I want to say upfront, and I don't want this to sound like an excuse, but we are not a health care system. We don't prescribe. We don't provide the care directly. We manage a drug formulary. We make available and accessible the drugs that our population needs, and at the best price for the government.
There are alerts in the system. I don't want to leave the impression that everything is reimbursed and that there are no alerts. What was not happening in 2004 was that we were not asking for regular reports of Blue Cross Medavie, who administer the program for us, to give us those reports. But they do send us reports of people who are exceeding the limits, and we do scrutinize those send them back to their care providers. We send letters to their care providers saying, “Did you know that we've been asked for two prescriptions?”
But things have changed in Canada with pharmacy. Pharmacists and pharmacies in every province are all connected now. There used to be a time when you could go doctor shopping for prescriptions and to three different pharmacies and nobody would know. Well, now they know. Now these alerts for drug interactions and for shopping around are done at the point of service, so we don't need to monitor that because it happens right there. If a pharmacist sees that someone went around somewhere else, at another Shoppers Drug Mart, to ask for a prescription for benzodiazepines, they will contact that pharmacist and the prescriber and it will stop right there.
It's the same for drug interactions. Because we are not the care providers, we don't monitor those. The pharmacists will say right away, “This drug is not good to take with this drug. You're taking this for your hypertension and this drug should not be prescribed to you.” Then they contact the prescriber immediately.
There are redundancies in the system and we don't need to be monitoring that now.