Pharmacy Reimbursements
An Agreement between the Ministry of Health and pharmacy proprietors specifies prescription costs are calculated by adding the acquisition cost of the drug material, the submitted pharmacy mark-up and a dispensing fee (up to a maximum).
The maximum dispensing fee is $11.40. A maximum pharmacy mark-up was implemented on August 23, 1999. The maximum mark-up allowance calculated on the prescription drug cost is:
- 30 per cent for a drug cost up to $6.30,
- 15 per cent for a drug cost between $6.31 and $15.80, and
- 10 per cent for a drug cost of $15.81 to $200.00. (There is a maximum pharmacy mark-up of $20.00 for drug cost over $200.00.)
For urine-testing agents, the pharmacy receives acquisition cost along with the mark-up and a 50 per cent mark-up in place of the dispensing fee. For insulin, the pharmacy receives acquisition cost plus a negotiated mark-up.
Dispensing and Prescription Quantities
The Saskatchewan Drug Plan places no limitation on the quantities of drugs that may be prescribed. Prescribers exercise their professional judgment in determining the course and duration of treatment for their patients. In most cases, the Drug Plan will not pay benefits or credit deductibles for more than a three-month supply of a drug at one time.
The pharmacist may charge one dispensing fee for each prescription for most drugs listed in the Saskatchewan Formulary. If a prescription is for the duration of one month or more, the pharmacist is entitled to charge a dispensing fee for each 34-day supply. The agreement does not prohibit the pharmacist from dispensing more than a 34-day supply for one fee.
The agreement also contains a list of two-month and 100-day supply drugs. Prescribing and dispensing should be in these quantities once the medical therapy of a patient is in the maintenance stage, unless there are unusual circumstances that require these quantities not be dispensed.