Issue link: https://maltatoday.uberflip.com/i/1531608
12 maltatoday | SUNDAY • 19 JANUARY 2025 NEWS IN Malta, patients cover 41% of the total spending on pharma- ceuticals – whether prescribed or purchased over the counter – outside of hospital care. This is significantly higher than the EU average, where out-of-pock- et payments account for 29%, according to the OECD's State of Health report on EU health systems. The report, released at the end of 2024, showed that in the EU, most retail and pharmaceutical spending is paid for by the gov- ernment or mandatory insur- ance schemes. However, in Mal- ta, only 55% of total expenditure on medicines is funded by the government, voluntary insur- ance schemes cover 4%, and a significant 41% is funded direct- ly by patients. Public coverage is particularly high in Cyprus, where 90% of all pharmaceutical retail spend- ing is financed from the public purse, followed by Germany, France, and Ireland, with cover- age rates exceeding 80%. How- ever, public coverage falls below 60% in 15 countries, including Malta, and is below 40% in Bul- garia and Poland. Slovenia is the only country where voluntary health insur- ance covers more than one-fifth of the costs. Malta also records the sec- ond-highest pharmaceutical spending per capita (€639), af- ter Germany (€721), while Den- mark (€266) reports the low- est expenditure. However, in Denmark, a comparatively high proportion of medicines is dis- pensed as part of inpatient or outpatient treatments, bypassing traditional retail channels. The report noted that pharmaceu- tical expenditure in Malta and Switzerland is 30% to 35% above the EU average. In contrast, per capita pharmaceutical spending in Poland, the Netherlands, and Estonia is at least one-third be- low the EU average. The report reveals that pre- scription medicines account for three out of every four euros spent on retail pharmaceuticals in the EU. Over-the-counter medicines (i.e., medicines that do not require a prescription from a physician) and other medical non-durables make up the remainder. Across EU countries, out-of- pocket payments accounted for 15% of all health spending on av- erage in 2022. However, in Mal- ta, this percentage increased to 30%. In addition, households in Lithuania, Latvia, Bulgaria, and Greece had to pay more than 30% of their total health spend- ing out of pocket. Malta also reported the sixth-highest proportion of health expenditure funded di- rectly by the state (67%). This is largely due to the lack of compul- sory health insurance schemes, which cover 52% of spending across the EU. This helps explain the high level of private spend- ing on medicines in Malta. As defined in the report, phar- maceutical expenditure cov- ers prescription medicines and self-medication spending. Re- tail pharmaceuticals are those provided outside hospital care, dispensed by a retail pharmacy, or bought from a non-specialist retailer such as a supermarket. Moreover, there are challenges in comparing how pharmaceuti- cals are managed and dispensed for hospital outpatients. In some countries, these costs are classi- fied under curative care, while in others, they are considered part of pharmaceutical expenditure. High out-of-pocket pharmaceutical costs in Malta, according to EU-wide report In Malta, consumers cover 41% of total spending on retail medicines out of pocket, significantly higher than the EU average of 29% JAMES DEBONO jdebono@mediatoday.com.mt