The Bermuda Health Council is under increasing scrutiny as questions arise regarding its ability – or willingness – to enforce its own regulations, particularly in light of an ongoing investigation into an exclusive pharmacy deal with Allshores. Concerns center on continued pricing discrepancies for essential medications, despite the Council’s stated goals of affordability and consistent pricing for residents.
At the heart of the issue is the national drug formulary, introduced to address rising healthcare costs and inconsistent medication prices. While the formulary sets regulated prices for certain drugs, reports indicate that some pharmacies are consistently exceeding those limits without apparent consequence. This raises fundamental questions about the Council’s authority and the fairness of the system.
The diabetes medication Ozempic, used increasingly for weight management, has become a focal point of the controversy. The regulated price for Ozempic 1mg is currently $193.45, plus a $35 dispensing fee, totaling $228.45. However, Bermuda General Agency (BGA) has been charging $255, and Phoenix Pharmacies have been charging patients $290 – more than $60 above the regulated price, as of late February. Repeated inquiries regarding these discrepancies have reportedly gone unanswered.
The situation surrounding Ozempic pricing has been complex. Initially, on October 31, 2025, the regulated price was set at $148.31 for a December 1 rollout. However, branded drugs like Ozempic were temporarily excluded on November 28 due to a lack of accurate pricing information. BGA briefly adjusted its price to $193.45 on November 29, only to revert to $255 on December 1. Ozempic was then re-included at $193.45 on December 9, the same price BGA had originally published. Attempts to seek clarification from the Council and pharmacy owners regarding these fluctuations were met with silence, and access to BGA’s website was subsequently blocked.
Concerns Over Double Standards and Lack of Enforcement
Critics allege a double standard in enforcement, with BGA and Phoenix Pharmacies seemingly immune to penalties for exceeding regulated prices, while other pharmacies are expected to comply. The formulary stipulates a $50,000 fine per offense for breaches, yet no fines have been levied to date. This disparity fuels concerns that larger players receive preferential treatment.
Health Minister Kim Wilson has directed the Health Council to review the Allshores deal. However, the Council’s initial press release emphasized that the review is “not a finding of wrongdoing” and does not question the principle of preferred networks. This framing has drawn criticism from those who believe a more thorough investigation is warranted.
CEO’s Past Warnings Contradict Current Actions
The Council’s own CEO has previously voiced concerns about the potential pitfalls of complex healthcare structures and consolidation. In 2020, he warned against adding structures “without regard to adequate accountability and consideration of system ramifications,” and cautioned that US-style consolidation could “limit patient choice.” In 2023, he warned that fewer companies making “significant population health decisions” could “derail” efforts to improve health, stating the Council would adjust insurer license conditions “if necessary.” He also criticized similar proposals by the Government as “being out of line with putting patients first.”
Despite these past warnings, the Council has not introduced regulations for insurers, allowing mergers, exclusivity deals, and vertical integration to proceed unchecked. A complaint filed in September 2023 regarding a potential conflict of interest between CG Insurance and CG Pharmacy received a response more than a year later, promising action that has yet to materialize. The CEO acknowledged the Council’s limited regulatory power over pharmacies but sidestepped the fact that it does have authority over insurers.
Asymmetrical Regulation and Independent Pharmacy Challenges
This asymmetry extends to regulation more broadly. The Council has implemented extensive new regulations for health providers, often with subjective criteria, while leaving insurers largely unregulated. Wholesalers also operate without specific regulations, while one wholesaler’s registration has been refused since 2020, despite others being processed. This situation is particularly ironic given the Council’s expressed concern about relying on a “single primary importer.”
Dr. J.J. Soares, who has successfully challenged the Council in court, succinctly summarized the situation, stating, “The health minister and Bermuda Health Council seem more focused on controlling doctors than on enhancing patient care or the quality of medical services.” Following a recent victory for My Pharmacy in November 2023, the CEO called for a “holistic review” of the Pharmacy Act, promising extensive new regulations.
Looking Ahead: Will Enforcement Improve?
The Council’s approach has been characterized as focusing on independent pharmacies while allowing larger partnerships to operate without the same level of scrutiny. After two decades, its most visible achievement has been a rebrand, while staffing and budgets have increased, and healthcare costs continue to rise. Whether the Council will change course and consistently apply its rules remains to be seen. The outcome of the Allshores deal review will be a key indicator of its commitment to fair and transparent regulation.
This situation highlights the critical need for consistent enforcement of healthcare regulations to ensure affordability and access for all Bermuda residents. What steps will the Health Council accept to address these concerns and restore public trust? Share your thoughts in the comments below.
Disclaimer: This article provides informational content only and should not be considered medical or legal advice. Consult with a qualified healthcare professional or legal expert for personalized guidance.
