Pharmacists cool with CDAP but Rafeeq hot

The Chronic Disease Assistance Programme (CDAP) has received high marks from pharmacists but former Health Minister Dr Hamza Rafeeq said government is simply subsidising cheap over the counter drugs and emphasis should be placed on assisting the public with expensive medication which they are unable to afford. Rafeeq said the “basket” of drugs in the programme for diabetes, heart disease and high blood pressure are the cheaper over the counter drugs which members of the public can purchase without having to pay $100 to see a doctor and get a  prescription. He said many of the drugs people need are expensive and these should be subsidised by government. Rafeeq said government seemed to be saying  “we will buy the cheap drugs and you buy the expensive ones yourself.” He said people have been questioning why they cannot get certain drugs free. “This programme is not working all that well,” he said. The programme was introduced last February and expanded last June to include people over 60 years. This increased the total number of people who can benefit to 125,000. However, not all of them will have chronic noncommunicable (eg diabetes, glaucoma, high blood pressure) diseases that would require medication. CDAP utilises specially designed triplicate prescription pad forms. One copy is retained by the physician, the second by the pharmacy dispensing the drug and the third is forwarded by the pharmacy to NIPDEC to facilitate data.

Wazir Hosein President of the Pharmacy Board said $1.1 million in medicine is currently in the system and the number of people accessing free medication is increasing. There are 240 private pharmacies involved in CDAP. Hosein said there are plans to increase the 20 prescription drugs now available to include drugs for asthma and prostate disease. There are no exact figures available but the number of people using CDAP has been estimated at 9,000. Hosein thinks the programme will encourage more people to attend to their health because now they “have no excuse” not to seek treatment. He admitted that many people may not be au courant (well informed) about the Plan. Another benefit is that CDAP complements the Public Service because pharmacists at clinics and hospitals will have a reduced work load so they will have more time with patients. While the drugs are free, visits to a doctor are not. Questioned about whether visiting a private doctor regularly to get a prescription would be expensive, Hosein said patients can get prescriptions for a three-month supply of medication. He said the programme was designed for “repeats” to save money.

Dr Steve Smith said he has used four prescription pads which total 200 prescriptions. The majority of them were for diabetes and hypertension. He described the programme as helpful. While the drugs available may be limited, he said the “point is that people are assisted by receiving medicines that are available.” He hoped to see a wider range of drugs available especially for arthritic pain and for inflammatory bowel disease. At Critchlow’s Pharmacy there is a good response from people who can’t get their prescriptions filled at hospital dispensaries and those recommended by doctors. Among those accessing the programme are people with a combination of diseases such as glaucoma and high blood pressure. The pharmacist reported that many people still are ignorant of the programme and are informed about it at the pharmacy. “Some will call on the phone because they don’t read the newspapers”, she said. The manager of a pharmacy in south Trinidad said to date the programme has been working well. “The number of prescriptions has been increasing tremendously, people are happy. They come in well equipped with their Identification Card. We send in our invoices and get payment, I think it’s a good idea.” She said doctors are taking “full advantage” in prescribing the items on the list of drugs in the programme. She hoped more items are added to the list.