Weight-loss drugs on the Barbados National Drug Formulary? The plan

A manifesto promise on weight-loss medication

Obesity medicines may be heading for the public drug list in Barbados. Speaking in Parliament during the March 2026 budget debate, Prime Minister Mia Mottley said the government is exploring adding weight-loss medication to the Barbados National Drug Formulary as part of the fight against chronic non-communicable diseases (NCDs), according to Barbados Today¹. The measure was not funded in the budget, she said, but "it is already committed to in the manifesto"¹.

Mottley said some weight-management medications are now "relatively safe", that some people will need medication alongside movement and good diet, and that lowering weight could improve control of blood pressure and diabetes¹. On 31 October 2026, speaking at the ceremony marking Barbados' certification for eliminating mother-to-child transmission of HIV, she returned to the theme: the government, she said, is finding it increasingly difficult to meet rising demand for services such as dialysis and treatment of eye complications, and, CBC reported, the country must now intensify its response to chronic illnesses, particularly diabetes and obesity².

How the Barbados National Drug Formulary works

The formulary is administered by the Barbados Drug Service⁴. Drugs on it are provided free of cost to people who are 16 or under, 65 or over, or diagnosed with asthma, cancer, diabetes, epilepsy, glaucoma or hypertension³. Others pay at private pharmacies, often more: in November 2025, Marlon Ward Rogers, president of the Barbados Pharmaceutical Society, said patients "can expect to pay higher prices at pharmacies" for drugs that the formulary often subsidises, and that shortage complaints usually came from government polyclinics⁴.

The programme is already under budget pressure. In April 2024, the Barbados Drug Service cut the maximum number of insulin pens it pays for to two per client per month (from up to five), to maintain "the viability of the programme", with exemptions for visually impaired people and anyone 18 or under⁵. A GLP-1 listing would add to that budget a drug class whose high prices, WHO says, are already limiting access worldwide⁷.

What the evidence says about GLP-1 obesity medicines

• Weight loss. In STEP 1, adults with overweight or obesity lost a mean 14.9% of body weight on semaglutide versus 2.4% on placebo at 68 weeks⁹. In SURMOUNT-1, tirzepatide produced a mean loss of 20.9% in the highest-dose group versus 3.1% on placebo at 72 weeks¹⁰.
• Hard outcomes. In SELECT, with 17,604 adults with cardiovascular disease and overweight or obesity but no diabetes, semaglutide reduced cardiovascular death, non-fatal myocardial infarction or non-fatal stroke by 20% (hazard ratio 0.80)¹¹.
• Chronic treatment. In STEP 4, after a 20-week run-in on semaglutide, participants switched to placebo regained weight (+6.9% from week 20 to week 68), while those who continued lost a further 7.9%¹². For a formulary, that means an open-ended cost, not a short course.

WHO's position: yes, but conditionally

On 1 December 2025, WHO issued its first global guideline on GLP-1 medicines for obesity: "GLP-1 therapies may be used by adults, but excluding pregnant women, for the long-term treatment of obesity"⁶. The recommendation is conditional, citing limited long-term data, current costs, health-system preparedness and equity; WHO projects the drugs will reach "fewer than 10% of those who could benefit by 2030" and warns that global demand "has fueled the spread of falsified and substandard products"⁶. Earlier, in September 2025, WHO added semaglutide, dulaglutide, liraglutide and tirzepatide to its Essential Medicines List as glucose-lowering therapy for adults with type 2 diabetes who also have established cardiovascular or chronic kidney disease and obesity (body mass index of 30 or more), noting that "high prices of medicines like semaglutide and tirzepatide are limiting access"⁷.

Open questions for physicians in Barbados

If the formulary moves, Barbadian physicians will have to settle several questions: which molecule, which patients (the WHO Essential Medicines List targets people with diabetes and comorbidities first⁷), and how to monitor safety. In March 2026 PAHO cited increasing reports of adverse events associated with misuse of GLP-1 medicines, listing less frequent but potentially serious events such as acute pancreatitis, gallbladder disease and intestinal obstruction, and urged countries to strengthen pharmacovigilance⁸. The new Barbados Medical Products Act, 2026 bars placing a medical product on the market unless it has been registered and granted marketing authorisation (section 43, with exemptions by order) and lets the regulator rely on stringent regulatory authorities in other jurisdictions (section 57); it comes into operation on a date to be fixed by Proclamation (section 80)¹³. Local uptake has so far been modest: in January 2024 CBC reported, citing a Barbadian consultant pharmacist, that Ozempic (semaglutide) was not being used on a wide scale in Barbados and that pharmacists had not seen increased demand¹⁴.