Wilson calls on Allshores to hold off on pharmacy deal
An insurer has been asked by the health minister to delay a controversial decision to designate one pharmacy group as its sole provider of certain high cost prescriptions, including weight loss drugs.
Kim Wilson told the House of Assembly yesterday that she directed the Bermuda Health Council to formally request that Allshores implement a 60-day deferral to May 1 for the introduction of the network policy.
Ms Wilson said the move by the insurer would materially alter how patients access their medications and required “comprehensive review, data analysis and structured dialogue”.
The change is due to start on Sunday and it was not clear if Alllshores had decided to comply with the request to delay implementation. Allshores was created with the amalgamation of BF&M and Argus Insurance, with a presence in the Caribbean, Gibraltar and Malta.
Allshores announced this week that it will restrict where its clients can purchase certain high-cost drugs — including the weight loss GLP-1 pharmaceuticals Ozempic, Mounjaro and Wegovy, the ADHD medication Adderall and certain specialised pharmaceuticals.
Allshores said high-cost prescription drugs including GLP-1 treatments, biologics and oncology therapies have become responsible for more than 30 per cent of expenses, despite representing about 3 per cent of prescriptions.
It said the change was undertaken in keeping with requests from its employer clients and was “increasingly common internationally” for cost containment.
The move has been criticised by the Bermuda Medical Doctors Association and independent pharmacies. The health council said it would engage in dialogue with Allshores.
Ms Wilson told MPs: “While the establishment of a preferred pharmacy network may be presented as an internal business decision, pharmacies are not simply retail outlets.
“They are an integral part of the healthcare continuum. They ensure continuity of care, provide patient counselling, support medication adherence and serve as accessible points of contact, particularly for seniors and vulnerable residents.”
She added: “Any change that materially alters how patients access their medications must therefore be examined not only through a commercial lens but through a public interest lens.
“That is why, as Minister of Health, on Tuesday, February 24, I directed the Bermuda Health Council to formally request that Allshores implement a 60-day deferral of its pharmacy network policy to May 1.
“This pause is essential to allow comprehensive review, data analysis and structured dialogue. Decisions of this magnitude must be guided by evidence and public accountability.”
The Bermuda Health Council said that it started a 60-day review of the preferred pharmacy model today.
It highlighted that the analysis was not of the general concept of preferred networks — which are not new to the island — and the council would not become involved in individual insurance decisions [see sidebar].
An Allshores spokeswoman said the company would be “working collaboratively and in partnership with the Health Council over the coming days”, adding that it had been doing so throughout the development of the initiative and prior to its launch.
She added that Allshores was reviewing a request for more information from the Health Council for additional information which it received yesterday.
She did not answer whether the programme has been put on hold or will start tomorrow.
A spokesman for the Bermuda Health Council said that a 60-day review of the preferred pharmacy model was launched today, after the minister’s statement in the House of Assembly.
He explained: “To be clear, preferred pharmacy arrangements and different reimbursement levels are not new in Bermuda.
“We are not reviewing the concept of preferred networks in principle and we are not getting involved in individual insurance decisions.
“Allshores has, to date, provided the council with detailed information outlining the objectives and safeguards associated with the initiative, including its focus on a defined high-cost speciality segment and continuity-of-care measures.
“Our review is not a finding of wrongdoing. Rather, it is a prudent step to assess how the model is being implemented in the current market context.
“What we are doing is taking a careful look at implementation to ensure it works smoothly for patients, especially those receiving complex treatments such as oncology or biologic therapies.
“In a small community like Bermuda, even changes that affect a relatively small group of medications can have wider ripple effects, so it is appropriate that we assess the impact in a measured and evidence-based way.
“We recognise that high-cost speciality drugs account for a growing share of overall prescription spending and efforts to manage those costs are legitimate.
“At the same time, continuity of care and reliable access to medication must remain protected.
“The Government has indicated its intention to modernise Bermuda’s competition framework to support fairness across sectors. That work is broader and applies generally.
“In healthcare, our focus remains straightforward: ensuring access, supporting affordability and maintaining public confidence in how the system operates.
“We are engaging constructively with Allshores and other stakeholders to gather objective information during this review period and we will report further once that process is complete.”
Ms Wilson told the House: “The health council has previously warned of the structural implications of vertical and horizontal integration in Bermuda’s health system.
“Our pharmaceutical sector is characterised by a small and saturated domestic market, limited upstream competition, reliance on high-cost importation channels and escalating pressures from speciality and advanced therapeutics.
“In such an environment, further concentration of market power — whether through mergers or contracting practices — can reduce competition, limit consumer choice and create conditions for price escalation.”
Ms Wilson said the merger and the latest move to restrict access to just one pharmacy threw into the spotlight Bermuda’s lack of modern, dedicated antitrust legislation governing business combinations and market dominance.
“This legislative gap leaves our economy vulnerable to excessive concentration and anticompetitive practices,” she said, adding that the Government will move forward with strong anti-monopoly and competition laws as promised in its 2025 election platform and the 2025 Throne Speech.
“The focus is on preventing any business arrangement from creating an effective monopoly, stifling competition or placing smaller healthcare providers at a disadvantage within the community.
“Strengthening competition requires proactive oversight of mergers and acquisitions, scrutiny of dominant market positions and the authority to prevent anticompetitive conduct before harm occurs.
“We must have legislative tools to investigate and, where necessary, prevent mergers or contracting structures that consolidate excessive market power.
“Fair markets are not self-executing in small jurisdictions, they require thoughtful regulation to protect consumers and innovation alike.”
At the same time, she said that competition reform most work hand-in-hand with pharmaceutical reform.
“That is why the Government has been advancing solutions such as pricing reforms and policies such as the implementation of the national drug formulary in collaboration with importers and retailers,” Ms Wilson added.
“The formulary introduces clearer pricing discipline, strengthens transparency and reduces unnecessary price variation across pharmacies.
“It supports evidence-based prescribing, protects consumers from inflated costs and ensures that Bermudians are not paying more than necessary for essential medications, no matter which pharmacy they purchase from.”
She said the measures, combined with wider access to healthcare and “the forthcoming roll-out of core benefits designed to guarantee universal access to necessary care”, would ensure that affordability is achieved through fair competition and smart regulation, not through market dominance or restricted patient choice.
The One Bermuda Alliance yesterday urged Government to immediately introduce anti-monopolies legislation which was it promised in 2024.
Shadow Health Minister Craig Cannonier said: “The Premier stood before the country in 2024 and said the Government would act to stop harmful monopolies and protect Bermudians from market dominance.
“But like so many of his promises, nothing has happened. Bermudians continue to pay the price while the Government continues to stand still.”
He added: “This government talks about fairness but refuses to deliver the legislation needed to enforce it. If the Premier truly believes in a level playing field, then why after two years has he still not introduced the competition laws he promised?
“On December 6, 2024 I begged the Premier and his cabinet to act quickly because the insurance companies were moving quickly. His lack of urgency will now hurt Bermudians.”
The OBA said David Burt, the Premier, had promised laws that would allow the Government to properly scrutinise mergers and acquisitions, protect competition and intervene where necessary.
It said Mr Burt admitted Bermuda lacked modern legal tools to address the harmful concentration of market power that was emerging in Bermuda’s small economy.
“Yet to date, none of those promised reforms have been delivered.
“Instead, Bermudians are facing increased uncertainty caused by unchecked consolidation in the insurance and healthcare sectors — developments the Government said it would prevent.”
• UPDATE: this article has been updated with comments from the Bermuda Health Council and Allshores
• To see the health minister’s statement in full, see Related Media
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