Peptides in Barbados: a guide for Barbadian physicians

Who this guide is for

This guide is for the physician in Barbados who wants the facts before forming an opinion. Peptides are not a passing fad: they are one of the most successful drug classes in modern medicine¹. But patients increasingly arrive with questions shaped elsewhere, by overseas clinics, social media and products bought abroad, while Barbados is rewriting its own medicines law⁷¹⁹. Here we summarise what the evidence shows, what the law of Barbados actually says, and what has happened locally.

Peptides: an established drug class

Since the introduction of insulin, more than 80 peptide drugs have reached the market for diabetes, cancer, osteoporosis, multiple sclerosis, HIV infection and chronic pain¹. The newest generation has outcome data. In SELECT, a randomised trial of 17,604 adults with established 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)². In STEP 1, semaglutide produced a mean weight loss of 14.9% versus 2.4% with placebo at 68 weeks³; in SURMOUNT-1, tirzepatide produced 20.9% in the highest-dose group versus 3.1% with placebo at 72 weeks⁴.

Global bodies have followed. In September 2025, WHO added semaglutide, dulaglutide, liraglutide and tirzepatide to its Essential Medicines List for adults with type 2 diabetes with established cardiovascular disease or chronic kidney disease and obesity⁵, and on 1 December 2025 it issued its first guideline on GLP-1 therapies for obesity: a conditional recommendation for long-term use in adults, excluding pregnant women⁶.

What the law of Barbados says today

Until the new Act comes into force, medicines in Barbados are governed mainly by three bodies of law and institutions⁷⁹¹⁰¹¹:

• The Pharmacy Act, Cap. 372D. It establishes the Pharmacy Council (section 10), requires anyone practising pharmacy to be registered as a pharmacist (section 3) and certifies and registers pharmacy premises (sections 15 and 16). Section 27 governs the sale of drugs: the Second Schedule lists "drugs that shall be compounded, dispensed or sold by a pharmacist or under the supervision of a pharmacist", and section 30 covers dispensing and compounding. Contravening the Act or its regulations is an offence carrying, on summary conviction, a fine of $2,000 or 12 months' imprisonment, or both (section 35). The Council includes the Director of the Barbados Drug Service and a medical practitioner appointed after consulting the Barbados Association of Medical Practitioners (First Schedule)¹⁰.
• The Medical Profession Act, 2011-1. It replaced the Medical Registration Act, Cap. 371, and its long title provides for the establishment of the Barbados Medical Council, the registration of medical practitioners, the regulation of their conduct and discipline, and "the regulation of advertising by medical practitioners". Part III sets up the medical register and the specialist register¹¹.
• The Barbados Drug Service. Created in 1980, it runs public procurement and the Barbados National Drug Formulary⁹. Formulary drugs are free for people aged 16 or under, 65 or over, or diagnosed with asthma, cancer, diabetes, epilepsy, glaucoma or hypertension¹². CBC described the new law as the most significant transformation of the Barbados Drug Service since its inception⁹.

The Barbados Medical Products Act, 2026

Parliament passed the Barbados Medical Products Act, 2026 in June: the Senate on 10 June and the House of Assembly on 16 June⁸. It was assented to on 18 June and published in the Official Gazette on 22 June 2026 as Act 2026-12⁷. Its key provisions for physicians⁷:

