Health

Drug Dispensing Fees in Canada

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For individuals and/or medications that are not covered under their provincial drug program or other source of insurance coverage, dispensing fees must be paid out-of-pocket.

How much do dispensing fees cost in Canada?

The average out-of-pocket dispensing fee in Canada is $10.88 per prescription, with most people paying between $4.49 to $13.50. The cost varies primarily based on provincial drug program fee caps, type of pharmacy and how many other pharmacies are nearby (local competition).

Cost by retailer

RetailerMinAverageMax
Costco Pharmacy$4.49$4.49$4.49
FreshCo Pharmacy$9.49$9.49$9.49
Food Basics Pharmacy$9.99$9.99$9.99
Village Pharmacy$9.99$9.99$9.99
Walmart Pharmacy$7.97$10.16$12.36
Save On Foods Pharmacy$8.99$10.32$11.85
Loblaw Pharmacy$8.49$10.45$12.15
Thrifty Foods Pharmacy$10.60$10.60$10.60
London Drugs$10.00$10.72$12.15
Sobeys Pharmacy$6.99$10.91$12.54
Canadian Drug Mart$10.99$10.99$10.99
DRUGStore Pharmacy$10.99$10.99$10.99
Metro Pharmacy$10.99$10.99$10.99
The Medicine Shoppe Pharmacy$8.99$11.10$12.54
Safeway Pharmacy$7.99$11.31$13.25
Pharmasave$9.49$11.56$12.54
IDA Pharmacy$10.99$11.60$12.60
Jean Coutu$11.67$11.67$11.67
Guardian Pharmacy$9.99$11.71$12.54
PharmaChoice$8.99$11.73$17.50
Shoppers Drug Mart$10.60$12.05$14.00
Lawtons Drugs$11.67$12.19$12.54
Rexall$10.99$12.74$14.57
Remedys RX$11.85$16.33$25.00

Do the numbers not look accurate for your area? Submit a local business’ pricing here and we’ll add it to this page!

Cost by province and territory

Province or territoryMinAverageMax
Newfoundland & Labrador$4.49$8.98$12.05
New Brunswick$4.49$10.11$11.67
British Columbia$4.49$10.23$12.99
Ontario$4.49$10.76$12.99
Nova Scotia$4.49$11.08$12.54
Saskatchewan$4.49$11.24$11.85
Alberta$4.49$11.40$12.15
Prince Edward Island$8.00$11.41$12.36
Manitoba$4.49$13.38$25.00

Example cost breakdown

For example, the maximum regulated price an insulin prescription covered by the Ontario Drug Benefit program filled in an urban area:

ComponentExample Cost
Drug ingredient cost – Manufacturer’s List Price (MLP) in Provincial Formulary Database$24.97
Wholesaler markup (if applicable)
Pharmacy markup8% ($2)
Pharmacy dispensing and professional fee$8.83
Total$35.80
  • Drug ingredient cost paid to the pharmaceutical manufacturer by the wholesaler or pharmacy
  • Wholesaler markup to cover storage and shipping costs, plus profit
  • Pharmacy markup to cover storage and operation costs, plus profit
  • Pharmacy dispensing fee for filling a prescription

Some pharmacies lump all of these costs into one on your receipt, making it look like you didn’t pay a dispensing fee.

Compare dispensing fees in your area

Enter your postal code in Lumino Health’s Find a provider tool to see a map of local pharmacies and their dispensing fees. The data is based on recent insurance claims submitted to Sun Life.

In British Columbia, you can use the Blue Cross’ Pharmacy Compass to compare dispensing fees and per pill prices of both brand name and generic medications.

2021 dispensing fees reports by Express Scripts Canada

Ontario only

Canada excluding Ontario

Factors that affect the cost

The cost varies primarily based on who is paying for the drug (provincial fee caps, private insurance or out-of-pocket), pharmacy chain and number of pharmacies nearby (local competition).

Who pays for the drug

Provincial drug programs (public insurance) cap dispensing fees and markup

Each province and territories’ public drug benefit program (Pharmacare) covers the cost of drugs and their dispensing fees for eligible medications (Ontario covers approximately 5,000 different drugs) prescribed to specific groups of people – typically seniors, those receiving social assistance, households with income under a certain threshold or those with high drug costs relative to their income.

Some provinces and territories have placed a cap on the dispensing fees that can be charged to their provincial drug program, limiting either the maximum charge, how frequently the charge can be applied on a given prescription, or both.

Most jurisdictions also place a cap on the markup a pharmacy or wholesaler can add to drug prices, typically applying it to a set list of more commonly used drugs.

Expenditure for pharmaceutical drugs represents the second largest cost to the Canadian health care system, only behind hospital costs.

