How a $3 pill can earn a pharmacist $200

A bar funded with public money

Imagine buying a baguette for $3 and the baker charging you $200 just to hand it to you. Absurd, isn’t it? Yet that’s exactly what’s possible in some pharmacies in Quebec, as long as the customer is a victim of a crime compensated by the IVAC. A Montreal pharmacist, outraged by the situation, sounded the alarm on the TV show Enquête. For him, the conclusion is clear: it’s “absurd” and shows “glaring laxity.” After all, it’s our tax dollars that are paying for it.

To back up his claims, this pharmacy owner (who remained anonymous for fear of reprisals) conducted a real-world test. He took the file of a patient covered by IVAC to whom he was dispensing clonazepam. This mild anti-anxiety medication costs only $3.22. Normally, he would charge about $12 in fees for this service. But for the experiment, he entered a $100 claim into the system. The result? It was accepted immediately. The money was paid out two weeks later. He then canceled the transaction to reimburse the government, but the point had been made.

$200 in fees with no questions asked

The pharmacist wanted to push the envelope even further. He repeated the experiment, this time charging a $200 fee for the same $3 medication. That’s sixteen times the normal price! And guess what? The system approved the transaction without batting an eye. His account was credited with $203.22. No alerts, no verification calls, no requests for adjustments from IVAC. If such an invoice had been sent to a private insurance company, it would have been blocked outright. “That’s outrageous—it wouldn’t have flown,” confirms our whistleblower.

Unfortunately, this is not an isolated case. The Enquête team pored over the data and discovered, as of October 31, 547 cases where pharmacists had billed astronomical amounts for basic medications costing between $3 and $13.50 per month. For example, for citalopram (a $4 antidepressant), an average fee of $97 was charged 33 times. For naproxen, a simple anti-inflammatory, the bill exceeded $100 on 56 occasions. On average, these inflated fees hover around $78.

Why isn’t anyone keeping an eye on the health insurance fund?

How is this possible? We asked IVAC directly. A spokesperson confirmed, in writing, that there is no mechanism in place to monitor fees. The explanation is puzzling: According to the organization, its system differs from that of the CNESST (which handles workplace accidents) because the IVAC is 100% publicly funded, whereas the CNESST is funded by employers. This is a surprising line of reasoning, especially since the CNESST itself only reimburses “usual and customary” rates.

The Order of Pharmacists acknowledges that these amounts seem high at first glance. Nancy Marando, director of communications, points out that the code of ethics requires a “fair and reasonable” price. However, the Order is awaiting a more in-depth analysis before making a decision and emphasizes that it has not received any complaints from IVAC on this matter.

Collateral Damage

This lack of regulations has very real consequences beyond the bill for taxpayers. The pharmacist who contacted us heard about this scheme from a colleague who was in the midst of a misadventure. The latter had just purchased a pharmacy and realized—too late—that the revenue had been artificially inflated through these repeated abuses of IVAC claims.

This new owner discovered exaggerated claims spanning several years. The result? He overpaid for the business, based on a distorted profit margin. The case is now in the hands of the courts, as the new owner is considering suing the seller. Yet more proof that when it’s “open bar,” the bill always catches up with someone eventually.

According to the source: ici.radio-canada.ca

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How a $3 pill can earn a pharmacist $200