Carrying rapid tests a business decision for Alberta pharmacies: ‘We’re doing it at a loss’

The economics of getting COVID-19 rapid antigen tests in Alberta had a fundamental shift in March.

According to an information bulletin issued to pharmacists last month, the province reduced the amount they are compensating pharmacies to hand out rapid test kits.

On Wednesday, Health Minister Jason Copping confirmed the change while also addressing rumours that the rapid testing program was ending in Alberta.

“These rumors are not correct. Free rapid tests continue to be available to all Albertans.”

But the costs to pharmacies changed.

Prior to March 7, pharmacies were able to claim $5 per kit from the province, compensation for their time and administrative work so Albertans could get access to the kits, one per person.

“At that point, we would also explain how it’s used and screen them for (whether) they had any questions and that sort of thing,” Suhaas Thaleshvar, pharmacist-owner at an Edmonton Medicine Shoppe, told Global News.

After March 7, that amount changed to $60 per case. With 108 kits per case, that works out to $0.56 per kit.

Pharmacies also have to pay to ship the rapid tests to their location as a result of the change, a cost that can range from $20 to $30 per case. That means some pharmacists are getting $0.35 or less in compensation per kit.

“I totally see why some pharmacies have chosen not to carry them,” Thaleshvar said, of the increasing costs being borne by his fellow pharmacists.

“Even the $5 that was used for a kit before, there was quite a bit of administrative work on the part of our staff. That was sort of almost break-even at that point.

“And then (at $60 per case), obviously we’re doing it at a loss.”

The Alberta Pharmacists’ Association (APA) notes that prior to March 7, pharmacists had to collect patient names and health-care numbers of people receiving test kits, requirements that were removed as part of the changes to a “more openly distributed and accessible” model.

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“Accordingly, (Alberta Health) reduced the compensation to pharmacies to reflect the simplified processes,” APA director of pharmacy practice Matt Tachuck said in an email.

Thaleshvar said his staff have had to shift their priorities when distributing the rapid test kits.

“We do make sure that (members of the public are) getting one, but they’re there often is no time to really do a full assessment and proper training sessions with each person,” the Edmonton pharmacist said, noting his staff still step novices through the swabbing and testing procedures.

In a previous pandemic update, chief medical officer of health Dr. Deena Hinshaw encouraged Albertans to pick up rapid tests at their local pharmacy and keep them on hand in case someone in the household develops COVID-19 symptoms and help “prevent onward spread.”

According to an Alberta Health spokesperson, the province has distributed 36.2 million rapid tests as of April 5 to the following places:

• 3.0 million to acute and continuing care
• 14.2 million for individual use
• 6.8 million to employers and service providers
• 8.6 million to K-12 schools
• 2.7 million to First Nations and Metis communities
• 0.9 million to municipalities

On Wednesday, Copping updated those numbers to say more than 40 million tests had been distributed by the province, including 14.9 million for individual use.

“We have an ample supply of testing kits, and participating pharmacies can continue to order them as needed to meet demand,” the health minister said.

Since the beginning of March, a downward trend appeared in the number of rapid tests being ordered by pharmacies:

• Mar 5-11 – 349,920 tests
• Mar 12-20 – 282,420 tests
• Mar 21-27 – 211,680 tests

In that same time period, wastewater levels of RNA from the virus that causes COVID-19 were trending up in Calgary and Edmonton, and the positivity rate for PCR testing was trending up provincewide.

Copping noted that in the past week, orders for rapid tests have increased and the province confirmed a million tests have been shipped since March 28.

Thaleshvar said his staff were becoming concerned that the rapid tests were taking up valuable storage space and going unused, but noted an increase in the number of calls requesting them about a month ago.

“And just a lot of people, we noticed, were coming in asking and it seemed like they were used to being told, ‘No, we don’t carry them,’ and they were just suddenly surprised when we do have them.”

Alberta Blue Cross lists the pharmacies in Alberta that carry rapid tests on their website.

–with files from Sarah Ryan, Global News