A pensioner is questioning the fairness of a new Government Employee Health Insurance requirement that all medications costing more than $500 be vetted so that it can pick the pharmacy offering the lowest price.

The Ministry of Finance told The Royal Gazette, in a previous article, that the new policy, implemented in March, allowed GEHI to save money on medications.

Under the new rules, pharmacists have to place a bid with GEHI on prescriptions over $500. If they win the contract, they can only provide it for a few months before they have to apply all over again.

One policyholder is questioning just how thoroughly GEHI is searching for lower-cost drugs.

“The medicine I was on stopped working,” they said. “My doctor put me on something else.”

The doctor told her about the new GEHI policy and soon afterwards, CG Pharmacy contacted her saying they had been selected to provide her with the new prescription.

“It was a cold call,” the pensioner said. “I did not place a request at any pharmacy. The doctor must have informed GEHI of the medication change. The pharmacist at CG was very friendly but made it sound like I did not have a choice.”

Knowing that she could not miss a dose of her medication, she allowed CG to fill her prescription. Later, however, she called her usual pharmacist and asked about it.

“My regular pharmacist said they had never been contacted by GEHI and they could bring in the medication at a lower price,” she said. “How can this be a fair process?”

She said in the past, her regular pharmacist had bent over backwards to get medications for her as cheaply as possible and she found their copay to be lower than other places.

“For the old medication, I was paying $100 copay with them, while it was $400 somewhere else,” she said.

The Ministry of Finance has pledged a 48-hour turnover for GEHI approvals. The pensioner, however, thought that in her case, the approval had taken around a week.

She said the GEHI policy change seemed more business-centred than client-centred.

“GEHI have been very wide sweeping in their new policy,” she said. “It is going to cause some pharmacies to sustain a loss of revenue and is not in the best interests of the clients.”

The Royal Gazette’s attempts to have the Ministry of Finance address the concerns have gone unanswered.

Meanwhile, Robin Tucker, the Shadow Minister of Health, wrote about the issue in an opinion piece in the Royal Gazette that raised a number of concerns.

The article questioned the roles of the Bermuda Drug Formulary and the Pharmacy and Therapeutics Committee.

It suggested pharmacies were being forced to assume additional administrative burdens as a result of this policy.

It raised concerns that “critical policies continue to be made without adequate consultation with key stakeholders”.