Province/TerritoryMaximum Dispensing FeeMaximum Pharmacy Markup charged to public drug program for most drugs
Alberta$12.15 ($18.45)3% to 7.5%, then add an additional 7% up to $100
British Columbia$10.008%
ManitobaMarket rateIncluded in dispensing fee, Wholesale: 5%
New Brunswick$11.00 ($16.50)8%
Newfoundland and Labrador$12.54Wholesale: 8.5% to 9%
Northwest TerritoriesNone
Nova Scotia$12.54 ($18.81)10% (8% if cost >$3,000), up to $325
NunavutNone
Ontario$8.93 to $13.258% (6% if cost >$1,000)
Prince Edward Island$12.366%, brand name: 10% or 9.25% (if cost >$2,702), to a maximum of $250
Quebec$10.03None. Wholesale: 6.5%, up to $49
Saskatchewan$11.8510%-30% up to max of $20
Yukon$8.75 ($17.50)30% (5% on DAA for hep C), Wholesale: 14%
Markup Policies in Public Drug Plans, 2019/20
National Prescription Drug Utilization Information System

These caps don’t apply to the prices paid by private insurance plans or by consumers out-of-pocket.

Private plans have less negotiating power, many of which are charged markups of 12% to 15%. A 2022 study of the difference in drug cost between private and public drug plans in Quebec, it was found that privately insured patients payed 17.6% more on average per drug prescription than publicly insured patients.

People paying cash lack the leverage created by negotiating as a group, so they pay even more.

However, dispensing fee caps do seem to have an effect on local dispensing fees.

For example in Nova Scotia’s Pharmacare Tariff Agreement between the province and the Pharmacy Association of Nova Scotia, the dispensing fee limit is the lesser of:

  1. Usual and customary fee charged to cash customers
  2. Maximum fee outlined in the agreement (eg. $12.25 in 2020, increased to $12.54 in 2022)

When the maximum was $12.25 in 2021, you can see that most pharmacies charged that amount or less:

These caps also encourage pharmacists to reduce the number of times a prescription is dispensed for medications used to treat chronic diseases by dispensing a 3 month supply instead of just 1 month.

Alberta

Alberta places a cap of $12.15 on dispensing fees ($18.45 for compounded prescriptions), up to a limit of 3 charges per day per patient and 2 fees per drug per 28 day period.

The maximum markup is:

  • Allowable Upcharge #1 is defined as 3% of the Manufacturer’s List Price (MLP) as per Alberta Drug Benefit List or 7.5% of Base Price as per Alberta Blue Cross Drug Price List (ABCDPL) or compound drugs.
  • Allowable Upcharge #2 is defined as 7% of: MLP plus Allowable Upcharge #1, up to a maximum of $100.

It is expected that a supply of 90 to 100 days will be dispensed for drugs that are used on a chronic or long-term basis.

British Columbia

The maximum dispensing fee reimbursed by PharmaCare is $10.00. If a pharmacy charges a higher dispensing fee than the maximum, the customer pays the difference.

The maximum markup for:

  • Most drugs maximum 8%.
  • High-cost drugs (expected daily cost of the typical dose is equal to or greater than $40.00) maximum 5%.
  • Products subject to Actual Acquisition Cost (AAC) pricing maximum 7%.
  • Effective March 1, 2017, the maximum markup on certain high-cost hepatitis C drugs covered by PharmaCare was reduced from 5% to 2%.
Manitoba

The Manitoba government capped dispensing fees charged to provincial drug programs in 2017 to $30 per prescription in order to save an estimated $11 million annually.

Pharmacies must disclose the total price of the drug and professional fee to a patient at the patient’s request.

Drug prices are listed in the Manitoba formulary and any pharmacy markup must be included in the dispensing fee. The wholesale markup Pharmaceutical Distribution Rate is 5%.

The Manitoba government also pays dispensing fees for prescriptions covered under any of the provincial drug programs such as Pharmacare, spending $54.9 million through the program on dispensing fees in 2016/17 – 22% of the total cost of providing drugs through the program.

Benefits are payable for up to 100 days’ supply.

New Brunswick

New Brunswick caps fees charged to the New Brunswick Drug Plans to $11 and $16.50 for compounds.

The maximum pharmacy markup for listed drugs is 8%.

Nova Scotia

Nova Scotia caps fees to $12.54 and $18.81 for compounds, with the price increasing every year for 5 years:

The maximum markup for most prescription drugs is 10%.

Ontario

Ontario caps fees charges to the Ontario Drug Benefit at $8.83, unless there are few other pharmacies nearby, meaning the pharmacy is rural or remote:

  • $9.93 if there is only 1 pharmacy within 5 km, or the nearest one is 5 to 10 km away
  • $12.14 if the nearest pharmacy is 10 to 25 km away
  • $13.25 if the nearest pharmacy is more than 25 km away

Up to 3 months (90 days) for prescriptions, other than controlled substances. ODB in Ontario and insurance companies will only pay for a maximum 100 days supply.

By law pharmacies have to post their dispensing fees publicly.

Prince Edward Island

New Brunswick caps fees charged to the public drug plan is $12.36 and $18.54 for compounds.

