PRIVATE pharmacies wishing to be included in the Chronic Disease Assistance Programme (CDAP) network of over 275 pharmacies will now have to pay a one-time set-up cost of about $68,000. This cost was previously borne by the public health system.
Recurrent costs for the programme, such as delivery of pharmaceutical supplies and internet access, would be met by the Health Ministry and by extension the taxpayers.
There has also been a reduction in the CDAP dispensing fee, paid to pharmacies, to $8 which took effect from July 1. The ministry said this would generate a cost savings of about $5 million per year.
Pharmacies would be restocked with CDAP drugs every month instead of two which was expected to increase the availability of drugs for customers. The ministry said the reduction in the dispensation fee would allow for the purchase of additional drugs and medical supplies and also cover the cost of the increase in the frequency of deliveries to pharmacies.
However, president of the Pharmacy Board Andrew Rahaman said pharmacies could not afford that at this point.
“They would have now finished setting up their infrastructure and they would be scraping up every cent they could to stock the pharmacy.
There is only the one per cent who could afford that. The average John Doe who opens a pharmacy doesn’t have that kind of money.
“The minister (Terrence Deyalsingh) said that was all right, no problem, we have enough people doing it already. I find that a bit discriminatory because 275 identical establishments would have gotten it free of charge. Those that opened up did so to make it more convenient for citizens in outlying areas. Citizens want a pharmacy closer to them. It could be close to 100 pharmacies because for the past three years they have not granted one CDAP applicant approval.”
He said there were a lot of elderly people who depended on the CDAP. “In my mind he is not considering the citizens. So what he’s saying is well, if the pharmacies don’t want to come in, don’t come in.”
Rahaman said the reduction of the dispensing fee was not $2 as the minister made it out to be, but $5.
“It used to be $13, then $10, then $8. The minister’s justification was, the cost of the medication was so low compared with the cost of the payment. If the ministry buys the cheapest medication for CDAP they cannot compare the price of the medication with the price of the service.
“All of that brings us to the issue of counterfeiting. We want all medication in Trinidad, including CDAP, tested. Trinidad has no facilities, or limited facilities, to test the medication. There is a medication called Diflucan which is about $200. We started getting an equivalent to Diflucan for $5. Something is wrong with the product. They are choosing the cheapest medication possible to put in the CDAP.” Rahaman also said receiving stocks every month was not the issue, but it was having a reliable supply of pharmaceuticals. “Our information is that it is because of non-payment. If we know we have to wait two months we will order enough for that period.
“It is the ministry that is tardy in paying the suppliers. The only way to get your road paved is to burn tires. The only way to get payment is to stop supplies and then the ministry would hasten to pay.”