Medicine Price Controls in The Bahamas: Markups and Diabetes Drugs

The 2022 drug price control expansion

Medicine prices in The Bahamas are governed in part by price control law, enforced by the Consumer Affairs Unit under the Price Control Act⁸. In October 2022 the government of Prime Minister Philip Davis used it on medicines. The Price Control (Drugs) (Amendment) Regulations 2022 were due to take effect on Monday, 17 October 2022, and to stay in place for at least three months, to 17 January 2023, with a possible extension¹.

The regulations capped wholesaler markups at 15% to 18% and retailer markups at 35% to 40% on a list that included vaccines, anti-diabetic drugs, decongestants, laxatives, contraceptives, antacids, anti-hypertension medicines, cough preparations, cardiovascular agents and serums¹². For about 40 years, wholesalers had worked on a 25% markup on prescription drugs and retailers, for about a decade, on 50%⁴⁵.

Pharmacies close, then a compromise

The Bahamas Pharmaceutical Association said it had not been consulted. Its president, Shantia McBride, told The Tribune: "There has been no consultation with our stakeholders on any level", and warned that small pharmacies could be forced to close¹. The Minister of Health and Wellness, Dr Michael Darville, agreed to defer penalties while pharmacies adjusted their inventory². In a statement calling for a meeting with the Prime Minister, the association said the reforms would hit "some 60-70 percent" of retail and wholesale revenues⁴.

On Tuesday, 1 November 2022, pharmacy operators across the country shut their doors to avoid fines for not applying the new regulations³. The ministry extended hours at its clinics so patients could still get essential medicines, and Dr Darville said: "As it stands right now, we are satisfied with what we have"³. Prime Minister Davis said: "Pharmacies will remain open, and we expect pharmacies to come into full compliance in the coming days"; The Tribune reported that retailers who did not apply the new regime could face enforcement measures or fines⁴.

The deal came within days. Wholesalers and retailers accepted a single markup across all price-controlled items: 20% for wholesalers and 40% for retailers, at the top of the government's original range, in exchange for ten more medicines on the list, including cancer and kidney treatment drugs⁵⁶. Ms McBride said two weeks later: "We've been doing good. We've been progressing"⁵. Branville McCartney, whose family owns Wilmac's Pharmacy, called the regime "certainly a stretch"⁶. An unnamed pharmacist told the same paper that some operators had raised markups on non-controlled drugs and dispensing fees, which reportedly reached $10 an item at some pharmacies, up from a historical $2.50 to $3⁶.

The controls expire, and the question stays open

The government kept the agreed expiry date. By 18 January 2023, pharmacies were moving shelf and system prices back to the pre-November margins; one pharmacist said: "We were looking for the end of those price controls"⁷. In June 2023 the Minister of Economic Affairs, Michael Halkitis, said the government "feels inclined" to protect consumers from inflated prices on pharmaceuticals and food, noting that price controls limit, but do not prevent, profit⁸. A pharmacist writing to The Tribune in July 2025 said: "We operate under price control regulations", and argued that a market of fewer than 500,000 people has limited power to negotiate with manufacturers¹⁰.

Enforcement continues in other forms. In February 2025 the Consumer Protection Commission reported finding a merchant in Bimini with 35 expired drug products, some dating to 2021; the chief price inspector for the Northern Bahamas said: "The major problem we are finding is expired drugs"⁹.

Why this matters for diabetes and GLP-1 drugs

The 2022 list was built around chronic disease: anti-diabetic and cardiovascular medicines were on it from the start¹⁵. The cost of chronic disease treatment remains a political issue. In his contribution to the July 2025 debate on the health bills, Prime Minister Davis spoke of "the diabetic who currently spends hundreds each month on insulin" and promised that, under the integrated National Health Insurance drug programme, "these medications will be free"¹¹.

GLP-1 drugs are the next test. In September 2026 the country's only full-time endocrinologist told The Tribune that demand for Ozempic (semaglutide) and Mounjaro (tirzepatide) is rising; the paper put monthly costs at $250 to more than $1,500 and reported a growing market for their "unregulated acquisition"¹². GLP-1 drugs are not yet on the national prescription drug plan, although the minister says coverage for obesity and type 2 diabetes is intended¹². Public reporting on the 2022 regulations does not say whether any GLP-1 brand was among the controlled anti-diabetic products.

What the international evidence says

The World Health Organization's 2020 guideline on country pharmaceutical pricing policies lists markup regulation, defined as governments setting "rates for how much suppliers can add to the costs of medicines", among ten pricing tools, alongside promoting generics and price transparency¹³. A WHO-commissioned systematic review in Health Policy found only seven eligible studies and concluded that the limited evidence "cautiously suggests" that regulating markups may reduce medicine prices and spending, but that design is critical¹⁴. A WHO/Health Action International analysis of 45 surveys in 36 countries found private-sector retail markups ranging from 10% to 552%¹⁵. Another systematic review found Western countries tend to use lower markup margins than some Asian countries¹⁶.