Bait and switch: How Alberta’s constant policy changes are leaving some pharmacists in the lurch

2025 has been a year of policy changes for Alberta pharmacists—with many feeling they're constantly being asked to do more with less. First, last fall, the Alberta government announced that they would be rolling back compensation for initial assessments and cut the amount of annual care plan follow-up appointments for which pharmacists can be reimbursed from 12 to four. Then, in June, the province announced that most Albertans would be have to pay out-of-pocket for COVID-19 vaccines this fall—and that they will only be able to receive the shots at public health clinics, rather than pharmacies. The province also announced that it would be increasing the maximum prescription drug co-payments for seniors and Albertans with Non-Group Coverage by over $10 per prescription, prompting concerns around affordability. For many pharmacists in the province, these changes have meant more uncompensated work and being cut out from public health programs like vaccinations—and without their consultation. Brittany Zelmer, the president of the Pharmacists’ Association of Alberta (RxA) says that the organization was “shocked and disappointed by the news that was delivered by the Alberta government” surrounding the exclusion of pharmacists from providing vaccines and the decision to charge Alberta for the inoculation. Zelmer says the move has the potential to confuse patients and make the vaccine less accessible for many Albertans. As for cuts to pharmacists’ reimbursements, Zelmer says that the change is "definitely frustrating."“Complex patients often need more frequent follow-ups,” she says. “Investment in chronic disease management definitely saves money in the long term, because those risks can be mitigated in the moment versus being reactive later.” Zelmer points to a pharmacist she knows who previously received referrals from a diabetes clinic. She would work with referred patients, especially complicated cases that required as many as 12 follow-ups. Now, these patients may suffer from complications that wouldn’t have otherwise emerged, and the pharmacist loses out on a much-needed revenue stream. “There's direct impact to the patient, and then there's direct impact to the pharmacies,” she says. “Bottom line, [pharmacists] built their practice around the services that were reimbursed, as outlined in our agreement, and now suddenly, that's at risk.”Pharmacists are left with the responsibility of explaining these changes to their patients, and are thus tasked with bearing the brunt of patient anger—which is both aggravating and time consuming, Zelmer explains. "It becomes a tricky balance of getting the daily tasks done at the same time as trying to field complaints that were based on decisions that didn't involve you.”According to Zelmer, all this disappointment and frustration is what led the RxA to launch the Voices in Vests campaign. The campaign is a grassroots initiative to get pharmacists and patients in the province to write to their elected officials and sign a petition. The RxA has also hosted a suite of town halls across the province with hundreds of pharmacists attending to learn about the changes from the government and how they can still protect patients. With all this frustration, a new pharmacists association representing independently owned pharmacists emerged late this summer. The Alberta Independent Pharmacy Association (AIPA) launched in August in response to the government’s numerous cuts and changes. According to Radwa Ghanima, the AIPA’s president, independent pharmacies are hit the hardest by the government’s new policies. “Independent pharmacies rely mostly on services,” she explains. “The government is cutting off how much we are paid for these services.” Zelmer, who says the RxA is aware of the AIPA, says that the creation of this new association is a clear sign that pharmacists are angry. While the two organizations haven’t had much direct communication, in order to advocate for the profession, “we need lots of voices,” she says. Ghanima says that members of the AIPA have been directing unhappy patients to write to their MLAs. Especially in rural areas, where independent pharmacists are often the only healthcare professional in the area, patients are worse off because of these cuts. A couple weeks ago, the AIPA held their inaugural meeting. “Folks came from all over Alberta,” Ghanima says, calling the meeting a success. And, despite coming from all corners of the province, she says that a lot of the issues expressed were the same: members are worried about cuts impacting patients and affecting their bottom lines. There is also fear that independent pharmacies will close en masse as a result of these cuts. “A lot of us are running on razor-thin margins already,” she says. Looking towards the future, Ghanima says that the AIPA will be reaching out to MLAs and other government officials in order to start a conversation on “how things can be done differently.” She also urges patients to speak up against the changes as well. “We want to encourage the public to advocate for us too,” she says. “There are so many stories of someone’s grandma living in a rural area that was helped out by a pharmacist going the extra mile. Now, those pharmacists really need the public’s help.”

Bait and switch: How Alberta’s constant policy changes are leaving some pharmacists in the lurch

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