UNDERSTANDINGYOUR NEW PHARMACY INVOICE

Here are all the details about the changes made to the invoice provided in pharmacy for medications included in the RAMQ’s list. It is essentially the same information that was provided previously, but presented in a more detailed manner.

Your pharmacist is more accessible than any other healthcare professional in the health system. He or she is also the medication expert, assigned professional responsibility for ensuring the safety of your treatment. Each time your pharmacist fills a prescription, whatever the type of medication or its cost, he or she does the following:

  • Consultation
  • Analysis of patient record
  • Verification, validation and preparation of the product
  • Advice and monitoring of the treatment

It's the pharmacist’s know-how and service, combined with the drug itself, that produces a positive impact on your health. To help you furthermore, your pharmacist can offer you seven new services.

Discover them

Cost price of the drug paid by the pharmacist

The cost price of the drug shown on the invoice is the actual price the pharmacist pays. It does not include a profit margin for the pharmacy.

Amount paid to the distributor (wholesaler) by the pharmacist

In addition to the cost price paid for the drug, the pharmacist pays the distributor an amount set by the government for ensuring drug supplies. This amount does not include a profit margin for the pharmacy.

Professional fees

Professional fees have always been part of the total price appearing on your invoice. They do not represent the pharmacist-owner’s net profit or salary. The fees encompass direct and indirect expenses related to the professional service and maintenance of pharmacy operations. The amount that appears under professional fees includes several items:

  1. Pharmaceutical evaluation: validation of the prescription, analysis of your patient record and counselling services
  2. Preparation and verification of the medication
  3. Professional responsibility for monitoring drug therapy throughout the course of treatment
  4. Operating expenses to sustain the pharmacy’s operations (salaries, rent, computer equipment, specialized devices, electricity, financial charges, etc.) to enable it to deliver high-quality service that is readily accessible, including extended opening hours.

Insured patient's contribution and amount paid by insurer

Publicly insured patients

The contribution from patients covered under the public plan, which includes the deductible and the co-insurance amount, is set by the government and based on various criteria. For more information, communicate with the Régie de l’assurance maladie du Québec.

1 800 561-9749 www.ramq.gouv.qc.ca

Privately insured patients

The amount payable for your prescription is determined by your insurer, based on your plan’s coverage. Your pharmacist has no information on the provisions of your private insurance plan.

For more information, communicate with your employer or your insurer.

RGAM price

The price paid by the RGAM (Régime général d’assurance médicaments, the prescription drug insurance plan) corresponds to the price payable by the RAMQ (Régie de l'assurance maladie du Québec, the Quebec health insurance board) for the medication that private insurers are also required to cover. This price does not include professional fees, and applies only to the cost of the medication and the amount paid to the distributor.

Uninsured amount

This is the amount not covered, or refused by, your insurer.

Staying loyal to your pharmacist:
a guarantee of health and safety

By purchasing all your prescription drugs at the same pharmacy, you help your pharmacist monitor your drug therapy and your health more effectively. This gives the pharmacist access to all the information contained in your patient record, which in turn ensures the best possible monitoring of your drug therapy. When you go to your pharmacist for frontline service, he or she will have everything needed to give you the right advice.

Choosing your pharmacist is your right

You are protected by the law: you have the right to choose your pharmacist, and no one can require you or pressure you to switch pharmacies. If you are subjected to such pressure by a private insurer or by an employee benefits administrator, you are urged to report the situation to the RAMQ. You can do so by phone, or by mail:

418 528-5659
(Quebec City area)
or 1 877 858-2242
(Elsewhere in Quebec)

Reporting
Régie de l’assurance maladie du Québec, Post box 6600, branch Q068, Québec (Québec)
G1K 7T3

If you also wish to inform the AQPP of complaints you submit, you can e-mail the information to: communications@aqpp.qc.ca

The law covering medication insurance now requires that the invoice given to patients in pharmacies for the drugs appearing on the RAMQ list include more information. You’re given the same information as before, but in more detail.

They include four different elements:

  1. Pharmaceutical evaluation: validation of the prescription, analysis of your patient record and counselling services
  2. Preparation and verification of the medication.
  3. Professional responsibility for monitoring drug therapy throughout the course of treatment
  4. Operating expenses*

*This means the pharmacy’s operating expenses that enable it to deliver high-quality service that is readily accessible, including extended opening hours. They encompass salaries, inventory costs, rent costs, computer equipment, specialized devices, electricity financial charges and other items. These are expenses any business needs to cover.

