CPhA asks Canada Health Infoway to delay upcoming $0.20 transaction fee for e-prescribing service

The Canadian Pharmacists Association (CPhA) has requested that Canada Health Infoway halt implementation of an upcoming fee of $0.20 per transaction for its e-prescribing service, PrescribeIT.Pharmacy associations across the country have raised concerns that the proposed new fee, scheduled to come into effect on Jan. 1, 2025, will force many pharmacies to withdraw from the service over financial constraints—and the perception of unfairness.“This $0.20 per prescription fee is fundamentally inequitable because [although the service benefits both prescribers and pharmacies] only pharmacies are being asked to pay for it,” said Joelle Walker, vice-president of Public and Professional Affairs at the CPhA. “The problem is that this solution, PrescribeIT, which has been federally funded up to now, has decided to put the cost solely on the backs of pharmacies.”Since its launch five years ago, Canada Health Infoway has been able to offer its PrescribeIT service free of charge to pharmacy professionals through financial support from the federal government. But, earlier this year, Infoway announced that additional fees would be necessary to ensure the long-term effectiveness and quality of its service.In response, pharmacy professionals from across the country have expressed concerns about the impact these proposed fee increases will have on independent pharmacies, which lack some of the resources of larger pharmacy chains.“They already operate on thin margins, particularly in rural and remote areas, and this additional cost burden could be felt more acutely by them," said Walker.While she stressed that PrescribeIT is a crucial part of Canada’s e-health strategy, the financial burden imposed by this fee structure threatens to undermine the sustainability of the role pharmacist play in the broader healthcare system.According to a survey conducted by the CPhA earlier this year, more than 65% of Canadian pharmacists said they would stop using PrescribeIT if these fees were introduced—a scenario that, Walker warned, the sector could not afford.Indeed, a growing number of Canadian pharmacy owners have publicly announced that they have quit their PrescribeIT contracts. And in response, a number of physicians and physician groups who use PrescribeIT have declared that they will not accept faxed requests from pharmacists. A number of regional pharmacy groups, including the Pharmacists’ Association of the Niagara Peninsula and the Pharmacists of Grey Bruce Counties have issued notices to area physicians stating: “We believe that prescribers who restrict communication to only PrescribeIT are violating a part of the Canada Health Act R.S.C., 1984, c. 6, s. 3: ‘to facilitate reasonable access to health services without financial or other barriers’.” Physicians have suggested that pharmacies simply add the $0.20 transaction fee to their dispensing fee, not realizing that to do so is not permitted under pharmacies’ contracts with their provincial drug plans. Absorbing even a small additional cost out of a dispensing fee that hasn't increased in several years, despite increasing operating costs, could be a serious blow. Read: This PharmaChoice member dropped PrescribeIT—will others follow?"If pharmacies are forced to pull out of the program because they can’t afford it, we risk going back to old fax systems, which are outdated and inefficient,” said Walker. “E-prescribing is the future and supports better patient care, especially for those managing multiple medications." According to Walker, the CPhA has communicated its concerns related the fee increase to Infoway and the federal health minister, to emphasize the need for all stakeholders to be held to the same standards."[The PrescribeIT] system is vital for modernizing healthcare, but its cost should be shared across all users who benefit from it," said Walker. She encouraged pharmacists who would be personally impacted by the PrescribeIT fee increase to email federal Health Minister Mark Holland with their concerns.Read the CPhA’s full letter here.

CPhA asks Canada Health Infoway to delay upcoming $0.20 transaction fee for e-prescribing service

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