My dream and project for those living with cancer

The PL slogan ‘You are Malta, your dream, our project’ is hogwash!

Dear Dr Robert Abela, for the last five years I have constantly asked for your government to implement my dream: The right to timely, comprehensive and universal access to cancer treatment approved by the European Medicines Agency (EMA).

Dear readers, Darzalex – the brand name of the monoclonal antibody Daratumumab that I need to help me survive multiple myeloma – was approved by the EMA in April 2017.  Today, nine years after its approval, Darzalex is still only funded through the Malta Community Chest Fund (MCCF).

How can a prime minister who is not afraid to throw away people’s lives with sub-optimal access to cancer medication remain credible?

The EU average wait for the funding of a cancer treatment through the country’s healthcare system is 19 months. Germany, Sweden and Estonia take an average of a 100 days to fund treatment following EMA approval. In Italy, this takes an average of 14 months. In Malta it is close to five years, or 60 months!

Why does the government choose to maintain this inefficient and life-threatening status quo?

When a drug is added to the government formulary it becomes a legal entitlement for all eligible patients. By funding through the MCCF, the government only pays for drugs on an individual, case-by-case basis

Dr Abela, my project for you, to execute now, before the election, is to fund freely all drugs and treatments approved by the EMA within 100 days; as happens in Germany, Sweden and Estonia. After all, was it not you who said that Malta’s national wealth, person to person, is now the same as Sweden?

If the MCCF is afraid of losing its position in the hearts of the Maltese nation it can continue to fund such drugs during the 99-day period following EMA approval.

Many Maltese think that the government funds all treatment for cancer. This is not so. If your cancer is too rare, too aggressive, and the medicine that you need too expensive, government throws you under the bus.

Only 16% of cancer treatment approved by the EMA is paid for by the public healthcare system. This means 84% is not. It also means ‘begging’ to the MCCF and disclosing highly private information about personal assets to the MCCF for an application for the funding of a cancer treatment to be considered.

We must all remember that the Maltese healthcare system is funded by us through the taxes we pay. Despite this ‘free’ public healthcare system, Malta has one of the highest rates of out-of-pocket spending in the EU. Where are our taxes going?

No other EU member state funds cancer treatment through a charity. Through the MCCF, the government has the perfect mechanism to avoid public scrutiny over how it allocates such resources.

Government also has not lifted a finger to address the fact that MCCF means-tests applicants. The criteria applied are not readily available, and I question if they even exist. This is a far cry from the European standard of dignity and certainty.

Over the past year-and-a-half, both the prime minister and the minister of health and active ageing have assured Maltese citizens that the formulary would be updated to include more cancer treatment.

It is now also an electoral promise. Unfortunately for many, including myself, this is a broken promise. How can I trust those who are so inhumane towards us cancer sufferers?

In 2025, government passed over to MCCF at least €25 million to cover the cost of funding for the acquisition of cancer treatment. I now ask: Why is it that government prefers to pay more for the acquisition of drugs through MCCF instead of including these in the formulary and seek to negotiate a better price with ‘big pharma’?

Is it by design or because of lack of vision?

I now speculate why:

When a drug is added to the government formulary it becomes a legal entitlement for all eligible patients. By funding through the MCCF, the government only pays for drugs on an individual, case-by-case basis.

Government appears to pay more but the total annual expenditure might be lower because government is not obligated to fund every patient who meets the medical criteria but only those who pass MCCF’s opaque means-test.  Government might be picking and choosing whom to treat; paying more whilst giving cancer patients less.

If a Maltese citizen is denied a life-saving drug, the ‘blame’ tends to fall on MCCF. This allows the government to avoid the increased transparency required from other public departments. This situation is likely to weaken the right of cancer patients to complain through regular public service channels.

For government, passing a lump sum to MCCF is faster than reforming the healthcare organisational and procurement system required to match the German or Swedish models. It ‘plugs the hole’ without having to fix the actual ship. Malta might be equally affluent as Germany and Sweden, but we certainly do not display the organisational and effectiveness skills to match!

This reliance on charity clearly maintains an unfair and uncaring system through a deliberate strategy designed to avoid the legal, organisational and financial obligations of a comprehensive and universal public health system that reacts in a timely manner to safeguard the right to life of Maltese citizens with cancer.

Clearly my dream has not been PL’s project. Nor can I ever trust PL ever again, as I have repeatedly done over past elections, that my dream will become their project.

Lara Said has been diagnosed with multiple myeloma since 2018. Multiple myeloma is an incurable but treatable cancer. With timely and the best treatment available today she can live for many more years. Currently, half of her treatment is obtained through the national healthcare system and the other half is paid for by MCCF.