Issue link: https://maltatoday.uberflip.com/i/1542674
6 maltatoday | SUNDAY • 18 JANUARY 2026 NEWS CONTINUES FROM PAGE 1 On a per capita basis, spending reached €648, the second high- est in the bloc after Germany. Around 90% of this expenditure was on prescribed medicines, with the remainder spent on over-the-counter products. This emerges from the State Of Health In The EU: Mal- ta – Country Health Profile 2025, issued in December by the Organisation for Economic Co-operation and Development (OECD) and the European Ob- servatory on Health Systems and Policies. Yet, despite high retail prices and a substantial out-of-pock- et burden, Malta records ex- ceptionally low levels of unmet medical need. In 2024, just 0.5% of the population reported be- ing unable to access medical care due to cost, distance or waiting times, seven times low- er than the EU average. Among people at risk of poverty, the rate remains among the lowest in the EU at 1%. Breakdown of pharmaceutical expenditure Pharmaceutical spending in Malta is split almost evenly be- tween public and private sourc- es. In 2022, government fund- ing covered 55% of total retail pharmaceutical expenditure, while out-of-pocket payments accounted for a substantial 41%, above the EU average of 39%. A small share, around 4%, is covered by voluntary health insurance or other private schemes. By contrast, in France, 83% of expenditure on medi- cines is covered directly by the state and only 12% is paid di- rectly by households. This reflects a broader reli- ance on private spending within the health system. Overall out- of-pocket health expenditure in Malta stands at 31%, nearly double the EU average of 16%. This includes costs such as den- tal care and private medical consultations. On average, governments or compulsory insurance schemes cover 35% of dental care costs in the European Union, but only 11% of these costs in Malta. For outpatient care, public or man- datory insurance covers 77% of costs across the EU, compared with just 59% in Malta. In the case of medicines, 59% of expenditure across the EU is financed by government or mandatory insurance schemes, compared with 55% in Malta. By contrast, inpatient hospital care in Malta is in line with the EU average, with 92% of costs publicly financed. According to the report, this trend is driven by long wait- ing times in the public sector and a preference for continui- ty of care and the wider range of medicines offered by private providers. Consequently, public coverage for most services re- mains below EU averages. Targeted assistance The report notes that on- ly individuals on low incomes and those with certain eligible chronic conditions, around 30% of the population in 2023, received free outpatient med- icines through yellow or pink cards. These cards cover treat- ments listed on the Govern- ment Formulary List. The list of scheduled chronic conditions, defined under the Social Security Act, is regularly updated and relatively compre- hensive, covering conditions such as hypertension and dia- betes. Pink cards are intended to provide additional protec- tion for particularly vulnera- ble groups, but only 3% of the population held a Pink Card in 2025. As a result, roughly two-thirds of the population do not qual- ify for either a yellow or pink card and must pay the full cost of outpatient prescriptions. However, the report suggests that the low proportion of peo- ple with unmet medical needs shows that the system is func- tioning despite its reliance on the private sector. Moreover, to mitigate dis- advantages linked to its small market size, Malta relies on in- ternational collaboration to im- prove affordability and access to new medicines. Life expectancy rebounds Malta's health system delivers several strong outcomes, most notably life expectancy at birth, which reached 83.3 years in 2024, 1.6 years higher than the EU average. This represents a successful rebound following a temporary decline during the pandemic. Malta ranks fourth in the EU for life expectancy, behind Italy, Sweden and Spain, and is on a par with Norway. The gender gap is also narrower than the EU average, with wom- en living 3.5 years longer than men, compared with a 5.2-year gap across the EU. Maltese citizens also enjoy a higher number of healthy life years than the EU average, re- porting fewer activity limita- tions after the age of 65. Persistent vulnerabilities Despite high life expectancy, the report identifies major vul- nerabilities, particularly life- style-related risk factors. Malta has the highest rates of over- weight and obesity in the EU for both adults and adolescents, driven by poor nutrition and low physical activity, especial- ly among 15-year-olds. Adult smoking rates also remain above the EU average. These risks are unevenly dis- tributed, with people with low- er levels of education twice as likely to be obese or to smoke daily. Workforce and infrastructure pressures persist. While physi- cian numbers are high, the pro- portion of general practitioners is declining and nurse density remains below the EU average. The report also flags a recent spike in antibiotic consump- tion, placing Malta off track to meet its 2030 reduction targets. As a small island state, Malta is also highly vulnerable to cli- mate change, with rising tem- peratures projected to lead to a 300% increase in heat-related deaths by the end of the centu- ry. Shortage of hospital beds Malta has fewer hospital beds per capita than most EU countries, contributing to overcrowding and pressure on emergency departments. In 2023, Malta had 4.1 hospi- tal beds per 1,000 population, down from 4.4 in 2020 and well below the EU average of 5.1. Hospital discharge rates are also lower than the EU average, but bed occupancy rates for cu- rative care are higher, indicat- ing limited reserve capacity. These pressures are most ev- ident at Mater Dei Hospital, which has faced persistent over- crowding and long emergen- cy department waiting times, driven largely by population growth. Malta among EU's biggest spenders on medicines as households shoulder a growing share of the cost Malta records one of the highest levels of retail pharmaceutical spending in the EU (File photo)