In order to deal with the enormous pressure that the corona vaccination brought with it, pharmacies were allowed to administer corona vaccines in 2021. The scheme was a success, and mostly pharmacies in over 80 municipalities were asked to assist, including in Bergen, Asker and Sandnes. At the beginning of July, there were still 60 municipalities that had such an agreement with the pharmacies, and vaccination is still ongoing.
But for every vaccine that is administered, there is a financial settlement that must be made. This has so far been done by the pharmacies sending an invoice to Helfo, which in turn invoices the municipalities. Two major advantages of this scheme are both that it runs automatically, but also that the correct municipality is invoiced. It is the vaccinated person’s home municipality that must be invoiced, not the municipality where the pharmacy is located.
On 30 June, the Ministry of Health and Care Services stopped this automatic settlement scheme, with effect from 1 July. Pharmacies in 60 municipalities are now scratching their heads over how to resolve the payment, write Today’s Medicinewho first mentioned the case.
General manager and pharmacist Sissel Ludvigsen at Apotek 1 Brandbu reacts to several things in this case, including that no time was given to prepare new agreements or alternatives. She was informed of the change on Friday 30 June at 1pm.
– We received no notification about this, she says.
– We don’t understand why the authorities are doing this, says professional director of the Apotekforeningen, Hanne Andresen, to Nettavisen.
The Ministry of Health and Care tells Nettavisen that this was a temporary arrangement. Read the full response further down in the case.
– I thought we could face the summer safely
Andresen says that in March she sent a letter to the ministry to ask for clarification on what would happen with the scheme. No clarification ever came until the scheme was removed on 1 July.
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What makes the change extra difficult for the pharmacy industry to understand is that pharmacists’ right to requisition covid-19 vaccine before this surprising announcement was extended until 30 June 2024.
– We interpreted that as a signal that vaccination was still important, and thought the settlement scheme would also continue. We thought we could go this summer safely, says Ludvigsen at Apotek 1 in Brandbu.
In addition, the fee the pharmacies had for vaccinations has also been removed. This means that all municipalities must negotiate a new price for the vaccination with the pharmacies.
Have to reinvent gunpowder
In Ludvigsen’s municipality, Gran, there is no vaccination centre. Two pharmacies are responsible for all corona vaccinations. Now Ludvigsen and other day-to-day managers in pharmacies around Norway must reinvent gunpowder.
– Helfo is, after all, an automatic settlement scheme that is already in pharmacies, with regard to blue prescriptions for medicines and so on. Now there will be a lot of unnecessary, manual extra work, with separate invoicing, both here with us, but also with the municipalities, says Ludvigsen.
And all this has happened days before the public holiday was kicked off.
– In order not to spoil those who had booked an appointment now in July, we have decided to continue the vaccination in the pharmacies. Then we just have to find a solution to the financial issue when the people responsible in the municipalities are back from holiday. But we don’t have a good, alternative settlement arrangement as it is today, says Andresen to Nettavisen.
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Although the major pandemic pressure has subsided, there is still extensive vaccination of the elderly and others who need a booster dose. In 2022, more than 150,000 vaccines were given by employees in the pharmacies, reports Dagens Medisin. FHI recommends that people in the age group of 75 years and older and nursing home residents where more than 6 months have passed since the last dose, receive a refresher dose.
– Even if there are no headlines in the major newspapers about hospitalized patients and deaths, there are still many people who get really sick from corona, especially those who have not been vaccinated or have only taken one or two doses a long time ago, says Ludvigsen.
Andresen learns that FHI will also recommend refresher doses for certain groups in the autumn.
Does not take self-criticism
To questions from Nettavisen about why the scheme was removed, State Secretary Ole Henrik Krat Bjørkholt (Ap) in the Ministry of Health and Social Care replies:
– The settlement scheme in the vaccination regulations, which expires on 30 June 2023, was established as a temporary arrangement when there was a need to increase vaccination capacity in handling the corona pandemic. Approximately 12 million doses have been given in the programme, and of these a very small proportion have been placed in the pharmacies.
When asked if it is no longer important to vaccinate against corona, Krat Bjørkholt replies that we are now “in a different situation, and that there is good immunity in the population”.
– It is a municipal responsibility to offer and carry out vaccination against infectious diseases in the national vaccination programme, he adds.
– What do you think about the criticism that comes out here, which is that this happened without warning and without any good alternatives?
– This was a temporary authorization, and it has been known all along that it expired on 30 June. The municipalities will still be free to enter into agreements with private actors to carry out vaccination. The only practical change is that the private actors cannot send their claims to Helfo, but that the financial settlement must take place between the private actor and the municipality, says Krat Bjørkholt.
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Therefore, Andresen did not receive an answer
– Andresen in the Pharmacists’ Association says that she sent you a letter in March regarding this, and that there was never any clarification before the scheme was removed on 1 July. What went wrong here?
– Assessment of various regulations has been part of the government’s overall handling of covid-19, and unfortunately it has taken some time to decide whether each of the various regulations should expire or be extended, the state secretary replies.
Andresen of the Apotekerforeningen tells Nettavisen that the public health report was considered in the Storting a few weeks ago. The Government was then tasked by the Storting to look at how pharmacies can be better used in vaccination work.
– After that, two weeks pass before the settlement scheme for pharmacies is removed without warning. Isn’t this a bit strange?
– As I said, this was a temporary arrangement that came into place during a phase of the pandemic where it was important to facilitate a high vaccination capacity. Now we have another need, and that is the basis for this decision. As before, the municipalities can enter into agreements with private providers regarding the implementation of vaccination. Even if the need for vaccination is in periods higher than the current level, we cannot see that it will have any effect on the municipality’s vaccination capacity and preparedness if the current scheme is not extended. This is also supported by the Directorate of Health. The government will follow up the Storting’s decision and see this in the context of the Pharmacy Act Committee’s NOU on the future of pharmacies, concludes Krat Bjørkholt.
2023-07-16 06:37:30
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