BC Revamps Pharmacy Fee Model and Safer Supply Program Amid Kickback Scandal

British Columbia has announced significant policy changes targeting the way pharmacies are paid for dispensing addiction medications. The province is set to modify the fee structure to eliminate the financial reward that has led some pharmacies to engage in predatory practices, such as providing kickbacks to vulnerable individuals. This move comes on the heels of investigative reports detailing how approximately 60 pharmacies were allegedly paying patients to maximize their billings under the publicly funded drug plan, a system that has also encouraged the diversion of prescribed opioids.

In addition to revamping pharmacy payments, the province will revert its prescribed alternatives program to a model where medication consumption must be witnessed by a healthcare provider. This means that patients will no longer be allowed to take these medications offsite, a step that is hoped to further discourage misuse and trafficking. Health Minister Josie Osborne explained that the reforms emerged after numerous allegations and leaked Ministry of Health documents, which pointed to a pattern of exploitation involving patients with substance-use disorders. These patients were reportedly incentivized to misrepresent their conditions in order to receive the maximum allowable doses for kickback payments, commonly averaging around $50 per week.

The investigation has also shed light on broader systemic issues; medications with high street value, like hydromorphone, may either be used as intended, sold illegally, or exchanged for other substances, while less valuable drugs are frequently discarded at the taxpayer’s expense. The diverted medications have found their way into markets not only locally but also on a national and international scale. Recent law enforcement efforts, including a seizure in Prince George involving suspected fentanyl, methamphetamine, cocaine, and a substantial quantity of hydromorphone, underline the severity of the issue.

Amid ongoing investigations by multiple agencies, including the College of Pharmacists of BC and local police, health officials have said that any evidence of wrongdoing will prompt strict actions, including the potential shutdown of offending pharmacies and referral to the authorities. Meanwhile, the BC Centre on Substance Use is in the process of updating its clinical guidelines to reflect these policy changes, acknowledging that while the adjustments may destabilize some patients currently benefiting from the program, they are necessary to address the unintended consequences that have emerged from the existing system.