Long-time pharmacist Alex Tam runs Eastside Pharmacy, will be out of the PharmaCare system as of Saturday. Alex Tam at his pharmacy in Vancouver Downtown Eastside November , 2015. (John Lehmann/The Globe and Mail)John Lehmann/The Globe and Mail
A group of health-care professionals who work in the Downtown Eastside has made a last-ditch appeal to British Columbia's Health Minister to stave off the likely closing of Eastside Pharmacy, saying patients' health would be at risk if it is forced to shut down.
But Health Minister Terry Lake has thrown cold water on that prospect, saying civil servants followed an approved process when they rejected the pharmacy as a provider under the provincial drug plan, which effectively puts it out of business.
Eastside Pharmacy, run by long-time pharmacist Alex Tam, was among nearly 50 pharmacies targeted earlier this year in a provincial crackdown designed to weed out those with a history of billing or business problems. The pharmacy is losing its right to claim PharmaCare expenses after an audit found problems with record-keeping and billing practices.
The prospect of the pharmacy closing has alarmed doctors who work in the neighbourhood. They maintain Eastside Pharmacy and Mr. Tam provide exemplary service to hard-to-treat clients, including people who have complex, chronic illnesses such as HIV.
"When PharmaCare cracked down on unscrupulous methadone pharmacies who gave (and continue to give) kickbacks to vulnerable addicted patients, we were grateful," says a letter to the Health Minister signed by 18 people, including several doctors affiliated with the Vancouver Native Health Society.
"A consistently ethical alternative has been Alex Tam's Eastside Pharmacy. Mr. Tam collaborates closely with multiple care providers … to provide the best possible care for all 800 PharmaCare patients served by his team, [including] the 250 patients with HIV," the letter says.
However, Mr. Lake said it's not his place to intervene.
"It's not my decision to make. That's really important to understand," he said Tuesday at a Downtown Eastside community centre, where he was marking World AIDS Day.
"These [pharmacy] decisions are made by professional civil servants. They follow the provider enrolment regulations, so they're following the law. There's a process in place. So it's not my role as a politician to interfere in that process."
Under new regulations, Eastside Pharmacy was required to apply for re-enrollment as a provider in PharmaCare, the provincial drug plan. The Ministry of Health denied that application, based on an audit of a two-year period – between Sept. 1, 2012 and Aug. 31, 2014 – that found problems with record-keeping and billing practices at the pharmacy.
Following several extensions, the latest granted last month, Eastside Pharmacy will be out of the PharmaCare system as of Saturday.
Mr. Tam maintains that problems identified in the audit have been fixed and that he has hired extra help to keep up with administrative demands.
The minister, however, referred to findings in the provincial audit that concluded that Eastside Pharmacy owes $1.1-million to the province for invalid or ineligible claims.
"Our ministry takes the responsibility of using taxpayers' money very seriously, and when we have over $1-million in discrepancies, in MSP billings, PharmaCare billings, that's a serious issue," Mr. Lake said.
Mr. Tam has had opportunities to work with the ministry and could also challenge the decision in court, he added.
A spokeswoman for Vancouver Coastal Health – which oversees health services in the neighbourhood – said the agency is working closely with doctors and other pharmacists to ensure clients' pharmacy needs are met by Saturday.
Eastside Pharmacy was swept up in a program – enabled by a new provider regulation – that took effect last year and was designed in part to stem unscrupulous operators who catered almost exclusively to people on methadone.
For years, B.C. has been plagued by complaints about pharmacists who offer cash or other incentives to methadone users in pursuit of lucrative dispensing fees. Those fees – introduced in 2001 to make methadone treatment more widely available – are among the most generous in the country and can amount to $6,500 a year for each patient.
Wendy Stueck
Andrea Woo