By Sue-Ann Wayow

CABINET has approved changes to the Chronic Disease Assistance Programme (CDAP) in Trinidad and Tobago which provides free prescription drugs to all citizens for managing chronic illnesses.

The changes will save government over $4 million, said Health Minister Dr Lackram Bodoe as he made the announcement on Thursday during a post Cabinet media briefing.

To date, for the year 2025, the minister disclosed that over $40 million have already been spent on the CDAP programme.

CDAP was established in 2003 and, as at July 2025, would have covered 11 chronic diseases, offered 52 pharmaceutical items and operated through 230 private pharmacies serving over 300,000 citizens.

Dr Bodoe said, “Whilst we note CDAP’s success, we must also recognise its current challenges including rising cost, outdated drug regimes, and gaps in diagnostic support.”

A CDAP review committee was commissioned on June 5 to assess clinical, operational and financial performance.

The committee recommended outdated and inferior medication be removed from the list.

For example in the area of mental health – the drug sulpirid is being replaced by risperidone- a more effective anti psychotic agent.

For cardio vascular patients simvastatin is being replaced by rosuvastatin or crestor.

Two medications were added to offer assistance to persons with cardiovascular disease-plavix and losartan.

Dr Bodoe said, “The total savings of over TT$4 million will be saved over this CDAP cycle and this will be driven primarily by smarter drug selection  and diagnostic procurement.”

“The most significant saving, almost 70 per cent, will come from replacing the current blood glucose monitoring system.”

He said currently, glucose strips cost the government approximately $1.15 per unit. Through a government-to-government arrangement with India, Trinidad and Tobago can acquire ISO certified WHO prequalified strips at less than .34 cents per unit. Delivering and quality will not be compromised, he ensured.

Dr Bodoe also said the strips should be compatible with testing machines.

The ministry will also develop a new initiative so citizens can have access to specialised drugs delivered through private pharmacies under regulated pricing agreements and at no direct cost to governments, details of which will be forthcoming.

A full implementation proposal is expected to be brought to the Cabinet by year end.

To expand the reach of CDAP to all citizens, government will be removing the $68,000 cost for pharmacies to get on board with the programme and the figure they will have to pay will be much less.

“Pharmacies will now be permitted to self source the IT equipment which will be in line with ministry specifications whilst the ministry provides software support,” Dr Bodoe said.

He provided figures for four years spent on the CDAP programme.

However, it was still but a fraction of the overall cost for the health sector, he said.

The health minister also lamented the underutilisation of some health facilities including  the Couva Hospital.

He said, “Couva Hospital remains a very valuable asset to the people of Trinidad and Tobago. At this time, we are looking at all the options available to fully operationalise Couva Hospital. It is quite worrisome at this point in time that there are no more than 20 to 25 patients occupying beds in the Couva Hospital and that is a 230 bed hospital.”

Work is also ongoing at the Central Block at the Port of Spain General Hospital and Dr Bodoe said he intended to do a tour of the facility soon to determine its state of readiness.

He also said of the regional health authorities, only the North Central Regional Health Authority (NCRHA) board has not yet been installed.

Dr Bodoe said there were more doctors than nurses in the public health sector and the new boards should be working to proportionate medical staff accordingly.