Former Health Minister raises concerns over prescription plan
By ALISON LOWE
Tribune Staff Reporter
alowe@tribunemedia.net:
FORMER Health Minister Dr Bernard Nottage expressed concern yesterday that despite seeking to expand access to medications, the National Prescription Drug Plan may fail to address the long-standing problem of certain drugs being unavailable at community clinics for those who need them.
Dr Nottage told Parliament he believes Bahamians are on a "collision course with premature death" as a consequence of the high prevalence of chronic non-communicable diseases (CNCDs) like diabetes, hypertension and heart disease that are often preventable through lifestyle and dietary changes. Sixty per cent of deaths in The Bahamas are said to be CNCD-related at present.
The MP's comments came after Prime Minister Hubert Ingraham, in his contribution to Parliament on the NPDP regulations as Minister responsible for the National Insurance Board, said he believes many Bahamians die unnecessarily because of lack of access to medications for chronic non-communicable diseases.
The NPDP is intended to, in its first phase, make medications for 11 CNCDs available free of cost to certain categories of Bahamians, including those over 65, NIB-registered invalids, children under 18 years of age and up to 25 years of age if still in full time education.
Mr Ingraham said: "I'm no doctor but I honestly suspect that many people who are required to take medication like high blood pressure pills or diabetes etcetera end up dying because they don't have it. They don't have the means to get it or a public health facility was out of it."
"It is my hope and expectation that (as a result of the implementation of the drug plan on August 1) people of any constituency will no longer have to go to the clinic to find out there there's no diabetes pills or high blood pressure pills. That everybody will have their supply, and that they will pick it up and take it."
The Prime Minister explained during his contribution how 11 private pharmacy companies with 16 locations have at present been voluntarily contracted to dispense the medication free-of-cost to patients on behalf of the Government, and in places where such private pharmacies do not exist, such as in many family islands, public clinics will play this role.
He admitted that governments "have not done a good job all of these years" of ensuring the necessary medications required by local populations have been available in some of the family island clinics.
"Even if we have to contract services outside of National Insurance, we have to make sure that all of these clinics have medications," said Mr Ingraham.
Dr Nottage said this is an area that will "require a lot of attention" if the NPDP is to work successfully.
"Will these clinics be adequately supplied at all times? It may well be that this contract about which he spoke to enable drugs to be transported to these clinics will do the trick, but I doubt it seriously," said the former health minister. He also noted that the 115 public clinics also suffer from a shortage of qualified pharmacists to dispense medications. There is a recognised shortage of Bahamians with pharmacy qualifications at present.
Dr Nottage further noted the fact that only 11 private pharmacy companies have at present entered into contracts with the National Insurance Board to dispense medications under the NPDP, out of a total of over 30.
He said that his inquiries on the matter have revealed that many are concerned about receiving payment promptly from the government for their services, and the possibility of ending up at a financial loss through their participation in the plan.
"One of the problems for private pharmacies is that they will have to carry two different inventories, one for general patients and one for plan patients and that could be very expensive. They are concerned that they will purchase plan medications and if they are not sold that it will be at their loss and they will need help to cover any loss. They are concerned that they will only cover those plan items that will move quickly and therefore people may find they have some but not others. I think these are very real concerns that have to be looked at," said Dr Nottage.
In his contribution, Prime Minister Hubert Ingraham said he is "not satisfied" with the number of pharmacies that have agreed to participate in the plan and called on more to do so. He suggested they would see increased profits as more people will be attracted to make purchases at their pharmacies and outlined how claims for payment would be made within a week.
Former minister Dr Nottage noted that overall the PLP supports the NPDP "a little bit of something good is better than nothing," but considers it "limited" and something that they would have preferred to see come into effect along with the full comprehensive health coverage they pushed for during their last term in office.
The present government is of the view that their comprehensive plan was "unsustainable" in the form that was proposed.
July 23, 2010
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