This is the full text of an announcement from a group of independent pharmacies and wholesalers on pharmaceuticals pricing.

The undersigned pharmacies and wholesalers will continue to sell Ozempic at or below the Health Council’s Phase I regulated maximum. (eg, 1mg Ozempic at $193.45 plus a $35 dispensing fee), in line with the council’s December 9, 2025, Phase I update that listed Ozempic and other patented branded drugs on the regulated price list.

We complied from Day 1 and will keep doing so. Patients who rely on these medicines deserve stable, affordable pricing and a regulator that enforces its rules fairly.

We welcome the council’s review of the formulary. It demonstrates that although we share the goal of lowering medicine costs, the best path is a fair and level playing field, not price controls or market consolidation.

The council’s advisory justifies a pause by noting that Ozempic and similar therapies "are experiencing significant changes in pricing, demand and supply dynamics globally".

It adds: “Given the rapidly evolving international market for these medicines, the health council is reviewing the available data and market conditions to ensure that regulatory and pricing decisions remain informed by the most current evidence and market realities.”

We have long argued in consultation that this is the fundamental flaw of price controls.

Bermuda imports medicines from four major markets, the US, the EU, Britain and Canada, so exchange rates, supply, shipping and pricing are always evolving. A formulary that fixes prices in time cannot keep up. We urge the council to instead focus on a level playing field. Build on prior moves such as pushing transparent pricing on receipts, competition among all participants and rules applied equally to everyone.

The council has put Phase II implementation and enforcement on hold along with moving branded medicines such as Ozempic to Phase II, citing market developments. That means for Ozempic and other planned medicines, enforcement is explicitly deferred. A formulary that is paused whenever “the market” is invoked is not a reliable framework for affordability or fair competition. The same logic cuts against the council’s hands-off approach to the Allshores-Phoenix exclusive pharmacy deal.

Allshores has indicated that this arrangement is intended to deliver better pricing and oversight.

We are concerned that pricing available through certain channels exceeds the formulary level. This underscores the importance of maintaining open competition among multiple providers, which is often the most effective way to protect affordability, transparency and patient choice.

While the council has noted that these medicines are subject to rapidly evolving global market conditions, we believe that maintaining both fair enforcement of existing pricing frameworks and careful review of arrangements that may limit competition is essential to ensuring patients receive the intended benefits of regulation.

Exclusive dispensing models can reduce patient choice and may limit the competitive pressures that typically help to keep prices aligned with regulatory benchmarks.

When imports or dispensing are concentrated in one or a few players, whether through reliance on a single dominant importer or through exclusive deals that channel volume to one pharmacy group, there is no competitive pressure to lower prices. The dominant player has little incentive to pass on savings or to align with a regulated cap when it faces no meaningful competition.

The council’s own “market” narrative, used to exempt Ozempic, is in fact the best argument against doubling down on concentration, whether in a formulary that depends on few importers or in deals that lock patients into one provider.

The council is now openly questioning whether its phased approach is fit for purpose, but the advisory offers no time-bound interim rules, no clear explanation for the pause, and no commitment that dominant players will face the same scrutiny as small pharmacies. The result is continuing uncertainty for patients and independents, and more room for larger, vertically integrated players to set prices while enforcement is off the table.

Taken together, the council’s own language, “significant changes globally”, “rapidly evolving market”, “pause”, “review”, shows why a formulary cannot succeed when the drugs that matter most are the ones that it says are too dynamic for a fixed list. It also shows why the council’s noncommittal stance on the Allshores deal is hard to reconcile with BGA and Phoenix’s prior breach of the formulary.

Invoking “market forces” to exempt Ozempic while the dominant wholesaler either cannot source competitively or will not act in good faith to meet the island’s desire for lower medicine costs is exactly what happens when concentration replaces competition, in a formulary that depends on few importers or in exclusive pharmacy deals.

We call on the council and Government to ban exclusivity deals and strengthen oversight of conflicts of interest. In particular, we call on the council to use its role in health and insurer oversight to require that the Allshores-Phoenix exclusive arrangement be scrapped and replaced with open, competitive access. Allshores and other insurers should be required to use free and fair individual bidding for costly medicines across all pharmacies rather than collective bidding so that competition can help to drive down prices.

We pledge to continue honouring the formulary Ozempic price.

Margins are small, but Ozempic is no longer under patent in Canada and will soon be available as a generic from third-party manufacturers, allowing the kind of competition we advocate for, and ultimately lower prices.

We support the health minister’s request for a 60-day deferral of the Allshores pharmacy arrangement. Unfortunately, Allshores has not formally confirmed it will honour that request. As a result, its customers may not benefit from the lower Ozempic price we are able to offer.

We urge the council to back the minister’s call and to require that such arrangements are replaced with competition.

Signed:

Pharmacies

Caesar’s Pharmacies

Lindo’s Pharmacies

My Pharmacy

Northshore Pharmacy

People’s Pharmacies

Robertson’s Drugstore

Wholesalers

Scalene Pharmacy Warehouse