Bodoe: Ministry supports access to affordable medicine

Health Minister Dr Lackram Bodoe. - File photo

HEALTH Minister Dr Lackram Bodoe said investigations into alleged monopolies fall under the Fair Trading Commission, and the ministry does not regulate drug prices or decide which companies apply for product registration.

However, in a WhatsApp response to Newsday, he added that the ministry is committed to a rigorous and transparent approval process and supports access to safe, effective and affordable medicine.

“As the Honourable Prime Minister has indicated, the government is committed to advancing measures that increase competition within the pharmaceutical sector and ultimately help reduce costs for the population. This includes ongoing engagement with key stakeholders and efforts to strengthen market competitiveness, which can positively influence both pricing and availability of medications.

“Within the Ministry of Health, our mandate is to ensure that all suppliers entering the market meet the established regulatory standards for safety, efficacy and quality of drugs for both the public and private health sectors.”

On December 1, during a sitting of the Public Administration and Appropriations Committee, Private Pharmacy Retail Business Association president Glenwayne Suchit alleged there was a monopoly in the pharmaceutical sector.

He claimed Suchit claimed one pharmaceutical and healthcare distribution company owns 74 per cent of the pharmaceutical private market. And three distributors control 70 per cent of wholesale pharmaceuticals market.

During that same hearing, it was revealed about $80 million in unused drugs had expired while in storage over a ten-year period.

Pharmacy Board to review standards

Earlier this year, the Pharmacy Board of Trinidad and Tobago (PBTT) began a nationwide assessment of pharmaceutical standards across public and private practices, including pharmacies and distributors.

PBTT president Ricardo Mohammed said the initiative recognised the need for consistent national standards and the interdependence of public and private pharmacy operations.

“We have to ensure that whatever happens on the distributor side and the retail side is within the best interest of the patient, and that is something we have been working very hard on with this new board.”

He said the board plans to present its findings to the Health Minister, with the aim of securing legislative changes that would allow the PBTT to act in more situations.

Mohammed said that the board is a regulatory authority under the Pharmacy Board Act of 1962, responsible for granting licences to pharmacies and pharmacists and issuing practising certificates, as well as monitoring the profession and how it is conducted.

He noted the board’s remit does not currently include setting best practices for storage, dispensing and tracking of pharmaceuticals in public institutions, but he has been seeking legislative revisions to empower the PBTT in those areas.

Mohammed said the board is aware of drug shortages and concerns about market dominance.

“From time to time, the Pharmacy Board will receive reports related to drug shortages and procurement issues. However, no action can be taken by the Pharmacy Board because most of these reports and issues referenced do not fall directly within the purview of the Pharmacy Board. However, when the opportunity arises, the Pharmacy Board will engage with relevant stakeholders – the Ministry of Health, Chemistry, Food and Drugs, the Drug Inspectorate, the Private Pharmacy Retail Business Association (PPRBA) and most of all our membership – as to what is happening.”

He attributed shortages to foreign exchange constraints and delays in pharmaceutical registration at the Chemistry, Food, and Drugs Division (CFDD), and called for CFDD reforms.

For example, he said CFDD has up to 180 days to reply to requests, and responses can be negative or seek further documentation after that period, causing additional delays.

“This has been a major problem for pharmacists and persons who want to import pharmaceuticals into the country because, based on purchase history obtained by the PPRBA, the process in which this is done at the Chemistry, Food and Drug level is alleged to favour certain companies.

“We know for a fact that there are some companies that have major shareholdings with regard to procurement practices and supply chain, who appear to have their stuff registered by Chemistry, Food and Drugs faster than some of the smaller companies.”

He said the Fair Trading Act treats 40 per cent or more market share as monopoly power, and the PPRBA found one company had about 68 per cent overall in the retail trade, even if not across every drug class. The act does not bar a company from controlling 40 per cent or more of a market, but penalises abuse of dominance.

Mohammed highlighted distributor-owned retail chains as a major issue. He said 536 pharmacies were registered nationwide in 2025, with about 40 large chain outlets, and unfair trading practices were straining independent pharmacies, leading to dozens of closures in 2024.

“What we found that was a little concerning is that we are seeing prices being advertised that are below wholesale prices by some of these big chain pharmacies, who we know are owned by a parent company, which is owned by the distribution company.”

He explained pharmacies are capped at a 35 per cent markup on dispensary items, but most operate at around 25 per cent, which barely sustains growth, especially as pharmacists are not paid for clinical advice that can save patients money. By contrast, markups in other retail sectors like clothing and supermarkets range from 35 to 100 per cent.

Yet some chains use markups of about eight per cent — either due to high-volume discounts from distributors or affiliation with them — and customers gravitate to the lowest prices. He estimated that if independent pharmacies close owing to undercutting, thousands of jobs could be at risk, with five to six employees per pharmacy.

He added that monopolies can set exorbitant prices when they are the only source of the product in demand. Over the past year, he said, the board observed significant price increases from some distributors, despite stable shipping and ingredient costs.

“And these same companies are buying out all these smaller ones, buying out all the different generics, and increasing the price little by little. So what is happening is that the healthcare bill for the average person goes up significantly. And what is happening is that a lot of people cannot afford to buy their medication right now, so now they rely on the public sector.

“When you go to the public sector, though, the procurement processes are flawed. And because these procurement processes are flawed, because sometimes the same company is supplying the government with the majority of their pharmaceuticals, there is no competition on the market that will allow them to bring down the prices.”