Scarcity of some drug brands but generics available – Drug Service

Key brand name drugs to treat diabetes and other illnesses are in short supply on the island, the head of the Barbados Drug Service (BDS) said Monday. But she said there was no need to panic.

A widely used brand of insulin, used to help manage blood sugar levels, is among select drugs in short supply, said the BDS’ acting director Delores Mascoll, but there are several other brands available.

“Right now, we are experiencing some serious challenges with drug shortages, and many of these challenges aren’t just with generic products, but quite a few of them are with branded products, and this is not normal. So we are seeing challenges where the manufacturers of these branded products are having difficulty at the point of their manufacturing. It’s either raw material shortages or problems within the actual manufacturing process,” she said after the Government of India handed over a refrigerated truck for the BDS.

Mascoll stressed that there is no need for patients to panic, as an easily accessible generic brand is still available.

“One of the biggest challenges we are facing right now is a shortage with a particular brand of insulin. Now I don’t want patients to panic, because there is an alternative to that particular brand of insulin which is readily available at this point in time. It may just be a matter of them having to liaise with their physician so that they can be changed to that particular brand of insulin temporarily until the supply has been reestablished to the other brand. I just want patients to understand that,” she explained.

Mascoll also sought to respond to concerns from some patients that there have been changes to the national drug formulary, which sees patients who previously were able to get five insulin pens per month now only get two.

She explained that though the change was made to protect the supplies of the easy-to-use pens due to the shortages, vials are still available and are effective.

“There are two particular brands of insulin where you get it in a 10ml vial, or you can get it as a pen that holds 300ml. So the 10ml vial is 1000 units, whereas the pen is 300 units. It is more cost-effective for the Barbados Drug Service for patients on high doses of insulin, to give them the vial, than it is to give them multiple pens [because] the pens are more expensive. The pens are more convenient, I agree, but they are more expensive for persons to maintain on high doses.”

She added: “We have to maintain the viability of the programme, and sometimes unfortunately difficult choices have to be made because it’s not just antidiabetic medications, it is hypertensive medications, patients on heart disease, it is cancer…. The Ministry of Health has to look at the entire picture.”

Later in the day, in a statement on the availability of insulin and change in protocol on insulin pens, the BDS stressed there was no shortage of any therapeutic class of insulin on the formulary. However, due to supply challenges, there is currently a scarce supply of Humulin 70/30 on island.

“On the Barbados National Drug Formulary…there are currently 13 brands of insulin available to all beneficiaries. Patients are advised that in the event they are unable to source Humulin 70/30 they should consult with their physicians regarding the selection of a suitable comparable product,” it said.

Explaining the decision to institute protocol changes in the maximum quantity of insulin pens for which the BDS will cover the cost, it added: “The change in protocols will not prevent a client from receiving an adequate amount of insulin to treat their condition, as comparable options are available in every therapeutic class of insulin. The exceptions to the new protocol are visually impaired persons and persons 18 years of age and under. The BDS will continue to provide a monthly maximum of four Apidra Solostar pens and/or five of the other pens…for these two categories of persons filling their prescriptions in the government pharmacies only.”

Meantime, Mascoll also acknowledged that there has also been a slight price increase for medication under the drug formulary, but stressed that the Barbados Drug Service continues to pay the cost of the medicine, while the beneficiary fee, which is a reduced cost that the patient pays, has slightly risen. The fee had not changed since 2011.

“It was felt that in order to maintain the viability of this system, the pharmacies needed an increase just to keep their heads afloat,” said Mascoll, adding that the ministry agreed, thus introducing the increase at the start of April.”

(SB)