VANCOUVER, British Columbia — The British Columbia Pharmacy Association (BCPhA) has recommended to the provincial government a different approach for managing spending on immunizations.

BCPhA said Monday that it has submitted an analysis to British Columbia’s Select Standing Committee on Finance and Government Services Budget 2014 Consultations. The association’s report calls for vaccination-related spending to be grouped as one area of the provinces, rather than as different "silos" of health care providers.

Currently, funding for immunizations in the province is divided among health authorities, pharmacists, physicians, pediatricians, licensed practical nurses and other providers.

Doing away with these silos, BCPhA explained, would enable the government to improve the tracking of immunizations administered by each provider in relation to cost and lower spending by directing patients to health providers with the highest immunization rates and lowest cost.

"Breaking the funding silos for services like immunizations is one way government can immediately accomplish its goal of providing British Columbians with alternative service delivery models that offer better programs at less cost," BCPhA chief executive officer Geraldine Vance said in a statement. "As the lowest-cost provider of immunizations, pharmacists believe integrating funding for this service will enable the province to manage spending more effectively, which will ultimately benefit patients."

Specifically, the BCPhA report recommends that British Columbia eliminate the silo approach to PharmaCare budgets; assign all immunization-related expenditures to one area of the health care budget to better manage costs; allocate spending on vaccinations based on health provider output (immunization rates and accessibility) in relation to costs; divert immunization-related spending from low-rate, high-cost providers to high-rate, low-cost
providers; and ensure that funding for pharmacy-administered immunizations is kept at current spending levels for the fiscal year starting April 1, 2014.

"The positive impact that pharmacists are having on the health care system by increasing the rates of immunizations administered in pharmacies is not being fully recognized. This is because pharmacy’s positive contribution to expanding access to immunizations in the province is viewed in the silo of the PharmaCare budget and is consequently managed within the confines of drug-related costs rather than as a health and wellness related expenditure," BCPhA stated in its analysis.

"We believe it would be more effective for all providers to be evaluated together so funding for these services could be allocated based on output, specifically rates of immunization and accessibility in relation to cost of service," the report said. "This restructuring would allow the B.C. government to better realize alternative service delivery for immunizations."

BCPhA noted that the number of publicly funded, pharmacist-administered vaccinations in the province has surged in recent years, climbing from 31,659 in the 2009/10 flu season to 49,000 in 2010/11 and then jumping to 92,286 in 2011/12. The figure has more than doubled for 2012/13, soaring to an estimated 190,000. The association added that B.C. pharmacists are expected to provide even more flu vaccines in the current 2013/14 flu season.

BCPhA’s report also urged the provincial government to invest in pharmacy-based care to mitigate drug costs, sustain rural pharmacy services, broaden pharmacy-based care to achieve cost avoidance and improve health outcomes, and invest in primary care.

"We believe pharmacy can play an integral role … by providing access to high-quality
health services that contribute to better patient outcomes," the association’s report concluded. "Additionally, we believe pharmacies present B.C. with an opportunity to avoid costs, achieve service delivery efficiencies and improve continuity of care for patients."