Pharmacists in Alberta struggle to cope in the face of significant government budget cuts

Alberta's decision to reduce funding for the Comprehensive Annual Care Plan (CACP) has left pharmacists across the province fearing for the long-term sustainability of the business.Last month, the province announced it would cut the number of followup appointments that could be billed under the program from 12 to four per year, while reducing the reimbursement fee for each appointment by 30%, starting on Nov. 1, 2024."We're still adjusting to how we care for patients," said Carlene Oleksyn, managing partner of Mint Health + Drugs Pharmacy in Spruce Grove, Alta.Oleksyn explained that, over the last few weeks, her practice has been forced to consider scaling back on patient care activities such as monitoring blood pressure, conducting lab tests and following up on results."The proactive care that we are used to providing . . . that is what they're going to be missing," said Oleksyn.She is also concerned for the long-term implications of these cutbacks on rural communities like hers, where pharmacists often act as primary healthcare providers in the absence of other medical practitioners."We serve a population of about 60,000 people, and there are no walk-in clinics at all,” said Oleksyn.These cutbacks, she warned, could cause a surge in unnecessary visits to emergency rooms and urgent care facilities across the province.“We don't have that ability [anymore] to sit them down and take their blood pressure . . . and hopefully save an ER visit by adjusting their medications,” she said. Oleksyn also stressed that vulnerable patients in these communities—such as seniors and individuals with chronic conditions—will be hit the hardest. “If we’re only being paid to see them four times a year, that’s definitely not enough,” said Oleksyn.She pointed to the hundreds of thousands of Albertans with no family doctor. Indeed, estimates indicate between 700,000 and 800,000 Albertans have no dedicated primary care provider. “Our own community lost three just this spring to retirement,” she added.As the provincial government increasingly relies on pharmacists to fill critical gaps in healthcare coverage caused by the ongoing family doctor shortage, Oleksyn asserts that cutting funding to programs like the CACP sends a mixed signal."[The] government has basically said, 'We don't value your services . . . your services aren't worth what you say they are,'” said Oleksyn. “It's extremely disheartening."Randy Howden, past president of the Alberta Pharmacist Association (RxA), shared in an interview with Pharmacy Practice + Business that concerns about reducing funding to the CACP were raised with the province ahead of these cutbacks.“Unfortunately, the minister and the government decided to make these changes the way they did,” said Howden.Howden warned the monetary pressures currently facing the provincial government might impact decisions related to the sustainability of the pharmaceutical profession.The decision to reduce funding for the CACP comes after the provincial government surpassed its annual pharmacy services budget by $30 million. If this deficit continues into the new year, Howden fears the provincial government may impose additional caps to control its spending. "If the government doesn’t get the savings they wanted with this cut, they might decide to do even deeper cuts,” Howden warned.Howden mentioned that some pharmacists have confided in him the uncertainty surrounding programs like the CACP have caused them to fear for their job security."I’ve had pharmacists call me, one in particular, in tears, praying for her job because of what’s going on, and that’s sad," said Howden.Nevertheless, Howden stressed the need for greater advocacy and increased public awareness regarding the importance of pharmacists in Alberta's healthcare system."I know pharmacists are doing great care,” said Howden. “I know we can do even more if we’re provided more resources and a better model."

Pharmacists in Alberta struggle to cope in the face of significant government budget cuts

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