Ont. teacher says she's being forced to switch pharmacies to maintain medication coverage
A Waterloo, Ont. teacher says she’s frustrated after learning the arthritis medication she depends on is no longer covered under her benefits plan.
Amy Miller received a notice from her provider, Ontario Teachers Insurance Plan, indicating in order to maintain her coverage for the drug, she needs to transfer the prescription to MemberRx, a speciality pharmacy.
“There are so many things that are wrong with it,” Miller says.
The medication she takes to treat ankylosing spondylitis, a type of arthritis that causes inflammation in the joints and ligaments of the spine, would cost $1,700 per refill if she had to pay out of pocket.
“The drug I'm on now is a TNF blocker, so you inject it every 10 days and it sucks up all the inflammatory cells, which allows me to move normally,” Miller explains.
The letter goes on to say: “If you do not speak with a member of the MembersRX pharmacy team, you will be responsible for paying for the cost of these high-cost speciality drugs.”
Miller admits she’s known about the coming change since last year, but hasn’t transferred her prescription yet because she doesn’t agree with the options in front of her.
“I’ve been dragging my feet ever since, to be quite honest,” she says.
With MemberRx, Miller will no longer be able to go pick up her prescription when she wants because their physical pharmacy is located in Mississauga. Delivery is her next option.
“But we live in a condo,” she said. “These things need to be refrigerated and I don't necessarily go straight home after work… They said they could deliver it to the school. I also don't want my medication coming to my place of employment.”
Privacy is also a major worry.
“They actually wanted to drop it off at Michael's craft store this week, which to me is odd.”
Miller’s pharmacist Ron Yochim at Pharmasave Waterloo Wellness Pharmacy, echoes her concerns.
“The patient should have the choice to pick up their medication at whatever pharmacy they choose to pick it up,” Yochim said. “And then in terms of safety as well, we have no way of knowing if a patient is on another medication unless they tell us if they're receiving it at a different pharmacy.”
In an email to CTV News, Ontario Teachers Insurance Plan says there is no profit motive or retail element in the MemberRx model.
“All proceeds are returned to the benefit plans that have partnered with MemberRx to support members on complex, chronic therapies,” Ontario Teachers Insurance Plan says in part. “Lower costs mean the benefit plans can continue to provide the best coverage, at the best value, for the medications their plan members need. About 1 per cent of plan members require MemberRx pharmacy support for their specialty drug needs. For the other 99 per cent, plan members continue to fulfill their everyday prescriptions at the pharmacy of their choice.”
Even so, Miller feels a responsibility to speak up for others affected by the change.
“I'm sure people are annoyed and maybe they're not speaking up, but I am going to speak up about this because it's ridiculous,” she says.
CTVNews.ca Top Stories
Child under 5 dies of measles in Ontario: PHO
A young child has died of measles in Ontario, marking the first death in the province from the highly contagious virus in more than 10 years, a Public Health Ontario report confirms.
NEW Pack the macaroni necklace: Lessons on evacuations from a woman who fled one of Canada's worst wildfires
Carol Christian had 15 minutes to evacuate her home during the Fort McMurray wildfires in 2016. She ended up losing the house and everything inside. Now, she wants to share the lessons she learned.
Think twice before sharing 'heartbreaking' social media posts, RCMP warn
Mounties in B.C. are urging people to think twice before sharing "heartbreaking posts" on social media.
'Ugly produce': One way Canadians are shrinking rising grocery bills
As the cost of food in Canada has risen, grocery shoppers are looking at ways to reduce their grocery bill, and more are choosing price over beauty, turning to companies that deliver so-called 'misfit' produce at a fraction of the cost.
Vatican revamps norms to evaluate visions of Mary as it adapts to Internet age and combats hoaxers
The Vatican on Friday radically reformed its process for evaluating alleged visions of the Virgin Mary, weeping statues and other seemingly supernatural phenomena, insisting on having the final say in whether the events are worthy of popular devotion.
Wildfires burning across Canada: Communities threatened as flames creep closer
Thousands of residents fled Fort McMurray this week, fearing a repeat of the 2016 wildfire that forced out the entire community and torched more than 2,400 homes.
5 secrets to moving better and preventing avoidable injury
Countless people seek emergency care for back pain, muscle strains and similar injuries resulting from “moving wrong” during mundane, everyday tasks such as bending over to tie shoes, lifting objects or doing household chores.
Trudeau calls New Brunswick's Conservative government a 'disgrace' on women's rights
Prime Minister Justin Trudeau assailed New Brunswick's premier and other conservative leaders on Thursday, calling out the provincial government's position on abortion, LGBTQ youth and climate change.
French police fatally shoot a man suspected of setting fire to a synagogue
French police shot and killed a man armed with a knife and a metal bar who is suspected of having set fire to a synagogue in the Normandy city of Rouen early on Friday, the latest apparent act in a storm of antisemitism roiling France amid the Israel-Hamas war.