From the outset of Ontario's drug wars, Dalton McGuinty's government has been unapologetic about the fact that some pharmacies will be forced to close as a result of its reforms.
There's little to suggest that a month-long public relations fight with pharmacists has done much to alter the Liberals' thinking. But as the battle enters its final stages, the government seems to be preparing a concession - probably part of the game plan all along - aimed at limiting just how many of the stores will be forced under.
Government and industry sources suggest that the likeliest "give" will be some form of transitional fund, along the lines of what Alberta provided when it undertook more modest pharmacy changes.
The idea would be to provide short-term funding to give drugstores a chance to shift their model toward one in which more of their revenue comes from providing additional publicly funded health-care services, such as extensive consultations. (At present, their profits come largely from "professional allowances" - the payments from generic drug manufacturers in return for stocking their products, which the government plans to eliminate in order to achieve lower prices.)
What shape that funding will take, exactly, will likely be announced before this month is out. The obvious challenge for Health Minister Deb Matthews between now and then is to figure out how best to show she's listened to complaints about her reforms, without cutting too deep into the province's savings from lower prices.
There's an obvious political incentive for the government to direct the bulk of any additional funding toward smaller drugstores, which are both more vulnerable and more sympathetic than bigger chains. (There's a reason why independent pharmacists have been increasingly front-and-centre in the pharmacies' PR campaign.) But the Liberals can't just announce that they'll arbitrarily shut out Shoppers Drug Mart or Rexall.
Likelier is that the government will announce a base transitional fund across the board, then find ways to target additional money.
Part of that could be done by expanding planned premiums for rural and remote stores. But the government will have to get more creative if it wants to help out mom-and-pop shops in most of the province. It could, for instance, target some funding to stores that are under a certain square footage, or else tie dollars to a relative lack of front-of-store business.
As the Liberals settle on a final plan, pharmacies will be doing everything possible to boost the amount of money going into the pot. And toward that end, they seem to be adopting a double-pronged strategy.
On one hand, they're maintaining a vigorous ground campaign aimed at making Liberal MPPs nervous (and sending a message to other provinces considering similar reforms). As reported previously, that includes massive mail-outs, advertising campaigns and commissioned polling in at least 25 ridings.
But in their public comments, they've begun to adopt a noticeably more conciliatory tone. Even Shoppers CEO Jurgen Schreiber, perhaps mindful of Loblaw's announcement that it will respond to the market changes by expanding its pharmacy services, said Thursday that it's "not a bad thing" for his corporation to have to change aspects of its business model. The same day, industry representatives emerged from meetings with government officials - the first in weeks - proclaiming themselves heartened by the tone.
The reality is that there's no way the pharmacies will be entirely happy at the end of those ongoing talks, because they're still going to feel a lot of pain. But the question is how much the government feels compelled to cushion the blow.
Adam Radwanski