Private pharmacists are stepping in to reassure Barbadians that intermittent shortages of prescription medicines, including those for chronic conditions, are being managed and that alternative drugs are available while supplies stabilise, Barbados TODAY can reveal.
But patients can expect to pay at the pharmacies higher prices for those drugs which the Barbados Drug Formulary, administered by the Barbados Drug Service, often provides at lower cost.
Acting Drug Service Director Delores Mascoll declined to comment, stating she would have to get approval from her superiors. Permanent Secretary of the Ministry of Health, Wayne Marshall, was not available for comment.
“Within a week, two weeks, the suppliers do their best to try to get it back in, even if at a higher price, to ensure that the patients that need it can get it until they can get back the one on the formulary, which is at a cheaper price,” said Marlon Ward Rogers, the president of the Barbados Pharmaceutical Society, which represents the commercial pharmacies.
Supply chain issues
Ward Rogers blamed the shortage on supply chain issues triggered by geopolitical issues overseas.
He explained: “Ever since [the COVID-19 pandemic] and then exacerbated by the war in Ukraine, the shipping and different things… you got the Panama Canal, then you got the tariffs. So, it is a whole global thing. In Barbados, sometimes shipments are delayed, sometimes different things happen.
“However, as I tell most people, that most of the time when somebody say that something is missing, the brand-name medication might be missing, but there might be an alternative in a generic form; and then some people may say the pharmacies don’t have any. Then, for some items, it may be out of stock altogether.”
He continued: “A lot of the time when people say [there is a shortage], they say this because the polyclinic, which is on the government side, doesn’t have the medication. However, if they traverse into private, they would find it a lot of the time.”
Ex-minister’s alarm
On Thursday, Donville Inniss, a former health minister under the Freundel Stuart administration, in commenting on the government’s proposed expansion of the Queen Elizabeth Hospital (QEH), said Barbadians were finding difficulty accessing basic drugs in the public system.
“Beyond the QEH, much work still has to be done in the primary care setting, which is usually the first point of contact for Barbadians with the public health system. But then there are other issues such as access to basic medicines when needed,” Inniss told Barbados TODAY.
This position was supported by Ward Rogers.
“The former minister may [be right]… because he is talking from a government standpoint, which is the polyclinics and hospital, which are always out of stock… because, remember, what is on formulary and what the private pharmacies can buy are two different things.
“But the government going to obviously only buy a certain amount of medications that are on formulary. Whereas private pharmacies will buy what’s on formulary and also what’s not on formulary to be reimbursed.”
He continued: “So, when the polyclinic is out of formulary,… we may have the original brand that isn’t reimbursed for us, and yes, sadly to say, the patient may have to pay between like $15 to $100 or so, whereas at the polyclinic it would have been free… or if they bought it on formulary, it would be about $7 or $10.”
‘Pay full price’
Ward Rogers argued that when people then say a drug is not available, it is mostly because they don’t want to pay the full price.
He said: “I work in a pharmacy every day, and even if they got one or two things that are missing, mostly formulary items, I will serve them [customers] very swiftly with non-formulary items… It will be a higher price. However, as soon as it comes back in, I will turn around and get back the one that is at a lower price for the patient. .
“So, yes, I can say that certain formulary items have been out of stock. But what I can also tell you, that I have found companies that have the items, but at a higher price that I got back for my patients.
“For example, a drug was out of stock last week. I had to give a patient an alternative, and by yesterday, it was back in stock. So, the patient was still able to be given an alternative for the medication… just not the branded one; and within a week’s time, the item was back in Barbados. One, the patient still had a substitute; and two, even if it was still unavailable, within a week to two weeks, the medication would have been available again.
“I would say it’s a fluctuation of supply according to brands and so on. But to say a direct shortage where I wasn’t able to give my patient medication for the last week or whatever, no. Difficulty in finding other brands to make sure my patients can still have the medication because of the care that they desire, yes.”
He acknowledged that while it is more tedious to use the non-traditional suppliers when items are out of stock, pharmacists have to do the legwork and find other items for their customers.
Alternative routes
Ward Rogers said: “They have a lot of different suppliers that are not the traditional big boys, who do work hard to bring in a lot of different alternatives when the standard treatment is not available.”
“These alternatives would have been passed by the Barbados Drug Service; they obviously would have been tested to ensure efficacy, safety and stuff like that. We are not talking like backdoor treatment. But from the government’s perspective, [they] would not be on formulary or available at polyclinics and hospitals.”
emmanueljoseph@barbadostoday.bb
The post Pharmacies to patients: Alternatives available despite supply issues appeared first on Barbados Today.