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Doctors press province to reduce paperwork or pay for it

Doctors are pushing the provincial government to reduce the paperwork for writing some drug prescriptions or else pay them to complete the forms.

“It's just one of those passing things the GPs in our association are irritated about,” said Bill Mackie, the president of the B.C. Medical Association. “It's a constant irritant.”

At issue are the special authority forms that doctors have to fill out under the province's reference-based pricing program. Under the program the provincial PharmaCare plan will pay for the lowest price drug used to treat a condition.

If doctors believe a more expensive drug may help a patient, they can prescribe it, but they have the speed bump of filling out an extra form. The health ministry, which reviewed a similar complaint in 2003, looks at filling out the forms as part of normal patient care that should be included in the $29 the province pays every time a patient visits a doctor.

“The BCMA's position is that it's often times a big hassle,” said Mackie. “They're asking the doctors to do free work so they can save money . . . If they're making substantial savings on it they should be paying the doctors for their time. If they're not making substantial savings on it they should discontinue it.”

The BCMA brought those concerns last week to the Medical Services Commission, a joint government and BCMA body that governs what the provincial health plan will pay for.

Special authority forms have been used since the mid-1990s, but became an issue in the last year or so when the government asked doctors to fill out forms for a study of Alzheimer's drugs. “It's a poorly designed study,” said Mackie. “They're getting doctors in their offices to do their research and they're not paying for it.”

Reference-based pricing has expanded since the 1990s, Mackie said. There are now 25 forms covering some 128 different drugs, according to the BCMA's count. While some of the forms are short, he said, others such as the Alzheimer's one can take as much as two hours to complete.

“It does take appreciable time for people who have patients on these medications,” he said. “I don't think it would be a huge amount to pay for them.” Health ministry's in other provinces pay between $15 and $20 to fill out similar forms.

A health ministry official said the the government gets 11,000 special authority requests each month. Paying doctors $20 a form to fill them out would therefore add roughly $2.5 million to the provincial health budget.

“The Medical Services Commission understands that there may be additional administrative duties associated with completing some of these forms,” said the official in an e-mail. “It has encouraged the BCMA and PharmaCare to work closely together to retain the value and safety benefits of a managed drug system but also to reduce the administrative burden that some physicians may be facing.”

The BCMA's Mackie said the Commission has agreed to look into the details before its next meeting.

Andrew MacLeod is The Tyee’s Legislative Bureau Chief in Victoria. Reach him here.

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