Ontario Health Minister George Smitherman denied Saturday that the province is trying to bribe doctors into cutting prescription drug costs to the poor and elderly, saying the proposal is meant to curb the over-prescription of medication to seniors.
"There is no bribe here," Mr. Smitherman said, responding to criticism of a provincial proposal asking Ontario doctors to cut drug costs, and in return, obtain a funding boost for physician services.
"I think we have an opportunity to influence policy by [providing incentive]and rewarding appropriate behaviour and I think this is what's at play here," he said.
The offer reportedly asks doctors to cut taxpayer-funded prescription drug costs by $200-million over the next four years, in an effort to reduce spending in the Ontario Drug Benefits program. If the cuts were made, $50-million would be made available for physician services.
The proposal, contained in a letter of understanding between Mr. Smitherman and Ontario Medical Association president Dr. John Rapin that was leaked to the media, drew sharp criticism from some doctors who warned the move could be risky for elderly patients.
The letter is part of a tentative agreement reached in talks between the province and its doctors in September. A ratification vote will be held in November.
Dr. Rapin said reports of the proposal are "misleading" and fail to convey what the deal would actually mean for doctors.
"If there were such monies, those monies would be used mutually by the ministry and the [physicians]" Dr. Rapin said.
"It does not mean that doctors would be paid more to prescribe less. That's a misleading message . . . and it has no connection with reality."
"The only policy for 10 years has been to support drug review programs with the objective of improving access to the best and most effective drugs for our patients."
Speaking at an event in his Toronto riding on Saturday, Mr. Smitherman defended the offer, saying the government wants to stop over-prescription among Ontario patients and ensure that they are getting the best care.
He denied claims the proposal would pressure doctors to under-prescribe medication.
"The real issue is that everybody in the province of Ontario knows that we have a problem with over-medicating seniors," he said, citing "plentiful" studies that show an over-reliance on drugs such as antibiotics.
"This is motivated by one clear and pressing reality, which is that there are too many people in the province of Ontario who are over-medicated."
Inappropriate prescribing costs Canadians between $800-million and $2.6-billion a year, according to a 1997 study cited by health ministry officials.
They also point to a 1999 policy statement by the Canadian Association of Gerontology, which said that seniors were more likely to receive inappropriate prescriptions than anyone else.
Up to 46 per cent of seniors received at least one inappropriate prescription a year, and 19 to 36 per cent of drug-related hospital admissions related to prescribing errors, according to the statement.