Patients say B.C. pharmacies paying prohibited cash incentives to fill prescriptions at their locations

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Dozens of pharmacies are alleged to have offered kickbacks to patients to fill prescriptions at their locations or recruit others to do so, maximizing how much can be billed to the province's publicly funded drug plan.

A 40-year-old man leans against a windowsill in his Vancouver single-room occupancy hotel, awaiting a delivery of medication from a pharmacy. A drug user for half his life, he is now prescribed fentanyl patches that adhere to the skin, along with tablets of the opioid medication hydromorphone, to stave off withdrawal symptoms.

The Globe spoke to 28 doctors, nurses, pharmacists, patients and social-service providers to learn the scope of the practice and how such pharmacies covertly encourage patients to participate. Among them, two doctors, two pharmacists and several patients independently revealed the names of dozens of pharmacies alleged to offer kickbacks, including locations in Vancouver, Burnaby, Surrey, New Westminster and Victoria.

The college did not respond on Wednesday to specific questions from The Globe and declined an interview request with registrar and CEO Suzanne Solven. A statement provided by spokesperson Lesley Chang said the college “has a long-standing concern about the negative effects of incentive programs in the practise of pharmacy.” The Health Ministry did not respond to queries from The Globe.

In one case, a pharmacist reported the kickback scheme occurring at his own location to the college. He told The Globe that college representatives acknowledged that it was a problem they had been dealing with for years, and seemed keen on working with him to take action. “The College of Pharmacists doesn’t care,” she said. “They said, ‘We can’t accept your complaint unless it comes from the patient who’s directly benefiting from it.’ So the patient has to complain that they’re getting paid, essentially, which doesn’t make sense to me.”

“What we’re observing is a predatory shift toward bottom line over patient care,” he said. “And it’s not just that the patients themselves are suffering from a lack of patient-driven care, it’s that there is a huge public cost associated with it.” Health care providers say this expanded delivery service, which was intended to be a temporary measure and used only in exceptional circumstances, has been invaluable to many patients, such as those with mobility issues. But some pharmacies have also exploited it to bolster delivery and witness fees while failing to meet professional standards.

He recalled travelling to Ontario a few years ago, returning to Vancouver, and learning from a pharmacist that PharmaNet – the province’s database of every prescription dispensed in community pharmacies – showed his methadone was dispensed to him at his previous pharmacy every day, despite his absence.

 

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