Pay-Direct Drug plans: changes to the dispensing fee payments for Ontario pharmacies

PDF version


Further to focus update #208, the implementation of a reasonable and customary dispensing fee limit of $11.99 paid to pharmacies in Ontario is delayed until April 15, 2010


Our focus update #208 announced that the implementation of this reasonable and customary limit to dispensing fees effective March 9, 2010. Please be advised that we have delayed the implementation until April 15, 2010. We understand that our customers need additional time to position these changes appropriately with their plan members.


As previously communicated, Telus Health Solutions, Sun Life’s drug card provider, is implementing a dispensing fee maximum of $11.99 for prescriptions dispensed in Ontario. We consider that this amount represents the reasonable and customary rate as the majority of Ontario pharmacies have a dispensing fee at or below $11.99. Currently only 1 per cent of pharmacies (approximately 30) in Ontario charge a dispensing fee greater than $11.99. The dispensing fees for those pharmacies range from $12.00 to $15.99. If plan members have a prescription filled at one of these pharmacies after April 15, 2010, they may be subject to a small out-of-pocket expense for the dispensing fee portion that exceeds $11.99.  We are exploring options for those rare situations where a plan sponsor may need to reimburse their members for these potential out-of-pocket expenses.




Please call your Client Service Administrator at 1 877 786 7227