Trinidad and Tobago’s healthcare system is confronting significant structural challenges as allegations of pharmaceutical market monopolization surface alongside regulatory limitations. Health Minister Dr. Lackram Bodoe has clarified that while drug price regulation doesn’t fall under his ministry’s purview, the government remains committed to enhancing market competition to improve medication affordability and accessibility.
The controversy emerged during a December 1 Public Administration and Appropriations Committee hearing, where Private Pharmacy Retail Business Association president Glenwayne Suchit revealed startling market concentration figures. According to testimony, a single pharmaceutical distribution company controls 74% of the private pharmaceutical market, while three dominant distributors collectively command 70% of wholesale pharmaceutical operations.
Parallel to these monopoly concerns, the committee learned that approximately $80 million worth of medications expired in storage over the past decade, highlighting systemic inefficiencies in the nation’s drug management system.
The Pharmacy Board of Trinidad and Tobago (PBTT) has initiated a comprehensive nationwide assessment of pharmaceutical standards across both public and private sectors. PBTT President Ricardo Mohammed emphasized the urgent need for consistent national standards and legislative reforms that would expand the board’s regulatory authority.
Mohammed identified several critical issues plaguing the pharmaceutical ecosystem:
1. The Chemistry, Food, and Drugs Division’s prolonged approval process, taking up to 180 days for responses, allegedly favors certain companies
2. Distributor-owned retail chains engaging in predatory pricing practices
3. Significant price inflation from dominant distributors despite stable production costs
4. The closure of dozens of independent pharmacies in 2024 due to unfair competition
Market concentration has reached levels that trigger monopoly concerns under the Fair Trading Act, which considers 40% market share as monopoly power. Investigations reveal one company maintains approximately 68% control overall in retail trade.
The situation has created a vicious cycle where independent pharmacies struggle against distributor-owned chains that allegedly sell medications below wholesale prices. With pharmacy profit margins capped at 35% (typically operating at 25%), compared to 35-100% markups in other retail sectors, many independent operations cannot compete.
This market distortion ultimately transfers costs to consumers, with Mohammed noting that many citizens can no longer afford medications and must rely on the public sector, where procurement processes remain flawed and lack competitive pricing mechanisms.
The Pharmacy Board is preparing to present its findings and recommendations to the Health Minister, seeking legislative changes that would empower greater regulatory oversight and address these systemic challenges in the nation’s pharmaceutical distribution system.