ONLY HUMAN: Drug cuts may bring problems
THOUGH THE DEBATE on Monday’s Budget is probably the primary focus of most Barbadians today, there is another issue which impacts every man, woman and child and which deserves equal attention.
I refer to Government’s intention to roll out what has been termed an “improved” drug formulary from April next year.
A special committee was set up to review the Barbados Drug Service (BDS), and it has recommended that whereas up to five different medications might currently be disbursed for a single ailment, a patient might now receive “one or two”, depending on the nature of the illness.
Minister of Health Donville Inniss also revealed that pensioners and others who presently get their drugs free as part of the BDS service, would only continue to get them free if they collected them from one of the 14 BDS pharmacies across the island. However, if they wanted to continue to get their medication from private pharmacies, they would have to pay for them.
These were the two most significant points of this interview with Inniss. However, though he went on to point out that this exercise was really to save Government paying out $2 million a year to private pharmacies, he never said how the intended formulary would be “improved”.
From experience I know the devil is always in the details, and this has me on edge about the intended “improved” formulary. Because though the BDS’ intention to limit patients’ choices to “one or two” drugs from the options available seems reasonable, what the minister did not say is that a list of the drugs which are to be cut is in circulation, and it clearly shows that many of the better quality, but admittedly more expensive drugs will be deleted.
I speak here primarily of the combination drugs that provide better management for patients suffering with a chronic non-communicable disease and because of their condition are prone to develop other complications, or have co-existing ones.
This is particularly problematic in people with hypertension who may also have diabetes or heart disease or high cholesterol, or gout.
One example of this is Enalapril which is a tablet for high blood pressure but as an ACE inhibitor also helps to strengthen a patient’s heart muscles, thereby reducing the likelihood of that individual getting a heart attack as long as they take the medication properly and stick to their recommended diet and activity regime.
If these individuals are limited to the “one or two” choices of mainly single purpose drugs, some people could have side-effects such as increased urination, high cholesterol, low potassium, and in men, impotence.
Another example is chlorpropamide, which is a reliable and effective drug for treating diabetes with minimal side effects. However metformin, a less expensive diabetic drug has been kept, and though it is very effective in helping obese patients manage their blood sugar levels, it tends to cause diarrhoea and stomach upsets among many patients.
These are just two examples, they are many more. What I find difficult to accept is why we are taking these effective combination drugs off the formulary when such treatment is billed internationally as the way to go.
This could lead to people having more complications and needing frequent hospitalisation. So the savings made one way could go down the tube a next.
Don’t get me wrong, I am all for cutting the health budget and I agree wholeheartedly with the minister that it has to be done. Maybe the users’ fees proposed by the Minister of Finance is the answer.
Sanka Price is the SATURDAY SUN Editor. Contact him at [email protected]