Malta Chamber proposes ‘reimbursement system' for free medicines

Pharmacy owner Reginald Fava has proposed a reimbursement system whereby a patient pays for the free medicine he is entitled to, and then reimbursed. In the case that a person is not in a financial position to pay for the medicine upon collection, the Chamber has proposed the distribution of a pre-credited card which the patient presents to the pharmacy upon the collection of medicine.

The Chamber, which had already pushed forward such a proposal in 2009, believes the measure would help curtail waste of medicine.

In what appears to be a measure to address the pending payments which pharmacies are owed by the government, Fava said the reimbursement system would cater for two categories of patients: those who are entitled to free medicines but are in a position to pay for them upon collection and receive a refund from the state; and those who are entitled to free medicines and are not in a financial position to pay for them upon collection.

In the case where a patient is not in a financial position to pay for the medicine, the patient can continue collecting free medicine through the community pharmacy of your choice. According to the Chamber's proposal, medicines are collected upon the presentation of a 'My Health Card and Pin' as proposed in the White Paper issued by the government.

The card would be pre-credited with the medicines for which the patient is entitled. Deductions would be made upon each medicine dispensed to create the desired psychological effect for patients not to collect medicines which they do not need.

"The e-card roll out would need to involve family doctors and consultants to ensure that all patients are given a card irrespective of which category they fall under. Simultaneously, due attention must be given to primary healthcare for this to serve as a platform for related systems such as the electronic prescription," Fava said.

He added that in certain cases, the high cost of particular medicines could place virtually every patient in the second category. In such cases, special arrangements would be necessary.

The Chamber's proposal contemplates a medicines tariff to be agreed to by all relevant stakeholders.

"The tariff is to be revised periodically and shall stipulate the maximum refundable amount on each medicine. The tariff is to follow actual medicine prices at the level which the state opts to entitle patients for," the Chamber said.

"Pharmacies would supply the medicine at this basic price. Patients should be allowed to opt for a more expensive medicine than the basic entitlement and pay the difference in price. This difference would not be refundable by the State."

Asked for an immediate reaction, Health Minister Godfrey Farrugia said he personally disagreed with the proposal which would see a patient disbursing money over the counter and then reimbursed.

"However, it is also important for citizens to understand how much medicines cost. I personally disagree with the concept of a patient paying and then is reimbursed," he said.

Farrugia appeared to prefer the second proposal, whereby a patient is given a pre-credited card which is then presented to the pharmacy upon the collection of medicine.