The price of medicines

The back page report (April 1) on how new pharmaceutical rules may cause shortages indicates what I have been saying for the past 15 months. The Minister of Health found it very convenient to ignore this issue and never bothered to answer statements I had made regarding the effects of these rules, resulting in price hikes and possible shortages or the disappearance from the local market of certain medicines. Neither did he bother to do the necessary consultations with the constituted bodies in this field.

I am all in favour of the necessary changes in the pharmaceutical registration regulations to ensure quality, safety and efficacy of medicines on the market. In September 1997 I sought assistance and funding in this area from the World Health Organisation - Europe. Our excellent relations with WHO Europe had opened new horizons. An expert in this field was despatched to Malta to help in drawing up these regulations taking into consideration the Maltese scenario. This is the type of bilateral cooperation with a European organisation put to the advantage of our nation.

I disagree with the marketing authorisation procedures which will mean that a new tax of Lm50 is being imposed for the registration of pharmaceutical products coming from the EU. This tax is being imposed on different formulations (tablets, cream, ointment, suppositories and suspensions) and strengths of these same products which all must be registered separately. Higher tax, still undisclosed but most probably running into hundreds of Malta liri, will be imposed on medicines originating from countries outside the EU, such as Switzerland, the US, Canada, Australia etc.

It is already common knowledge that certain medicines and strengths of some medicines have not been registered. Such circumstances will lead to price hikes of certain pharmaceuticals. For example, one might find a product with two different strengths, the 1mg and the 5mg. The 1mg product is being registered while the 5mg product is not. One hundred tablets of the 1mg product are much more expensive than 20 tablets of the same product but with the 5mg strength. Simple mathematics shows that those who are on the 5mg strength tablets will have to pay more since now only the 1mg strength tablet is on the market!

Other importers are using different tactics to camouflage the price hikes of certain pharmaceuticals. A particular product used to be imported in packets of 24 tablets and cost Lm2.25. The same product now can only be found in packs of 12 and cost Lm1.68. If you need 24 tablets it is now costing Lm1.11 more than a few weeks ago.

More worrying is the fact that local importers may find these taxes as a deterrent to import these medicines administered to very specific patients who may be few in number. The economies of scale will render such importation unviable as the tax imposed by the government will be levied on these patients and the cost of the medicinal may become exorbitant.

Who is going to bear the brunt for this insouciance? Patients of all ages... including children and the elderly. Unlike other countries, we do not have easy access to cross a border to buy our medicines, which may be accessible and cheaper in a nearby country. Are we going back in time and having to go abroad to buy medicines instead of chocolates and toothpaste?

Unfortunately, the present Minister of Health preferred to re-invent the wheel and discard all the excellent work that was already carried out.