The professional fees you see on your invoice do not represent a net profit or salary for the pharmacist-owner.

It’s important to note that the cost price of medication and the amount paid to the distributor, as they appear on the invoice, are real costs paid by the pharmacist. These amounts do not represent any profit margin for the pharmacy.

Fees are established based on the pharmacy’s business conditions and the expenses it must assume to remain accessible to its patients and continue delivering high-quality services. Moreover, the variable level of complexity of the professional monitoring associated with each drug treatment may affect the professional fees.

The public plan rates are set by the government and are not representative of the pharmacy’s operating realities because they have not been indexed to inflation in the past 15 years, even though the pharmacy business and the drugs themselves have become considerably more complex. The public and private plans are very different, and comparisons between them are difficult to make. For privately insured individuals, the fee amount reflects the pharmacy’s business conditions and the expenses required it must assume to remain accessible to its patients The administrative and logistical management caused by the multitude of private insurance regimes that exist also create an additional workload for the pharmacy staff.

Every pharmacy is an independent business. The professional fees are determined based on the pharmacy’s business conditions and the expenses it must assume to remain accessible to patients and continue delivering high-quality services.

It is important to inform yourself and to choose your pharmacist and pharmacy based on the professional service provided rather than on the price of a prescription drug. The quality of service provided and your personal relationship with the pharmacist are important factors to consider in choosing a pharmacy, along with the opening hours and distance from your home or workplace

In addition, it is strongly recommended that you always go to the same pharmacy to ensure your safety. That way, your pharmacist will have access to all the information recorded in your patient file, which in turn ensures the best possible monitoring of your drug therapy.

It is normal for the price of services and products at a pharmacy to vary over time. This is the reality of an economic system in which competition comes into play and operating costs vary from one pharmacy to another. As can be seen on the invoice, the total price included various elements. The cost of a drug may sometimes be adjusted by the pharmaceutical company or by other parties. Fees may also vary due to additional expenses that the pharmacist must assume in providing service or simply due to inflation.

In addition, the community pharmacy environment has undergone changes in recent months. These changes may affect a pharmacy’s business model and the cost of drugs. As such, it is normal for price variations to occur.

It is your right to change pharmacies. However, for your safety and for continuous and adequate monitoring of your treatment, it is strongly recommended that you always go to the same pharmacy. Your pharmacist has access to your history and all the information recorded in your file, which in turn ensures the best possible monitoring of your drug therapy and positive impact on your health.

He or she will also be better placed to provide you with frontline service, if need be.

Staying loyal to one pharmacist helps ensure your health and safety.

The law protects you: you have the right to choose your own pharmacist. No one can require you or pressure you to change pharmacies. If you are subjected to such pressure by a private insurer or employee benefits administrator, you are urged to report the situation to the Régie de l’assurance maladie du Québec. You can do so by phone or by mail :

418 528-5659
(Quebec City area)
1 877 858-2242
(Elsewhere in Québec)

Reporting - Régie de l’assurance maladie du Québec - Case postale 6600, dépôt Q086 Québec (Québec) G1K 7T3

If you also wish to inform the AQPP of complaints you are filling, you may send the information by e-mail the information to: communications@aqpp.qc.ca

Methods for calculating deductibles and co-payments vary between the public and private systems. They also vary between each private insurer and according to the coverage set out by employers and insurers. It is therefore normal for two patients covered by different insurers to be paying different amounts.

For persons insured under the public plan: The contribution of patients insured by the public plan, including deductibles and coinsurance, is determined by the government according to various criteria.

For persons insured privately: The amount payable for your prescription is determined by your insurer based in particular on your plan’s coverage. The professional fees are set by the pharmacist-owner based on the drug’s complexity and on the pharmacy’s business reality. The price of a given drug will be the same for all patients in the same pharmacy.

This is the price assumed by the Régie générale d’assurance medicaments (RGAM) for the actual prescription drug. It is the price payable by the Régie de l’assurance maladie du Québec (RAMQ). Private insurers are also required to cover this amount. It does not include professional fees and involves only the cost of the drug itself along with the amount paid to the distributor.

The RGAM price may vary from the total price paid by the pharmacist in certain cases determined by the government. In these cases, the law states that this difference is to be paid by the patient.

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