Pharmacies are running out of popular products, including some strengths and pack sizes of Nurofen, as the pinch of the UK’s departure from the EU starts to be felt on Malta’s medicine chest.
The UK is now considered a third country by the EU and is no longer part of the single market for pharmaceuticals.
Household names like migraine-relief Solpadeine, “important” eye drops like Timolol, Cosopt and Travatan have also run out and well-priced generics like Thyroxine, used in thyroid hormone deficiency and not easy to replace, will soon no longer sit on pharmacies’ shelves, according to Mario Debono, chairman of the pharmaceutical division of the Chamber of Small and Medium Enterprises.
These were just the tip of the iceberg of pharmaceuticals that are expected to be a casualty of Brexit on the local market.
A Novartis representative subsequently told Times of Malta that all its products, including Travatan, would remain available as the company had made preparations ahead of Brexit to ensure supply.
Rennie, Panadol Advance, Feminax also running out
Heartburn and indigestion will no longer be beaten by Rennie, while among the list of soon-to-be missing or already out-of-stock products from the UK are Panadol Advance, the cranberry Canesten for cystitis, Feminax for period pain relief, and Difflam 3mg Lozenges for the throat.
The list includes a host of generics and products that have unique formulations the Maltese are used to but are expected to be unavailable now that the UK is out of the EU and considered a third country.
Giving examples of UK-manufactured products, Mario Debono said: “Can you imagine life without E45 and Sudocrem skincare?”
While these would be made available from other sources, they are likely to involve an increase in costs, he stated.
“Theoretically, we can turn to Ireland, but it is also a small country, facing its own problems, with some products starting to disappear from there too as the UK keeps its stock to itself,” explained Debono, whose division encompasses pharmacy owners, importers, wholesalers and private hospitals and clinics, and has a finger on the industry’s pulse.
Just the tip of the iceberg of pharmaceuticals not available on the local market
“Brexit put us in a difficult position,” he stressed.
The UK was the go-to-market due to the ease of sourcing goods, competitive prices and that, historically, Malta’s clinical forma mentis was based on its model.
Government struggling to find alternative sources
The pinch is also being felt by the government which was struggling to find alternative sources, Debono noted, highlighting the resilience of importers, who were managing to fill in the gaps with other products and formulations.
They had to first find an alternative from the EU market and then convince companies to sell to them at a good price, he said.
“Going to the European Union wholesale market and asking for, say 4,000 packs, was not easy,” he said.
Already, EU prices were higher than the UK’s where the market was driven by supply and demand.
The next hurdle would then be convincing consumers and doctors to use these alternatives.
Importing medicines from the UK now means re-registering – but this comes at a huge cost that companies did not find feasible, Debono said.
This could go up to a maximum of €48,000 for certain products, which was not viable for a small market.
Negotiations with the EU
Debono pointed fingers squarely at “unforceful” negotiations with the EU on the part of Malta, Ireland and Cyprus, saying “they should have brokered a special arrangement and presented the argument that the EU cannot push us into a worse situation in terms of price and availability.
“Political considerations have overridden the need for these countries to keep the same pharmaceutical market they had.
“Health is a matter of national – not EU – competence,” Debono insisted.
Cyprus has since found its own solution, going for national registration of products from the UK, doable as long as these products remained in the country, he said.
“This is what Malta should be doing,” Debono suggested, pointing out, however, that the cost of national registration was much lower in Cyprus than in Malta and that this, as well as the “vast” documentation process it involved, needed to be studied and cut down.
Debono said that in “punishing” the UK, Maltese consumers got a raw deal. Together with Cyprus and Ireland, it had been forced to accept something that would “ruin” the pharmaceutical market, which would now require a period of adjustment.
The industry was suffering “the perfect storm”, acknowledged the chairperson of the Healthcare Business Section of The Malta Chamber, Giulia Attard Montalto.
The negative impact on the availability of certain pharmaceuticals, both in the private and public sectors, was also exacerbated by the pandemic, which has caused significant disruption to previously well-established supply chains.
Pre-Brexit, Malta could purchase fractions of whole batch productions without having to commit to the large quantities that would otherwise have to be manufactured specifically for its relatively small size, she said, acknowledging that finding alternatives in the EU was “not always a straightforward process”.
The chamber was actively engaged in discussions with stakeholders and authorities to find longer-term, feasible solutions acceptable to the EU Commission to retain as many products as possible on the market, Attard Montalto said.