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Wednesday, July 16, 2025

Fair Trading Commission flags pharmacy concerns over sector breaches

by

Joshua Seemungal
24 days ago
20250622

Se­nior In­ves­tiga­tive Jour­nal­ist

joshua.seemu­n­gal@guardian.co.tt

Amid grow­ing con­cerns over re­strict­ed com­pe­ti­tion in the phar­ma­ceu­ti­cal in­dus­try, the Fair Trade Com­mis­sion (FTC) has ad­vised the Pri­vate Phar­ma­cy As­so­ci­a­tion of Trinidad and To­ba­go that there may be suf­fi­cient grounds for mem­bers to sub­mit for­mal com­plaints re­gard­ing po­ten­tial breach­es of the Fair Trad­ing Act.

Mean­while, an of­fi­cial in­ves­ti­ga­tion by the Health Min­istry in­to con­cerns about ris­ing drug prices, sup­ply short­ages, and the con­cen­tra­tion of con­tracts among a lim­it­ed num­ber of sup­pli­ers with re­spect to the Chron­ic Dis­ease As­sis­tance Pro­gramme (CDAP) is yet to be­gin.

Last Sun­day, Guardian Me­dia re­port­ed that Health Min­is­ter Lack­ram Bo­doe or­dered a com­pre­hen­sive re­view of the pro­gramme. He al­so said the min­istry will meet with phar­ma­ceu­ti­cal as­so­ci­a­tions to ad­dress long-stand­ing con­cerns with­in the in­dus­try.

In part one of a spe­cial in­ves­ti­ga­tion last week, Guardian Me­dia re­vealed that a Free­dom of In­for­ma­tion Act (FOIA) re­quest showed one com­pa­ny, Smith Robert­son and Com­pa­ny Lim­it­ed, re­ceived 42 per cent or $1.8 bil­lion worth of CDAP con­tracts be­tween 2015 and 2024, while Bry­den Pi Lim­it­ed re­ceived the sec­ond high­est share at 17 per cent ($742 mil­lion).

A let­ter from FTC Ex­ec­u­tive Di­rec­tor Be­van Nar­i­nesingh last week stat­ed, “The FTC ac­knowl­edges the Min­istry of Health’s re­cent de­ci­sion to un­der­take a com­pre­hen­sive re­view of the CDAP, as re­port­ed in the Trinidad and To­ba­go Guardian News­pa­per … The ini­tia­tive (The Min­istry of Health CDAP Re­view) is time­ly and aligns with our statu­to­ry man­date to pro­mote and main­tain fair com­pe­ti­tion, pro­tect con­sumer wel­fare and en­sure the ef­fi­cient al­lo­ca­tion of pub­lic re­sources.”

The FTC ad­vised that “there may be suf­fi­cient grounds for mem­bers of the Pri­vate Phar­ma­cy Re­tail Busi­ness As­so­ci­a­tion to sub­mit for­mal com­plaints to the com­mis­sion re­gard­ing po­ten­tial breach­es of the Fair Trad­ing Act”.

The as­so­ci­a­tion was asked to sub­mit de­tailed records of any ob­served ir­reg­u­lar­i­ties or an­ti-com­pet­i­tive con­duct re­lat­ed to CDAP.

Ad­di­tion­al­ly, the FTC ad­vised that “the sub­mis­sion of a com­plet­ed Com­plaints Form is re­quired in or­der to for­mal­ly ini­ti­ate the com­mis­sion’s com­plaints pro­ce­dure”.

Nar­i­nesingh told Guardian Me­dia no for­mal in­ves­ti­ga­tion was tak­ing place, “The com­mis­sion is aware of gen­er­al pub­lic dis­course con­cern­ing al­le­ga­tions of mo­nop­o­lis­tic prac­tices with­in the lo­cal phar­ma­ceu­ti­cal in­dus­try. How­ev­er, to date and de­spite en­cour­ag­ing the pub­lic to do so, no for­mal com­plaint or cred­i­ble ev­i­dence nam­ing any spe­cif­ic en­ter­prise op­er­at­ing in Trinidad and To­ba­go has been sub­mit­ted to the com­mis­sion by af­fect­ed par­ties.”

Re­tail phar­ma­cies feel threat­ened

Pres­i­dent of the Phar­ma­cy Board of Trinidad and To­ba­go Ri­car­do Mo­hammed has al­leged that re­tail phar­ma­cies are un­der threat due to the prac­tices of phar­ma­ceu­ti­cal con­glom­er­ates.

“Yes (it is threat­en­ing the sur­vival of some of these re­tail phar­ma­cies), in the sense that, one, it is al­leged that some of these com­pa­nies, when they ap­ply for a prod­uct, they get it faster than the av­er­age phar­ma­cy.”

