Tista’ taqra bil-
Malti.
Nationalist MEP Peter Agius has announced plans to push for joint procurement arrangements that could help address Malta’s persistent problems with medicine availability and pricing, which force many patients to purchase essential drugs abroad at half the domestic cost.
In a video published on social media, Agius highlighted diabetes medication as an example of medicines that Maltese consumers find significantly cheaper in other EU countries. He attributed the problem partly to Malta’s small market size, which limits importers’ ability to negotiate competitive rates compared to larger nations like Italy.
The scale of the access problem is stark. Data from the European Federation of Pharmaceutical Industries and Associations (EFPIA) shows Malta has the lowest medicine availability score in the EU, just 17 compared to an EU average of 80. This often means innovative medicines available elsewhere in the EU reach Maltese patients with an average delay of four years.
“When you buy for Malta, you have to account for that,” Agius explained, pointing to joint procurement as a solution whereby Malta would purchase medicines collectively with countries such as Italy and Greece, leveraging bulk-buying power to reduce costs and improve availability.
To translate this into action, Agius has submitted detailed amendments to three major pieces of EU health legislation currently under negotiation in the European Parliament’s Health Committee.
In his proposals for the Critical Medicines Act, Agius is seeking to make joint procurement feasible for smaller groups of countries. He has tabled an amendment to allow just three member states to launch a joint procurement procedure, a significant reduction from the nine originally proposed by the European Commission, which would make it practically easier for Malta to form buying blocs.
For the Pharmaceutical Package Regulation, a key proposal is the mandatory use of an electronic patient leaflet accessible via a QR code. This measure would decouple medicine imports from language barriers, allowing Malta to source packages from large markets like Germany, Spain, and Italy without being constrained by printed instructions in a language patients cannot understand.
A third set of amendments to the Pharmaceutical Package Directive aims to prevent a potential crisis by proposing an extension to a special derogation that allows Malta and Cyprus to source medicines from the UK. This exception is currently set to expire in 2026, before new EU-wide digital labelling systems are in place.
The proposal addresses a documented problem. Independent reports show Maltese consumers cover 41% of total spending on retail medicines out-of-pocket, compared to the EU average of 29%. Malta’s pharmaceutical spending per capita stands at €639, some 30% to 35% above the EU average, with studies finding Malta often has the highest unit dose prices for cardiovascular and respiratory medicines.
Malta’s private market operates with no statutory price controls, contributing to elevated costs. Meanwhile, medicine shortages affect all European countries, with the situation worsening in recent years due to manufacturing problems, parallel trade, and dependency on non-EU countries for active pharmaceutical ingredients.
Malta is already part of the Valletta Declaration group, a voluntary cooperation initiative among smaller EU states including Croatia, Cyprus, Greece, Ireland, Italy, Portugal, Romania, Slovenia and Spain, aimed at improving access to medicines through joint procurement and information sharing.
Whilst joint procurement has historically focused on medical countermeasures for health emergencies like pandemic vaccines, expanding the mechanism to cover routine medicines remains under discussion through proposals such as the EU’s Critical Medicines Act, which Agius’s amendments are designed to shape directly.
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