• Scope. A "medical product" includes medicines, biologics, diagnostics and devices, and expressly covers biological products (including "recombinant therapeutic proteins"), herbal medicines, extemporary medicines, medicated cosmetics, vaccines and poisons (section 2).
• Marketing authorisation. No one may import, manufacture, advertise, distribute or sell a medical product unless it is registered and authorised by the new Barbados Medical Products Authority (section 43(1)); products already on sale get 12 months after commencement to apply (section 43(3)). A pharmacist may compound for a particular patient only with active components already present in an authorised product (section 43(4)).
• Prescription-only lists. Drugs on a list published in the Official Gazette may be sold or supplied only by a practitioner for treatment under his or her direction, or by a pharmacist on a prescription signed and dated by a practitioner (section 34).
• Imports. Importing a drug requires a licence from the Authority and a manufacturer approved by it (section 37).
• Advertising. No one may advertise or sell a medical product represented as suitable for "off-label or non-evidence-based use" (section 49).
• Clinical trials. Trials on humans need clearance from a National Ethics Committee and authorisation from the Authority (section 55).
• Penalties. Most breaches carry a $5,000 administrative penalty (for example, section 43(5)); selling or advertising a product in a false, misleading or deceptive way is an offence punishable by a $50,000 fine or two years in prison, or both (section 71).
• Repeal and start. The Therapeutic Substances Act, Cap. 330, is repealed (section 79), and the Act comes into operation on a date fixed by Proclamation (section 80).

Implementation is under way with PAHO support: on 20 October 2026, stakeholders met in Bridgetown to review draft regulations on medical products and clinical trials, covering market authorisation, licensing, inspections, recalls and pharmacovigilance, and Barbados reaffirmed its goal of WHO Maturity Level 3 by 2029¹³.

Recent developments in Barbados

• Enhancement products and fade creams (June 2026). In the House debate, Dr. Sonia Browne, MP for St. Philip North, welcomed the regulation of herbal medication, sexual enhancement drugs and fade creams: "People will not be allowed to import products haphazardly, put them on a shelf, or market them to unsuspecting individuals"¹⁴.
• Weight-loss medication and the formulary (March 2026). Prime Minister Mia Mottley said adding weight-loss medication to the formulary is a manifesto commitment, though not funded in the 2026 budget¹⁵.
• Childhood obesity (October 2026). The Education Transformation Minister said 42% of Barbadian children are now overweight or obese, up from 31% in 2017¹⁶.
• Modest local uptake (2024). In January 2024, CBC reported, citing a consultant pharmacist, that Ozempic (semaglutide) was not being used on a wide scale in Barbados¹⁷.

The evidence map

Not everything sold as a "peptide" sits at the same level of evidence. GLP-1 receptor agonists have phase 3 trials with cardiovascular outcomes²³⁴. At the other end, a 2025 systematic review of BPC-157 found 35 preclinical studies and a single clinical study: in a retrospective series, 7 of 12 patients with chronic knee pain reported relief for more than six months after one intra-articular injection, but no clinical safety data were found¹⁸. For physicians, the distinction matters: under section 49 of the new Act, a product cannot be advertised for a use that is not evidence-based⁷.

How safe are they?

Approved peptides have well-characterised safety profiles. In SELECT, 16.6% of patients on semaglutide and 8.2% on placebo stopped treatment permanently because of adverse events². In March 2026, calling for stronger pharmacovigilance after reports of GLP-1 misuse, PAHO said several countries had reported adverse events linked to these medicines, mostly gastrointestinal and usually temporary, but also less frequent, potentially serious acute pancreatitis, gallbladder disease and intestinal obstruction, and warned that demand may push sales into unofficial channels such as the internet and social media¹⁹. WHO estimates that at least 1 in 10 medicines in low- and middle-income countries is substandard or falsified²⁰. For research peptides, the main problem is the absence of human studies rather than proven harm¹⁸: the most concrete risk is where the product comes from.

What it means for practice in Barbados

Patients will bring these questions, and sometimes these products, to the consulting room. Three practical points follow from the law. First, once the new Act is in force, a product without marketing authorisation will not lawfully be on the market in Barbados; the Act also provides for parallel imports and for reliance on decisions of stringent foreign regulators (sections 46 and 57)⁷. Second, physicians' own promotion is regulated by the Barbados Medical Council under the Medical Profession Act¹¹, and the new Act separately penalises advertising of off-label or non-evidence-based uses⁷. Third, adverse events will have a formal home: the Act requires a National Pharmacovigilance Programme (section 51)⁷, and PAHO calls on countries to strengthen pharmacovigilance so adverse events are promptly detected and reported¹⁹. The physician who knows the evidence and the law becomes the patient's reference; if patients do not find that in the clinic, they will look for it online.