Some stake­hold­ers, Mo­hammed said, al­leged that com­pa­nies may be re­strict­ing com­pe­ti­tion through the drug reg­is­tra­tion process. How­ev­er, Guardian Me­dia could not ver­i­fy these al­le­ga­tions in­de­pen­dent­ly.

“But what we are hav­ing is­sues with is that the in­creas­es in prices from phar­ma com­pa­nies are some­times be­ing sent to us, some­times week­ly and month­ly, and these price in­creas­es are some­times up­wards of five per cent, ten per cent, 18 per cent in some cas­es,” he said.

“Now that a new US tar­iff has come in­to ef­fect, it is go­ing to sig­nif­i­cant­ly af­fect phar­ma­ceu­ti­cal prices com­ing in­to the coun­try,” he added.

Mean­while, Pres­i­dent of the Pri­vate Phar­ma­cy Re­tail Busi­ness As­so­ci­a­tion Glen­wayne Su­chit ex­pressed a sim­i­lar con­cern.

“I have a break­down of all the le­gal no­tices over the last two years for all the drugs that have been ap­proved ... We can’t get ap­provals,” added Su­chit, a phar­ma­cist and busi­ness own­er with close to 40 years of ex­pe­ri­ence.

Six­ty-two per cent of the drugs, he al­leged, are for one com­pa­ny.

These con­cerns are not new. In March 2021, for­mer pres­i­dent of the Phar­ma­cy Board An­drew Ra­haman wrote a com­plaint to the FTC con­cern­ing Smith Robert­son’s ac­qui­si­tion of two phar­ma­ceu­ti­cal com­pa­nies–Os­car Fran­cois Lim­it­ed and In­ter­sol Lim­it­ed.

The Min­istry of Trade and In­dus­try ad­vised that the merg­er re­ceived the go-ahead af­ter a four-month re­view and ap­proval process. The FTC stat­ed that the com­mis­sion was sat­is­fied the merg­er would not ad­verse­ly af­fect com­pe­ti­tion or be detri­men­tal to con­sumers or to the econ­o­my.

In May 2021, for­mer UNC Ma­yaro MP Rush­ton Paray asked the then Peo­ple’s Na­tion­al Move­ment gov­ern­ment to act against al­leged ‘preda­to­ry price in­creas­es’.

Af­ter com­plaints, for­mer trade min­is­ter Paula Gopee-Scoon said she in­struct­ed the Con­sumer Af­fairs Di­vi­sion to de­vel­op a tool to mon­i­tor and pub­lish quar­ter­ly prices of the main es­sen­tial phar­ma­ceu­ti­cal items.

It was nev­er pub­lished and is un­avail­able on the Cen­tral Bank’s web­site.

Four years lat­er, the is­sue re­mains un­re­solved, Mo­hammed added.

Ac­cord­ing to Mo­hammed, who was elect­ed in 2024, the board is re­view­ing phar­ma­ceu­ti­cal laws to lob­by Gov­ern­ment to con­trol prices.

“In the last 50 or 60 years, noth­ing has been done in the Phar­ma­ceu­ti­cal Board Act to even con­trol dis­trib­u­tors, and one of the key things is to re­vamp that leg­is­la­tion, so we can reg­u­late dis­trib­u­tors ... ” he said.

Guardian Me­dia reached out to Agos­ti­ni Lim­it­ed, which owns Smith Robert­son and Co Ltd for com­ment on its mar­ket share, but the com­pa­ny de­clined to com­ment.

Re­quests for com­ment were al­so sent to the com­mu­ni­ca­tions team at AS Bry­den, but no re­sponse was re­ceived up to last week.

Price in­creas­es

Guardian Me­dia viewed sev­er­al let­ters sent by com­pa­nies in­di­cat­ing price changes to phar­ma­cies.

On De­cem­ber 8, 2024, one com­pa­ny, Smith Robert­son, wrote say­ing it was in­creas­ing the prices of close to 40 drugs.

Phar­ma­cies com­plained to Guardian Me­dia of re­ceiv­ing many of the no­tices in re­cent years.

Smith Robert­son: De­cem­ber 2024 No­tice

A De­cem­ber 2024 no­tice from Smith Robert­son states, “We would like to in­form you of an up­com­ing price change on the Glax­o­SmithK­line Eth­i­cal line of prod­ucts, ef­fec­tive Wednes­day, 1 Jan­u­ary 2025.”

There was no ex­pla­na­tion for the in­crease.

The range of in­creas­es im­ple­ment­ed ranged from $6 for a nasal spray to $3 for 5ml AMOX­IL syrup to $38 for Val­trex 500mg tablets.

