Claims up close: fees for services

MAY 2023 - Since 2012, the Canadian Foundation for Pharmacy has collected information on scopes of practice for pharmacists, province by province, including the fees paid by governments and claims data. Click here to download our latest Services Chart, updated in January 2023.

And you can click here for our overview of trends in claims data for pharmacy services.

In this article, we consider fees for services. How have they changed—or not—over the years? Since funding varies by province and by service, we focussed on the two services with the longest history of remuneration—influenza vaccinations and prescription renewals.

Influenza vaccinations

In 2022, fees for influenza vaccinations ranged from a low of $7.00 in Manitoba to a high of $15.66 in Québec. Saskatchewan has the second-highest fee, at $14.00, and Ontario has the second-lowest fee, at $850.

Two provinces have seen no change in their fee since year one: it remains at $7.00 in Manitoba and $13.00 in Newfoundland & Labrador.

Alberta’s fee, while similar to most other provinces today, is 35% less than it was when funding began in 2012. It was $20.00 until 2018, when government negotiations brought it down to $13.00. It temporarily increased to $15.00, from October 2020 to March 2022, to help offset extra costs during the COVID-19 pandemic.

Ontario’s fee of $8.50 is relatively new: it was $7.50 from 2012 until 2021. British Columbia’s fee of $12.10 is also somewhat recent, increasing from $10.00 in 2020.

Québec and Nova Scotia are the only two provinces to have regularly increased their fee in recent years:

• In Québec, the initial fee of $11.40, implemented in March 2020, increased to $17.40 in November that year. The increase included a temporary top-up fee of $5.50 to offset the costs of sanitary measures during the pandemic, which ended in May 2022, plus an additional fee of $0.50 to help cover the costs of supplies. In 2021 the “base” fee increased to $11.60, plus $0.50 for supplies, and in 2022 it increased to $15.66 plus $0.50 for supplies. Future increases have already been negotiated: the base fee will increase to $16.44 on April 1 this year, and to $17.27 on April 1 in 2024.
• In Nova Scotia, the original fee of $11.50 increased to $12.00 in 2015 and remained at that amount until 2020, when it increased to $12.40. In 2021, it increased to $12.55.

Prescription renewals

Since 2015, pharmacists in all provinces have had the authority to renew prescriptions. But not all can bill for the service.

For the first several years, starting in 2012, only B.C., Alberta and Saskatchewan remunerated pharmacies for prescription renewals. Québec began funding the service in 2015, followed by Nova Scotia in 2019, New Brunswick in 2021 and P.E.I. in 2022. This leaves Manitoba, Ontario and Newfoundland & Labrador as the last three provinces without funding for prescription renewals by pharmacists.

Fees range from a low of $6.00 in Saskatchewan to a high of $20.00 in Alberta, New Brunswick, Nova Scotia and P.E.I. Having said that, fees are tiered in New Brunswick and Nova Scotia:

• New Brunswick: $20.00 per renewal where there are four or more prescriptions; $15.00 per renewal for three prescriptions; and $10.00 per renewal for one or two prescriptions.
• Nova Scotia: $20.00 per renewal where there are four or more prescriptions; and $12.00 per renewal where there are one to three prescriptions.

Saskatchewan’s fee of $6.00, the lowest of all provinces, has not changed since year one (2012). Nor has B.C.’s fee of $10.00, also in place since 2012.

As with influenza vaccinations—and for most funded services, for that matter—the fee for prescription renewals in Québec has increased several times in recent years. It was $12.50 from year one in 2015 until 2017, then increased to $12.70 in 2018, $12.90 in 2019, $13.42 in 2021 and $14.09 in 2022. And as stipulated in the current agreement between the provincial government and the Association québécoise des pharmaciens propriétaires, the fee will increase to $14.80 as of April 1, 2023, and to $15.54 as of April 1, 2024.