The Tribune

By NATARIO McKENZIE

Tribune Business Reporter

nmckenzie@tribunemedia.net

LABOUR Minister Shane Gibson yesterday admitted that “there is some concern” with regards to the sustainability of the National Prescription Drug Plan, noting that the number of beneficiaries has more than tripled to 25,000 since it was first introduced three years ago.

During a communication in Parliament yesterday Mr Gibson, who has responsibility for National Insurance, noted that the drug plan began in September 2010 with 6,500 beneficiaries for its first phase.

Though still a fairly new programme, the Plan has managed to improve access to medication through the addition of both public and private pharmacies as participating providers. 

“There is no question that the Plan is being utilised, Mr Gibson said. “Since 2010, the number of participating pharmacies has grown from 108 to 121 to facilitate the increase in beneficiaries and the expansion of coverage.  I am proud to say that our beneficiaries are receiving medication they previously had to pay out of pocket and they are thereby saving hundreds of dollars each month. 

“I am advised that physicians have reported increases in compliance and better control of disease, particularly with glaucoma, since patients are able to receive quality medications free of charge.  While we have experienced medication shortages, in some instances, we have been able to locate substitute products and make them available to the pharmacies or authorise alternate dosing schemes.”

Addressing concerns over the Plan’s sustainability the minister added: “While this Plan is moving progressively in numbers, providers and coverage, there is some concern of the fiscal future of the Plan with regards to sustainability of the Drug Fund. 

“This anticipated concern is being addressed to identify mechanisms to ensure the continued success of the Plan in providing quality drugs and supplies currently covered and, as well, future expansions. Since inception, the Plan has been fully funded solely through the Medical Benefits Branch (MBB) of the National Insurance Fund.  However, it was never intended for the Medical Benefits Branch to be the lone funding source for the Plan.  The National Insurance (Chronic Diseases Prescription Drug Fund) Act, 2009 identifies the Medical Benefits Branch as a source of funding, along with funding from the Consolidated Fund and contributions from workers.

“For the year 2012, the contribution from the National Insurance Fund to the Plan was $7.46m.  The 2012 Financial Statements for the Chronic Diseases Prescription Drug Fund were audited by the accounting firm PKF Bahamas, which issued a clean audit report on the financial statements,” said Mr Gibson.

“While we are pleased about the clean audit report, we are well aware that if we continue in this direction and with the funding of mini-hospitals by the Medical Benefits Branch, the Branch will be challenged to provide continued funding for the Plan. Indications are that the Central Government will soon have to consider providing funding for the Plan, at least until the Drug Plan is incorporated in the pending National Health Insurance programme.”

Audited statements revealed a significant growth of 41 per cent in drug and medical supplies expenditure from $4.06m in 2011 to $5.71m for the year 2012.  “Much of this 41 per cent growth is attributed to reimbursement costs to private sector pharmacies as the purchase of drugs for the government sector pharmacies was significantly less in 2012 at $464,300 from $738,500 in 2011.  To the contrary, of the overall growth in drug expenditure, the statements also revealed a 32 per cent reduction in administrative expenses from $2.1m in 2011 to $1.4m in 2012.”

“The Drug Plan covers specified groups for specified chronic conditions. At present, this has resulted in the government purchasing some of the same medication for both the government pharmacies and The National Prescription Drug Plan.

“This by far is not ideal and through the implementation of the National Health Insurance programme we wish to integrate and merge the procurement system and distribution of drugs for all government entities inclusive of the Drug Plan, the Bahamas National Drug Agency and the Department of Public Health.”