Bry­den Pi Lim­it­ed: Jan­u­ary 2025 Ad­just­ments

A Jan­u­ary let­ter in­di­cat­ing in­creas­es from Bry­den Pi Lim­it­ed sig­nalled that price changes were due to a sup­pli­er price in­crease.

Of 41 list­ed drugs, 38 were in­creased, with three prices de­creas­ing.

The price in­creas­es ranged from $85.90 for Acas­ta 100ml to $6 for Enoxa­parin 80 mg to $34 for Zin­nat 250 mg tabs.

AP Scott: Lim­it­ed In­creas­es

Com­par­a­tive­ly, an­oth­er com­peti­tor, AP Scott, in a Jan­u­ary let­ter, list­ed four prod­ucts with in­creased prices.

Oro­fer Syrup 150ml and Oro­fer 40 cap­sules were list­ed as price ad­just­ments, while the two oth­er med­ica­tions were list­ed as sup­pli­er price in­creas­es.

Vul­ner­a­ble pa­tients, small phar­ma­cies strug­gle

As prices climb and avail­abil­i­ty fluc­tu­ates, vul­ner­a­ble pa­tients and small phar­ma­cies con­tin­ue to strug­gle.

Some el­der­ly pa­tients de­scribed the grow­ing dif­fi­cul­ty of ac­cess­ing af­ford­able med­ica­tion. Many re­ly on CDAP out of ne­ces­si­ty, and while oth­ers skip dos­es or aban­don treat­ments, oth­ers are forced to dig deep­er in­to their pock­ets.

Phar­ma­cists said they are do­ing their best to shield cus­tomers from ris­ing costs—but ad­mit it’s be­com­ing un­sus­tain­able.

“They are try­ing to pres­sure us and shut us down. They are try­ing to shrink the mar­ket,” an Ari­ma phar­ma­cy own­er, who re­quest­ed anonymi­ty due to fear of back­lash, al­leged. The own­er did not name the in­di­vid­u­als or com­pa­nies al­leged­ly re­spon­si­ble.

“I have no com­ment, but you take a look around any phar­ma­cy and tell me what you see,” said a fe­male phar­ma­cy own­er in Diego Mar­tin.

It’s 9:30 on a St James morn­ing, and 74-year-old Car­ol and her son are get­ting in­to their car af­ter pur­chas­ing med­ica­tion from Kap­pa Drugs.

“I get CDAP. Some­times, I don’t get the med­ica­tion be­cause some­times they don’t have it. If I need five box­es, some­times I get three or four. When I can’t get every­thing from CDAP, I have to go some­where else and buy it. I don’t even know if the price went up be­cause I need it. I don’t watch the price,” she said be­fore head­ing to the near­by St James Phar­ma­cy.

Over at the St James Phar­ma­cy’s carpark, cus­tomer Tardius Lewis spoke high­ly of the busi­ness.

“They tell you what is good for you. They are not try­ing to up­sell me. Who is not go­ing there, don’t know there,” he said.

Oth­er cus­tomers al­so praised the phar­ma­cy’s ser­vice and its ef­forts to keep prices down.

In­side of the phar­ma­cy bot­tles of med­ica­tion are stacked from waist height to the ceil­ing. Most prod­ucts had two stick­ers—one show­ing the old price, the oth­er the cur­rent price.

“It is a chal­lenge to main­tain the good prices we have. He (the boss) will want to raise the price, but he will think about the cus­tomers. He will be like, we will leave it at that price for now. The av­er­age busi­ness­man will not be will­ing to do that,” said man­ag­er Michelle Ramirez.

Fur­ther west in Diego Mar­tin, out­side West­Bees Su­per­mar­ket, a few cus­tomers fil­tered in and out of a near­by phar­ma­cy.

“I find it high, yes. Look, I now pay $1,600 for some­thing there. They tell me I get a lit­tle dis­count,” said a man in his ear­ly 70s.

A woman in her 70s, inch­ing to­ward the en­trance, added, “Oh, God. Don’t even talk about the prices go­ing up. Yes, I have no­ticed. Look, my cho­les­terol, the oth­er day I de­cid­ed to stop tak­ing it, be­cause when I take it, it’s gener­ic, and my feet start to swell.”

An­oth­er woman, al­so in her 70s, had just ex­it­ed a ve­hi­cle.

“I’ve stopped buy­ing my med­ica­tion and went on CDAP be­cause every month there was a dif­fer­ent fig­ure for the drug prices. I know it tends to have more gener­ic drugs, but that’s why I am try­ing it. I’m giv­ing it a go be­cause I can’t af­ford to buy them. I’m a re­tiree. Every time I go, it goes up by $5 or $10, but it adds up.”


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