"Our insurance expenses are sky-high"
In Quebec, a significant discrepancy exists between the fees pharmacists charge for private collective insurance regimes and the public RAMQ plan. This pricing difference has far-reaching implications for insured individuals, affecting their out-of-pocket costs and access to pharmaceutical care.
Typically, pharmacists receive higher fees from private insurance plans, leading to variations in how insured individuals experience costs and service levels. The public RAMQ plan, on the other hand, sets regulated fees and negotiated prices for pharmacists, resulting in lower pharmacist remuneration compared to private collective insurance regimes.
This discrepancy impacts insured persons primarily in two ways: out-of-pocket expenses and cost control. Individuals insured under private collective plans may face different copayments or charges linked to the pharmacist's fees and remuneration structure, which can be higher or vary more than RAMQ's regulated system. In addition, private plans may have less bargaining power or different formulary controls, potentially affecting the final cost to the insured.
The Federation of Health and Social Services (FSSS-CSN) has noted that the cost of medications is increasingly weighing on workers' budgets. In recent years, the number of FSSS-CSS members with minimum coverage has risen significantly, from 26% in 2016 to 49% in 2025. This trend suggests that more and more workers are choosing minimum coverage to save money on insurance costs.
Steve Boutin, a maintenance worker, is one such individual. He now compares pharmacies before purchasing due to significant price variations, a practice that has become necessary due to the wide range of fees charged by pharmacies. Boutin, who has minimum coverage, spends over $4,500 a year on family collective insurance.
The Quebec Association of Pharmacy Owners (AQPP) justifies these fees by citing the complexity of medications and monitoring required. However, the Quebec Pharmacists' Code of Ethics states that pharmacists must charge a fair and reasonable price.
The Ministry of Health and Social Services (MSSS) is aware of the gap between public and private regimes and is conducting studies to better understand the situation. The FSSS-CSN is urging the MSSS to align pharmacist fees between private and public regimes to alleviate the financial burden on insured individuals.
Insurers like Beneva and Desjardins offer online services that compare medication prices in different pharmacies for their members, providing a useful tool for individuals seeking to manage their costs.
All Quebecers must be covered by drug insurance, either through the public RAMQ or a private regime offered by an employer. The increase in regime costs is mainly due to more expensive medications and higher pharmacist fees for those covered by a private collective insurance regime compared to those covered publicly by the RAMQ.
When eligible for a private regime, individuals are required to join it and enroll their spouse and children, while the public regime is for those who do not have access to a private regime, such as self-employed workers, unemployed persons, or seniors.
As the cost of insurance continues to rise, it is clear that action is needed to address the discrepancies in pharmacist fees between the public RAMQ and private collective insurance plans. A more uniform pricing system could help alleviate the financial burden on insured individuals and promote greater access to pharmaceutical care for all Quebecers.
- The pricing discrepancies between pharmacists' fees for private collective insurance regimes and the public RAMQ plan in Quebec also impact the realm of personal finance, as individuals with private insurance often face higher out-of-pocket expenses due to varying pharmacist fees and remuneration structures.
- In the quest for health and wellness, one can find ways to improve financial management through the use of services provided by insurers like Beneva and Desjardins, which offer comparisons of medication prices in different pharmacies, helping individuals with private insurance to manage their costs effectively.
- The Quebec Pharmacists' Code of Ethics emphasizes the importance of charging a fair and reasonable price, which leads to a crucial question in the realm of justice: should pharmacists be held accountable for the disparity in fees between the public RAMQ and private collective insurance plans, considering its implications on health, wellness, and personal finances for insured individuals?
