MONTREAL — Seven major Quebec unions representing over 365,000 public sector employees are calling for government intervention to curb rising prescription drug costs, specifically targeting pharmacy dispensing fees charged to private insurance plans. The organizations argue that escalating costs are forcing members to reconsider their private insurance and potentially shift to the public system, the Régie de l’assurance maladie du Québec (RAMQ). This growing financial burden on workers is prompting a demand for greater equity and affordability in pharmaceutical care.
The core of the issue lies in the disparity between fees charged to the RAMQ versus those billed to private insurers. Currently, there’s no cap on what pharmacists can charge private plans, leading to significantly higher costs for the same services – sometimes two or three times as much, particularly for specialty medications. According to the unions, these inflated fees are a major driver of increasing insurance premiums, making coverage unsustainable for many workers. The situation highlights a broader debate about ongoing challenges in Quebec’s healthcare system, including stalled contract negotiations with public sector pharmacists.
“It’s really about fairness,” stated Roberto Bomba, treasurer of the Fédération interprofessionnelle de la santé du Québec (FIQ). “The government is able to cap fees for the RAMQ because otherwise, there’s no control. Well, it needs to cap them for the entire population.” The FIQ, representing 58,000 healthcare professionals, estimates that higher pharmacy dispensing fees cost their members $48 million annually, compared to an estimated $26 million if they were covered under the public system – a difference of $22 million. This translates to roughly $380 per worker per year, a significant expense for many families.
Demanding Amendments to Bill 15
The unions are urging the Quebec government to amend Bill 15 to grant it the authority to regulate pharmacy fees charged to private insurers, mirroring the control it already exercises over the RAMQ. The organizations submitted a letter to the National Assembly on February 11 outlining their concerns and requesting action. They argue that such regulation is essential to protect both insured individuals and the long-term viability of both private and public drug insurance plans in Quebec. The Association des pharmaciens des établissements du Québec (APES), which represents over 2,000 pharmacists in institutions, has as well been vocal about its own contract negotiations with the government, which have been stalled for two years.
Beyond Pharmacy Fees: Rising Costs and Absenteeism
While pharmacy dispensing fees are a key focus, the unions acknowledge that rising drug costs and increased employee absenteeism also contribute to the overall increase in collective insurance expenses. The cost of medications, particularly specialty drugs, continues to climb, putting pressure on insurance plans. A growing number of insured workers taking prolonged absences from work adds to the financial strain. However, the organizations maintain that addressing pharmacy fees is a crucial step towards controlling costs and ensuring equitable access to pharmaceutical care.
Stakeholders and Collective Bargaining
The coalition of unions making this demand includes the FIQ, the Fédération de la santé et des services sociaux – CSN (FSSS-CSN), the Fédération autonome de l’enseignement (FAE), the Fédération nationale des enseignantes et des enseignants du Québec (FNEEQ-CSN), the Fédération des professionnelles (FP-CSN), the Syndicat de professionnelles et professionnels du gouvernement du Québec (SPGQ), and the Fédération des employées et employés de services publics (FEESP-CSN). These groups represent a broad spectrum of public sector workers, from teachers and healthcare professionals to government employees.
The situation also raises questions about the role of collective bargaining in healthcare costs. The APES, acting as a professional union, works to defend the professional, economic, and social interests of its members, negotiating collective agreements. The current lack of a contract for public sector pharmacists, as highlighted in recent reports, underscores the complexities of negotiating fair compensation and working conditions within the healthcare system.
The Broader Landscape of Quebec’s Insurance Coverage
Currently, approximately 40% of Quebec’s population is covered by the public health insurance plan (RAMQ), while 60% relies on private insurance, often through their employer or union. This dual system creates a disparity in access and affordability, with those covered by private insurance potentially facing higher out-of-pocket costs due to unregulated pharmacy fees. The unions’ proposal aims to level the playing field and ensure that all Quebecers have access to affordable pharmaceutical care, regardless of their insurance status.
The potential financial impact of capping pharmacy fees is substantial. For the FIQ’s 58,000 members alone, the estimated savings of $22 million annually could be reinvested in other healthcare priorities. More broadly, regulating pharmacy fees could help stabilize insurance premiums and make coverage more accessible for all Quebecers.
As of February 20, 2026, the Quebec government has not yet responded to the unions’ request to amend Bill 15. The next step will likely involve further discussions between government officials and union representatives. The outcome of these negotiations will have significant implications for the future of pharmaceutical care in Quebec and the financial well-being of public sector employees.
This is a developing story. We encourage readers to share their experiences with prescription drug costs and insurance coverage in the comments below.
