PETER CHRISTOPHER
Senior Multimeda Reporter
peter.christopher@guardian.co.tt
Global inflationary pressures have likely led to increased cost in health care, and as a result programmes like Chronic Disease Assistance Programme (CDAP) may be due for a review, economist Dr Marlene Attzs said yesterday.
On Monday, during a Standing Finance Committee sitting, Finance Minister said in parliament that CDAP is putting a strain on the Health Ministry's budget.
During the committee sitting Imbert said, "It is proving quite difficult to finance the purchase of free pharmaceuticals and all the other free services that are available in the health sector. So I just want Members (of Parliament) to understand this. We believe this is important, we have to do it, but to find that $500 million is going to prove to be very difficult.”
When asked about the Minister's position, Dr Attzs said it should be contextualised alongside a conversation of healthcare reform.
She said, "How do we ensure efficiency, both in terms of quality and delivery in our healthcare system. Given that CDAP really supports free prescription drugs and other pharmaceutical items for non-communicable diseases such as our diabetes, asthma, arthritis and high blood pressure, for example, I think the first issue would be how do we prevent the occurrence, and the increase in the occurrence, of these kinds of diseases? What kind of preventive measures can be put in place?"
Given that global inflation has seen prices soar internationally, she said a review of the procurement of drugs for the programme may be required.
Imbert said for the 2024 fiscal year, some $555.9 million had been allocated for pharmaceuticals in the Minister's presentation. The breakdown of the latter included $132 million (oncology drugs), $20.6 million (HIV drugs), $40.5 million (antibiotics), $60 million (NCD drugs), $48.7 million (psychiatry), and $84.8 million (non-pharmaceuticals) with $1.4 million for HPV vaccines.
"My second point is that there should be a multifaceted approach to reviewing the costs associated with CDAP, including a review of the existing process to ensure that the government and the people of Trinidad and Tobago are getting value for our money," Attzs said.
"I presume the programme has been reviewed over the years, but maybe it's time for another review, given what has been happening globally, the increase in prices globally and the fact that we would then have to pay higher prices for pharmaceuticals. That review can outline whether we need to review the approved list of drugs and whether we need to review the procurement process to obtain these pharmaceuticals and whether there is a possibility of negotiating better prices."
However Dr. Attzs warned that any adjustment to CDAP should take into consideration the programme is meant to cater for the most vulnerable in our society.
"There always has to be a balancing act in terms of the escalating costs of the impact on the budget. But we should be mindful that CDAP really allows those persons who are among the most vulnerable in our society to have access to these pharmaceuticals that they need to manage their health status. So whatever recalibration that has to be done to this programme, we should ensure that those vulnerable persons in our society are not, in any way, disadvantaged or inconvenienced in terms of their access to affordable healthcare to manage their health status," said Dr Attzs.
In a post to social media, the Finance Minister clarified his statement was not meant as an indication that he intended to reduce the Health Ministry's allocation.
He said, "Yesterday, in Parliament, I sought approval to INCREASE expenditure on health care by $495 million to a total of $8 billion in 2024 and said that we must now ensure that we get value for money. The media twisted my words to mean I wish to reduce expenditure on health."