The maximum pharmacy markup for listed drugs is 6%, brand name: 10% or 9.25% (if cost >$2,702), to a maximum of $250

Quebec

Quebec caps fees charged to fill a prescription at $10.03. There is no pharmacy markup policy, but wholesaler’s markup is limited to 6.5% to a max of $49.

Since September 15, 2017, pharmacists are required to provide an itemized invoice that shows a breakdown of medication cost, including:

  • Drug cost
  • Wholesaler’s markup
  • Professional/dispensing fee.
Saskatchewan

Since March 1, 2021, Saskatchewan caps the Saskatchewan Drug Plan at $11.85, which pharmacists can choose to charge it for each 34 day supply dispensed, for each prescription.

The maximum markup is based on the acquisition cost of the drug:

Acquisition drug costMaximum pharmacy markup allowance
Up to $6.3030.0%
$6.31–$15.8015.0%
$15.81–$200.0010.0%
More than $200.01$20.00

The province maintains a list of drugs that can be prescribed and dispense in 2 and 100 day quantities.

Type of pharmacy

In general, convenience-focused stores cost the most, followed by independent pharmacies, then large chain grocery stores and Walmart, while Costco is the cheapest.

Cheapest: Costco Pharmacy

Costco’s pharmacy offers the cheapest fee in Canada at $4.49 and you do not need a Costco membership to use their pharmacy. All you have to do when you visit is tell the employee at the door that you want to use the pharmacy.

In addition, their markup for all products is capped at 15% and their pharmacy fees are low in order to get customers in the door to shop. The downside is that Costco store are often quite busy so you might wait a while while your prescription is filled, giving you time to look at and buy their other products.

However, with only 105 locations across Canada, getting to one may not be the most convenient option depending on how close the nearest store is.

If there isn’t a convenient location, you can use Costco’s Prescriptions by Mail service at costcopharmacy.ca (all provinces except PEI and Quebec) to have your medications refilled at the click of a button and delivered to your home via Canada Post Expedited Parcel in 2 to 5 business days with free shipping. You have to sign for it, so it may end up at your nearest Canada Post location. They will also transfer prescriptions from other pharmacies for you at your request. 

This service is likely ideal for those with a relatively static medication situation.

Expensive: Shoppers Drug Mart

Their higher prices are likely a convenience charge for having so many locations nearby, many of which are open late outside of business hours.

Varies: Independent pharmacies

While not the cheapest option due to not having the leverage that comes with higher volumes, independent pharmacies are generally known for providing more personalized service, getting to know you as a patient and taking more time discussing your history and offering advice. If you have new or evolving health conditions, are regularly changing medications or take more than 3 medications, it may be worth using a good independent pharmacy.

Cost with private insurance coverage

Most private health insurance policies will cover a percentage – typically 70% to 90% of the cost of prescriptions, including the dispensing fees and some waive the dispensing fee altogether. You would pay the remaining amount out-of-pocket.

How to save money on dispensing fees?

Ask for a 3 month supply

Drugs used on a chronic or long-term basis, such as cholesterol-lowering or blood pressure medication, oral contraceptives, insulin, etc. can be dispensed in larger quantities to patients with stable medical situations.

Ask your doctor if they can write your prescriptions for refills of 3 months or more, rather than 1 month, to reduce the number of refills you have to do per year and thereby reduce the total dispensing fees you pay.

Shop around

The cost of prescription drugs can vary greatly depending on where you shop. Call your local pharmacies and ask how much it will cost to fill your prescription(s). Ask for a breakdown of the cost of the drugs, including the dispensing fee and drugs themselves.

You may save money by switching pharmacies, even if your insurance covers a portion of the fees.

FAQs

What is a dispensing fee?

A dispensing fee is an amount charged by a pharmacist for preparing and dispensing a prescription.

It is charged for each separate prescription that they fill, every time they prepare the prescription. Each must be stocked, counted, labelled and prepared in a separate bottle or tube.

Each pharmacy sets its own fees, which vary considerably between pharmacy locations and can become a significant cost for patients – especially those with chronic diseases (frequent refills, even daily) or complex medical situations (many prescriptions). These fees directly impact Canadians’ access to important prescription drugs and the sustainability of Canada’s health care system.

What is a professional fee?

Professional fees are charges for the time a licensed pharmacist or pharmacy technician spends talking to patients about their treatments, reviewing or managing their medications. A dispensing fee is a kind of professional fee.

What are compound drugs?

Compound drugs are a mixture of 2 or more ingredients that must be prepared specifically for an individual patient. They require more time and resources as well as a sterile environment to prepare, so they often come with a higher fee.

Sources

About the author

Alex Wideman
Alex Wideman is a consumer rights advocate, serial entrepreneur and the editor-in-chief of Cansumer. He has a bachelor's degree in electrical engineering from Queen's University. He is passionate about helping others save time and money and has been creating consumer-focused online resources for over 10 years. More about Cansumer Read more

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