NHI Prescription Drug Programme in The Bahamas: 160,000 and Shortages

From 44,000 to 160,000 patients

In March 2025 Minister of Health and Wellness Dr Michael Darville told Parliament that more than 160,000 Bahamians with chronic non-communicable diseases are slated to receive free prescription medication under National Health Insurance (NHI)¹. The existing National Insurance Board (NIB) chronic disease plan covered just over 44,000 Bahamians, mostly government workers and their families¹. The conditions named were hypertension, diabetes, heart disease, certain cancers, renal insufficiency and mental illness¹. "This is a huge initiative by our administration and will change medical outcomes," Darville said¹.

The 2025 health bills

In July 2025 the government brought a compendium of five health bills: the National Health Insurance Bill, 2025 (repealing the 2016 Act), the National Health Insurance (Specified Chronic Diseases) (Prescription Drug Fund) Bill, 2025, a Pharmacy Bill, the Health Promotion and Wellness Bill, 2025 and the Dental Professions Bill, 2025²³⁴. Prime Minister Philip Davis told the House that the drug plan would use bulk purchasing to lower costs and partner-pharmacy contracts to reach patients across the islands, and that the pharmacy bill would allow "secure electronic prescription systems that reduce errors and prevent fraud"². Darville called the package "a comprehensive health reform package ideal for our archipelago"⁴. In April 2026 The Tribune listed passage of the National Health Insurance Act, 2025 among the government's achievements⁸.

The opposition questioned the gaps. East Grand Bahama MP Kwasi Thompson said "Cancer is a leading cause of catastrophic health expenditure in The Bahamas," argued that cancer treatment must be included "clearly, explicitly, and boldly," and warned that late payments to participating doctors could erode public trust³.

Pharmacists' concerns: payments and shortages

In June 2026 Tribune Business reported pharmacists' fears of late or delayed payments once the National Prescription Drug Plan moved from NIB to NHI, and that the plan was already facing temporary shortages of some chronic-illness medicines, with emergency procurement activated⁵. One pharmacy operator, speaking anonymously, said: "With government, their margins are very, very small… so really and truly, it's just a cash in and cash out system," and "How is it I have to wait six months to get paid, which is common for some people"⁵. The same operator warned that slow tendering could push the country back in global supply queues: "If Cayman ready, and Jamaica ready and Trinidad ready, and we ain't ready, we go to the back of the line"⁵. Philip Gray, chief executive of Quality Care Pharmacy, said shortages exist but are not alarming: "There are a couple but not in a major way"⁵.

A month later the tone softened. After a nearly three-hour meeting with Darville and Minister of State for Health Owen Wells, Bahamas Pharmaceutical Association president Dr Marvin Smith said members were "a little less nervous" and that "there's been no disruption in service"⁶. "The minister said this programme only works if it is sustainable," Smith said, adding that the BPA wants pharmacists to take on patient monitoring, medication compliance and immunisation⁶.

Supply chain: a market without drug registration

The expansion depends on a supply chain that regulators have limited tools to police. The Tribune reported, citing Comptroller of Customs Ralph Munroe, that only a handful of companies are authorised to import such products¹¹. Chief Pharmacist Dr Gina Archer said The Bahamas has no national drug registration system¹¹, and a pharmacist writing to The Tribune described it as "a non-registration market" where imports occur "without local product registration or batch testing"¹². Bulk purchasing for 160,000 patients raises the stakes of that gap²¹².

GLP-1 drugs: the next coverage decision

Darville has said the government intends to expand NHI to cover GLP-1 medications for obesity and type 2 diabetes, acknowledging the cost but arguing the long-term benefits would make it worthwhile; today these drugs are not covered by the national plan and cost patients $250 to more than $1,500 a month⁷. The clinical case is strong: in SELECT, semaglutide cut cardiovascular death, heart attack or stroke by 20 % in adults with cardiovascular disease and overweight or obesity¹⁰. The cost case is harder: in the STEP 1 extension, people who stopped semaglutide regained two-thirds of the weight they had lost within a year, which implies long-term treatment¹³. The World Health Organization's December 2025 guideline urges fair access pathways and projects that GLP-1 drugs will reach fewer than 10 % of those who could benefit by 2030⁹.