently the Ontario Government is forcing sweeping cuts to how pharmacists are compensated. One flashpoint is how prescription drugs are priced. There is a perception that drugstores are cash cows. The reality is very different.

Basic pricing on a prescription is as follows: Drug cost at manufacturer cost+8%+dispensing fee.

This seems fairly clear. However, the cost at the manufacturer level is not the same price I can buy the drug at for sale in my store. I must pay a wholesaler their cut. So, if a drug costs $5 a bottle, I pay $6. My 8% markup is based on the $5 price. So my profit has started to erode. The dispensing fee is the cost to fill the prescription. It was put into place many years ago for the simple fact that the pharmacist pays the same level of attention to a drug that costs $1 as to a drug that costs $400. So the 'real' profit may be considered to be in the dispensing fee.

The dispensing fee the government pays is $7. The actual cost of dispensing a prescription is around $14. An average pharmacy in Ontario does over half their business with ODB (Ontario Drug Benefit)

Where does this other $7 come from? Basically, from professional allowances. These are, in essence, bulk discounts. The manufacturer says "buy $X worth of drugs and we will give you $Y in rebates.

More on that tomorrow. Otherwise this post will be waaaaay too long!

Pharmacy in Ontario

As many of you who read my blog know, I am a pharmacist. Recently the Ontario government announced sweeping changes in how pharmacy operates. First, a little background information.

All pharmacies in Ontario are PRIVATE retail businesses. The government does not own any of them. The government runs a drug plan called the Ontario Drug Benefit program. ODB for short. This plan is similar to Blue Cross, Green Shield etc. In fact, most drug plans base their model on the ODB medel. The way it works is thusly: A patient brings in their prescription. The pharmacist enters it into the computer along with the patient's drug plan number. This information is sent over the internet usually (sometimes by dial up modem etc) to a centralized computer, be it the Green Shield computer or the ODB computer. Said computer then spits back a response. This response is usually a 'paid' response. In this response is the patient's deductible (if any) and how much the plan deigns to pay the pharmacy. Yup, what we bill and what the drug costs is NOT necessarily, or even often, what we actually get paid.

Here is where it gets tricky. Basically, as the province's largest drug plan, ODB has negotiated a cut-rate fee. Similar to how , say, an interior decorator may get a discount on paint because she buys so much. However, ODB and many other drug plans, have started to cut back what they pay us. This happens in a variety of ways. One of the easiest things for the plans to do is...nothing. So when the manufacturer ups their price on the medication, the plans conitnue to pay the old price. So that eats into our proft margin as well.

The other way that the government eats into our profits is by not changing what they pay for the dispensing fee. Remember, the fee is basically where the profit would be. The government has increased the fee by a whopping $0.54 since 1989. That works out to around an 8% increase for a 21 year span. Clearly costs have increased more than 8% over 21 years! Do you know anything that has not increased more than 0.38% per year???? Basic inflationary costs are around 3%. Per year. So the govt has been getting a MASSIVE deal for their $7. Yet they claim to be paying too much.

Next installment. Where the money goes. Or what you get for your money

Monday, April 12, 2010

Garthering Supplies

I am getting the finishing touches together for my bag. Found some nice, basic fabric in a non-icky colour for lining. Couldn't find a zipper at the same store. I need a 12" zipper. All they had in 12" were plastic ones. Which didn't strike me as very sturdy. Not sure where else to look. We only have the one fabric store in town, really. Do quilting shops carry zippers? Michaels? Anyhow, here are the pieces I've gathered so far:

Off to search for zippers.....

Wednesday, April 07, 2010

Could it be?

Finished. And then again it might not be. But the Bag is closer to being finished than ever before. Yup, the body of the bag is done. I have started strap knitting. Oooh! That sounds kinky. I made the bottom a different colour for kicks and also made it a bit wider than the pattern calls for. As written, the bag would be about 3 inches wide on the bottom. I wanted a bit more so I aimed for 4-ish inches wide. All in all I am pleased.


Thursday, April 01, 2010

Fingernail Friday on a Thursday

Since this friday is Good Friday, I decided to do fingernail friday a day early: