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Doc’s pain

Sanka Price

Doc’s pain

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SOME DOCTORS are unhappy with announced cost cuts by the Barbados Drug Service (BDS) because they are fearful of the impact on patients.
They are so concerned that they have asked their union, the Barbados Association of Medical Practitioners (BAMP), to lobby the Ministry of Health on the matter.
Yesterday, BAMP president Dr Carlos Chase confirmed the cuts in the BDS’ formulary, which will take effect from April 1, had been discussed.
“We plan to formulate something on it because there are a lot of ramifications,” Chase said, but gave no further details.
The cuts, as explained by Minister of Health Donville Inniss last November, are expected to reduce Government’s bill to private pharmacies by up to $2 million a year.
He said the special committee set up to review the BDS had recommended that whereas up to five different medications might currently be disbursed for a single ailment, patients could receive one or two depending on the nature of the illness.
Inniss said though cuts were necessary to reduce the spiralling BDS budget, they would be done “without compromising the delivery of service”.
However, doctors who spoke with the SUNDAY SUN yesterday said chopping the number of drugs would not necessarily save money, but may endanger patients.
“If you have 200 people on seven various diabetic drugs and you reduce that to two drugs, it means the 200 people would go onto the two available. The savings would come if the two drugs are cheaper,” said one doctor.
“However, if some people are allergic or for some other reason cannot tolerate the drugs available, then patients could stop taking their medication, and this could lead to complications resulting in hospitalization – and that is the danger of this move by the BDS.”
Speaking specifically about the slashing of 28 hypertensive drugs from the formulary, family physician Dr Colin Alert said if it were just to cut costs, that approach may be “penny wise and pound foolish”, adding any reduced access to such pharmaceuticals could lead to patients not complying effectively.
“The consequences of uncontrolled hypertension include heart disease and strokes. If money is not spent trying to control hypertension, then it will be spent managing patients in hospital, sometimes on intensive care beds, Alert said.
Some patients will need dialysis, currently costing above BDS$120 000 per patient per year – not cheap.
The costs of tertiary care are much higher than the costs of primary care.”
Alert, who was associated with the Heart & Stroke Foundation of Barbados for many years, said studies showed hypertension was the most prevalent chronic disease here, after obesity, with approximately 70 000 sufferers: with the elderly affected more than any other group.
Like other doctors who spoke with the SUNDAY?SUN, Alert said the need to cut costs in the health sector was urgent, “but swiping wildly may end up causing more harm than good”.