ADDICT PAYMENTS REQUIRE PROBE

As we mentioned yesterday, pharmacies in B.C. have been collaborating
with the drug industry to keep prices artificially high. A study
commissioned by the B.C. Ministry of Health shows that customers and
taxpayers are being overcharged by almost $250 million a year. The
same gouging occurs in other provinces.

This is only the latest in a series of controversies that have dogged
the pharmacy profession.

According to a recent CBC report, some drug stores in Vancouver's
Downtown Eastside are giving people dealing with drug addiction
kickbacks to get their business.

If the report is correct, drug addicts get $10 a week, or more, for
bringing methadone prescriptions to get filled at certain pharmacies.
They may also get cash for filling other prescriptions at those
pharmacies, including the restricted painkiller Tylenol 3.

Aside from questions of propriety, which we'll come to in a moment,
offering kickbacks is completely irresponsible. Physicians in the
area report that patients are demanding medications they don't need
so they can receive a payment at the pharmacy. It's believed they
then sell the unused drugs on the street, expanding the cycle of addiction.

And these allegations are anything but an exception. Two years ago,
six pharmacies in the Lower Mainland were charged with over-billing
the federal government for methadone. One pharmacist was jailed and
$2 million has been recovered. And there are well-supported
complaints, going back to 2000, of addicts getting kickbacks in North Surrey.

As for the matter of propriety, provincial regulations explicitly
forbid the offering of cash or incentives of any kind to methadone patients.

Pharmacists are well aware of this. They're required to sign an
agreement to that effect.

It might be tempting to assume this is just the work of a few bad
apples. Yet when a group of physicians complained to the B.C. College
of Pharmacists months ago, nothing happened. It was only when the CBC
filmed an addict apparently getting a payoff at a local drug store
that the college promised action.

Nor are the problems confined to B.C. Ethically dubious practices
occur on a countrywide basis.

It's common in most parts of Canada -- though not in B.C., where the
practice is outlawed -- for pharmacies to sell their dispensing
records so drug companies can see which medications are prescribed by
doctors in the region. The drug firms employ that information to call
physicians and lobby for their product.

That means a private transaction between doctors and their patients
is being turned into a commercial product and sold for cash. Although
patient identities are withheld, physician groups rightly condemn the
practice as intrusive and unprofessional.

Then there's the phenomenon of online pharmacies. These are private
businesses, usually run by licensed pharmacists, that offer cut-rate
drugs over the Internet.

They invite customers to fax their prescriptions to an online
service, where they are rewritten using a cheaper drug. Because the
pharmacy has no way of knowing the medical history of its customers,
this practice is also condemned by physicians.

Some of these activities may be illegal. Others are certainly
distasteful. But they all have one thing in common: They involve a
decision to put money-making ahead of other interests.

Of course there's nothing wrong with turning a profit. It's how the
business world functions. And drug stores are just that -- business operations.

But is this what will happen if other parts of our health-care system
are privatized? Will patient interests be replaced by bottom-line
considerations?

Premier Gordon Campbell has already experimented with commercialized
health services as a way to make ends meet and reduce costs. His
health minister is considering additional options.

Yet the government has been unable to prevent price gouging,
kickbacks and more by pharmacies. Is it reasonable to suppose they
can do better with private hospitals or fee-for-service clinics?