The rollout of Bermuda’s new medication formulary has been nothing short of a fiasco, according to one independent pharmacy owner, who claims the process has been riddled with unfair practices and bureaucratic hurdles. But here’s where it gets controversial: Denis Pitcher, co-owner of My Pharmacy alongside his wife, Olivia Benyak-Pitcher, argues that the Bermuda Health Council’s (BHC) approach has left smaller pharmacies struggling to keep up, while potentially favoring larger players in the industry. Could this be a case of unintended consequences, or is there more to the story? Let’s dive in.
In a bold move, the Pitchers have gone public with their concerns, sending a detailed letter to industry stakeholders and the media. They highlight three major issues: a flawed consultation process, excessive bureaucratic requirements, and inconsistent information sharing. And this is the part most people miss: the confusion among importers, who feel they’re being treated unfairly in the midst of this overhaul. The couple specifically points to the BHC’s back-and-forth on whether branded drugs, like Ozempic—a popular medication for diabetes and weight loss—would be included in the formulary.
For instance, on September 19, the BHC issued an update on drug pricing regulations, revealing that the pharmacy price for 0.25mg Ozempic was actually lower than the wholesaler price, leaving pharmacies with no profit margin. While there are exemptions for pharmacies to sell certain medications above the recommended price, the application process is, in Pitcher’s words, ‘cumbersome.’ Here’s the kicker: pharmacies face significant upfront risks when importing medications, yet they often have to wait months for final cost invoices, making it nearly impossible to claim exemptions in time.
The confusion didn’t end there. On October 31, another pricing update was released, proposing wholesale prices with a maximum dispensing fee. Then, on December 9, the BHC clarified that the formulary applied only to generic drugs—except for Ozempic and specific insulins like Tresiba, Fiasp, Levemir, and Tradjenta. But here’s the twist: just days earlier, the Bermuda General Agency (BGA) had slashed prices for branded medications, only to revert them back shortly after. For example, Ozempic 1mg dropped from $255 to $193.45, then jumped back to $255 on December 1. Tresiba 200 units followed a similar pattern, raising questions about the timing and transparency of these changes.
Pitcher openly questions the logic behind these decisions. ‘If the goal is to set fair and equal prices for all, why create such a complex bureaucracy for exemptions?’ he asks. The Pitchers also highlight the practical challenges of overseas ordering amid rapid price fluctuations. They were given one price a month before the formulary launch, only to be told later that some low-priced medicines would be excluded due to insufficient pricing data. Then, on December 9, those medicines were retroactively reincluded—but at higher prices. Is this a case of poor planning, or something more deliberate?
Olivia Benyak-Pitcher adds that the December 9 email from the BHC introduced a ‘burdensome’ transition process for selling above regulated prices, requiring extensive documentation. Meanwhile, the BGA has maintained its $255 pricing for Ozempic since December 9, while smaller pharmacies like theirs are forced to navigate red tape, waiting weeks for import costing data to seek exemptions. Does this level the playing field, or tilt it further in favor of larger entities?
Despite submitting feedback on November 28, the Pitchers say their concerns were ignored. Ricky Brathwaite, CEO of the BHC, denies any bias, stating that the council is an independent regulator not partnered with any supplier. He explains that initial prices were set using market data and a consistent methodology, with ongoing validation. ‘The goal is to address affordability and inconsistent pricing,’ Brathwaite says. ‘Bermudians have historically paid vastly different prices for the same drugs, which isn’t sustainable or fair.’
But Pitcher counters that increased government regulation only adds administrative costs, disproportionately affecting small providers. ‘Big players can afford full-time staff to navigate these policies,’ he notes. ‘Meanwhile, we’re left struggling to keep up.’ Is this a necessary trade-off for fairness, or a step too far?
The situation took a dramatic turn when, after the Pitchers went public with their complaints, the BGA locked them out of their online ordering platform, forcing them to place orders by phone or email. While the BGA later suggested it would restore access after system changes, the couple remains skeptical. Are they being punished for speaking out, or is this merely a coincidence?
As the dust settles, one question lingers: Is Bermuda’s new formulary a step toward fairness and affordability, or a bureaucratic nightmare that favors the few at the expense of the many? We’d love to hear your thoughts in the comments. Do you think the BHC’s approach is justified, or does it need a rethink? Let the debate begin!
