A patient displays medications and a $50 cash kickback that a pharmacy employee delivered to him, in violation of College of Pharmacists of B.C. bylaws, on Feb. 6 in Vancouver. The man told The Globe and Mail that the pharmacy pays him $50 per week and does not change his fentanyl patches, as ordered by his doctor.A 40-year-old man leans against a windowsill in his Vancouver single-room occupancy hotel, awaiting a delivery of medication from a pharmacy.
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.
with amounts being kicked back to patients commonly being reported as $50 a week, according to five people receiving such payments. Additional cash is offered to those who recruit others to those pharmacies. Lisa Howard, a family physician who provides primary and addictions care in Vancouver’s Downtown Eastside, said she and her colleagues have reported problem pharmacies to the college on several occasions.
“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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