The rollout of Bermuda’s new medication formulary has been nothing short of a nightmare, according to one independent pharmacy owner, who claims the process is riddled with unfairness and confusion. But here’s where it gets controversial: Denis Pitcher, co-owner of My Pharmacy alongside his wife, Olivia Benyak-Pitcher, isn’t just complaining—he’s calling out the Bermuda Health Council (BHC) for what he sees as a deeply flawed system that favors bureaucracy over fairness. And this is the part most people miss: the impact on small pharmacies like theirs, which are struggling to keep up with constantly shifting rules and prices.
In a detailed letter to industry stakeholders and the media, the Pitchers outlined their grievances. They argue that the consultation process was inadequate, the bureaucratic hurdles were overwhelming, and information sharing was inconsistent. Importers, they claim, were left in the dark, unsure of how to navigate the new system. One of the most contentious issues? The inclusion of branded drugs like Ozempic—a medication used by diabetics and those seeking weight loss—which the BHC seemed to flip-flop on, leaving pharmacies in limbo.
Here’s the kicker: On September 19, the BHC released an update on drug pricing regulations, revealing that the pharmacy price for 0.25mg Ozempic was actually lower than the wholesaler price, effectively eliminating any profit margin for pharmacies. While there are exemptions for selling medications above the recommended price, the application process is, in Pitcher’s words, ‘cumbersome.’ He points out the inherent risk in importing medications, especially when it takes two months for shippers to provide final cost invoices—making it nearly impossible to claim exemptions in time.
The confusion didn’t end there. On October 31, another pricing update was sent out, proposing wholesale prices with a maximum dispensing fee. Then, on December 9, the BHC clarified that the formulary applied only to generic drugs—except for Ozempic and certain insulins like Tresiba, Fiasp, Levemir, and Tradjenta. But here’s the twist: Just days earlier, the Bermuda General Agency (BGA) had slashed prices for branded medications, only to revert them back shortly after. For example, Ozempic 1mg dropped from $255 to $193.45, then jumped back to $255 on December 1. Tresiba 200 units followed a similar pattern, raising questions about the timing and transparency of these changes.
Pitcher doesn’t hold back: ‘I thought the point was to set fair and equal prices for all,’ he said. ‘Instead, they’ve created a bureaucratic maze for exemptions.’ He highlights the whiplash pharmacies faced, from being given prices a month before the formulary launch to sudden exclusions and retroactive re inclusions at higher prices. The timing of BGA’s price changes, he argues, didn’t align with the information pharmacies were receiving, leaving them scrambling to adapt.
And this is where it gets even more heated: Benyak-Pitcher points out that while the BGA has maintained higher Ozempic prices since December 9, smaller pharmacies like theirs are drowning in paperwork, forced to wait at least a month for import costing data to seek exemptions. ‘These points were ignored,’ she said, noting their feedback submitted on November 28 received no response or remedies.
Ricky Brathwaite, CEO of the BHC, denies any bias, emphasizing that the council is an independent regulator not partnered with any supplier. He explains that initial prices were based on market data and reference pricing, with ongoing validation and refinement. ‘The goal is to address affordability and inconsistent pricing,’ he said, noting that Bermudians have historically paid wildly different prices for the same drugs—a system he calls unsustainable.
But Pitcher counters that the solution isn’t more government control; it’s cutting red tape. ‘With more regulation comes more costs,’ he said, arguing that small providers like his will struggle while larger players thrive. And the fallout? After speaking out, the Pitchers claim the BGA locked them out of their online ordering platform, forcing them to order by phone or email—a slower, more cumbersome process. While the BGA has since suggested restoring access, the damage, Pitcher says, is done.
Here’s the question that lingers: Is the BHC’s formulary rollout a step toward fairness, or does it disproportionately burden small pharmacies while favoring larger entities? And what does this mean for the future of healthcare accessibility in Bermuda? Weigh in below—let’s spark a conversation that could shape the way forward.
