Manitoba among last of provinces to allow customer rewards at drug counter

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This article was published 19/09/2023 (763 days ago), so information in it may no longer be current.

Racking up rewards at the pharmacy counter might soon be a thing of the past.

The College of Pharmacists of Manitoba (CPhM) is considering banning pharmacy inducements, which includes loyalty points, rebates, coupons and other rewards given to patients.

“CPhM’s foremost responsibility is to uphold the public interest,” Anja Sadovski, the college’s communications coordinator, wrote in a statement. “When it perceives that a practice, such as inducements, poses a risk to public safety, it becomes our duty to act in the public’s best interest.”

“We really, really feel … that pharmacies should focus on overall health outcomes and having individuals access the right therapy and medication at affordable costs.”–Darren Murphy, Northway Pharmacy

Manitoba is among the last Canadian provinces to allow pharmacy inducements. Inducements “introduce economic incentives into health-care decision-making, undermining these crucial (pharmacist-patient) relationships and overall health outcomes for the patient,” Sadovski wrote.

CPhM is collecting public feedback before changing any regulations. It launched a survey on its website last month; the survey closes Oct. 30.

Sadovski couldn’t say how many Manitobans use pharmacy inducements. Nearly half — 43 per cent — of surveyed practising pharmacists told CPhM their workplaces offered inducements in 2017, she wrote.

Pharmacy inducements bring a range of perks and potential harms, noted Neil McArthur, director of the Centre for Professional and Applied Ethics at the University of Manitoba.

“There’s a pretty strong case to be made that these inducements are actually benefiting consumers,” he said, adding purchases can lead to discounts on groceries and travel. “People do spend quite a bit on drugs.”

Marilyn Decena footed a $200 bill last week. She clutched a bag with her husband’s medication as she left Shoppers Drug Mart.

The PC Optimum points can help, Decena said. She’s been a member for more than two decades. She collects points while buying medication at Shoppers Drug Mart; accumulated points can be spent at Loblaw brands like Real Canadian Superstore and No Frills.

“People need to save money,” Decena said. “Especially if you’re retired, you know, it’s hard.”

Inducements become tricky if people ignore their medication requirements, like delaying a refill until they can get bonus points or otherwise altering their prescription usage, McArthur stated.

“Some people are … going to be shopping for the best deal” instead of the best care, said Darren Murphy, CEO of Northway Pharmacy.

The local chain prefers not to offer inducements. Instead, it focuses on customer retainment through patient-pharmacist relationships and pharmaceutical care, including home visits and medication reconciliation, Murphy explained.

“We really, really feel … that pharmacies should focus on overall health outcomes and having individuals access the right therapy and medication at affordable costs,” he said.

Some patients using government-funded programs might fill prescriptions they don’t need to for inducements, costing taxpayers money, Murphy added.

“We are definitely sensitive to the fact that a lot of Manitobans do rely (on) or enjoy incentives,” he underlined. “It’s kind of everywhere.”

Exchange District Pharmacy offers a rewards program to keep competitive with large chains, said Ryan Chan, the pharmacy manager.

“There’s pros and cons with (inducements), but by removing it … now the chains don’t have the competitive advantage.”–Ryan Chan, Exchange District Pharmacy

Even so, the uptake rate is “quite low” — maybe one per cent of patients use it, Chan guessed.

“The goal of pharmacy is not about incentive, it’s about patient care,” he said. “There’s pros and cons with (inducements), but by removing it … now the chains don’t have the competitive advantage.”

Once the College of Pharmacists of Manitoba’s survey closes, the organization will review the responses alongside feedback from members. The lieutenant-governor must approve any regulation change.

McArthur from the Centre for Professional and Applied Ethics questioned the public survey’s integrity.

“They say right in the survey that they … object to these incentives,” McArthur said. “If you’re going to do a consultation with the public, you should actually not be decided yet.

“They’re really biasing their respondents.”

The survey’s preamble states “the banning of pharmacy inducements aims to enhance patient safety, promote unbiased healthcare decisions and maintain integrity of the pharmacy profession.”

It also lists the provincial pharmacy regulators who’ve already prohibited pharmacy inducements. Alberta, British Columbia, Quebec, Prince Edward Island, Newfoundland and Labrador, Ontario and New Brunswick are recorded.

“The preamble’s intent is not to sway public opinion but to provide further context,” Sadovski wrote in a statement. “Listing provinces where the prohibition of inducements is already in place underscores that this is not a new concept.”

CPhM launched the survey to understand how a policy change will affect Manitobans, Sadovski continued. The survey mentions a future focus group involving members of the public.

Different perspectives will influence decision-making, and consultation will “better inform” what is included in the ban, Sadovski said.

The survey is found on the College of Pharmacists of Manitoba website.

gabrielle.piche@winnipegfreepress.com