Barra l-medicini life saving liema huma dawk il-medicini li jinghataw b’xejn f’malta? Jiena kull meta mmur ghand it-tabib tieghi sakemm ma jkollux xi free sample hu dejjem ikolli nixtri dak li jiktibli.

thanks

[Daphne – Jekk ikollok problema kronika – per ezempju tal-qalb jew diabete – tista tapplika biex tibda tiehu l-medicini b’xejn mid-Dipartiment tas-Sahha. M’hemmx ghalfejn ikunu ‘life-saving’. Ghalhekk hija daqstant stupida din il-bicca xoghol tat-tnaqqis tal-prezzijiet tal-medicini. Min hu vera fil-bzonn johodhom b’xejn.]

I’d just like to add that you can certainly get Augmentin and many other prescription medicines without a prescription from your local friendly pharmacist. Yes, it’s against the rules, but I guess the controls are quite lax.

The pill can be a contraceptive, and it can also be used for medicinal use, so what’s wrong with it being reduced in price as well?

I smell something else underneath this whole argument!

[Daphne – Yes. You smell somebody who recognises the thin end of a wedge when she sees one, and who can’t stand illogical ‘reasoning’.]

[Daphne – How do you know how much each and every medicine costs in each and every other EU member state? I haven’t seen a published list of hundreds of branded pharmaceutical products across 27 columns, one for each EU member state. Have you? That aside, exactly why do you think that the price of medicines should be the same right across the EU when the price of nothing else is? What gives branded pharmaceuticals the special status that, for example, cars don’t have? Nothing. If you can think of something, please let me know. Fundamental need? I think we all need a car more than we need Benylin cough syrup or Canesten pessaries.]

I cannot understand how the prices of medicines are cheaper abroad.

[Daphne – Who told you that they are, Maria? Where did you get this information? Also, define ‘abroad’. Abroad is a big place.]

Something must be wrong. Either because of government-induced costs or else exaggerated profit by importers and pharmacy owners.

Medicine is an essential commodity.

[Daphne – So is food. So are cars. So are clothes. So is the roof over your head. So are water and electricity. Do you want price control or government interference in profits there too (scratch the water and electricity…)? On the scale of essential commodities, which of these do you rank highest: children’s cough syrup, tablets for erectile dysfunction, the contraceptive pill, creams for itchy skin, petrol, electricity, water, basic foodstuffs, clothes and shoes, furniture for your home, plates to eat off, cutlery to eat with, a cooker, a refrigerator, a car. I don’t know about you, but on my list, the pharmaceuticals came last, last, last – and by a long shot.]

You were wrong in saying that Augmentin is abused. Augmentin is an antibiotic and used when there is an infection.

[Daphne – I know exactly what Augmentin is, and I also know what antibiotics are used for, what they should not be used for, and how they are misused. If you think that antibiotics are not extensively misused in Malta, then you haven’t been following the news too keenly. With Italy, we are top by far of the EU league table on antibiotic use. The health authorities have sounded the alarm repeatedly on antibiotic over-use, which is building a worrying strain of antibiotic-resistant bacteria. Doctors have been warned of the dangers of prescribing antibiotics unnecessarily, and patients have been warned of the public risks involved in taking antibiotics when they needn’t. Over and above that, a very recent survey showed that the majority of Maltese don’t know that antibiotics are useless against viruses and only combat bacteria. Most of those surveyed said that they would take antibiotics for a cold or the flu.]

Nobody takes it capriciously. First because you can become resistant to it, and also because it is expensive to buy, so one takes antibiotics if necessary.

[Daphne – Define necessary. Necessary is when you have a serious infection or are at risk of a serious infection, e.g. when you have been bitten by an animal, when you have swallowed heavily polluted water, or when you have a bacterial infection that can cause pneumonia. How many times does this happen? Not often. And yet sales of Augmentin are through the roof. “Nobody takes it capriciously” – yes, thousands do. There are survey results, sales records and antibiotic resistance problems to prove this.]

Moreover one can only get it against a prescription. With regards to anti-dandruff shampoo and Betnovate scalp application, the answer is simple. One is not a medicine while the other is.

[Daphne – Really? Define medicine. Are pills that give you erections medicines? Are contraceptive pills medicines? Both Betnovate and Head & Shoulders shampoo are chemical treatments for scalp problems – I deliberately say treatment rather than cure, because the problems each deals with are chronic and they can only deal with the symptoms. The difference between them is that Betnovate is a registered pharmaceutical product while Head & Shoulders is registered as a cosmetic treatment, so they fall within different categories at law. That’s all.]

I had a quick look at the Medicines Act of 2003.

http://www.doi.gov.mt/EN/parliamentacts/2003/Act%203.pdf

Article 80 (2) (Page 110) and I quote:

“Upon presentation of a prescription for a medicinal product, unless the prescriber specifically requests a particular branded product by writing “branded” or “®” on the prescription, a pharmacist can dispense the medicinal product prescribed or an equivalent medicinal product having the same chemical entity, dose, dosage form, formulation and dosage frequency as the medicinal product indicated on the prescription.”

So generic substitution is available upon the discretion of the prescribing doctor or consultant either by omission or by conscious choice.

I’ll give an example:

If the doctor prescribes Viagra® Tablets, then the pharmacist has to dispense the branded product.

If the doctor prescribes Sildenafil Tablets (generic name for Viagra), then the pharmacist may choose to dispense the branded or any equivalent generic.

I am not sure if this has changed but generic substitution was not allowed if the doctor prescribes the branded product.

I would appreciate if someone can confirm or dispel my perception.

[Daphne – I doubt it. Aspirin (I don’t feel like thinking of anything else) is aspirin is aspirin. But perhaps a pharmacist will pop in and let us know.]

Public lists of products which are allowed on the Maltese market:
http://www.ema.europa.eu/htms/human/epar/a.htm (medicinals authorised for all the EU markets including Malta)

http://medicinesauthority.gov.mt/pub/PI%20List.pdf (medicinals authorised on the Maltese market)

http://www.medicinesauthority.gov.mt/pub/MA%20List.pdf (parallel imported medicinal products authorised on the Maltese market)

Any pharmacist and/or doctor may easily help you identify generics or cheaper equivalent medicinal products.

Daphne – many thanks for finding the time to comment on what I said.

Kindly note that while respecting your journalistic contribution which is by far the best on this Don Quixote island I need to make it clear that I have never voted Labour and will never do so.

To be more precise I enjoy reading and learning from your diverse contributions

This government needs a kick in the butt as the Rip Van Winkle syndrome has taken over completely.

If I may chip in…state schools will always be state schools, whatever educational system they adopt. “Free” education is there for those who cannot afford to pay for it; those who can pay have the option of choosing the type of education they desire for their children.

My children also attended an independent school and I can tell you that even there you find parents who do not contribute at all in their child’s education.

All this may sound unfair on those who cannot afford to pay for their kids’ education, but life is not fair after all!

One also has to factor in the free credit advanced to government by supplying medicines and getting paid months if not years after you have had to pay your supplier abroad through your bank overdraft.

[Daphne – Nice one. I forgot to mention that yesterday. The government has a direct hand in putting up the price of medicines by failing to pay its pharmaceuticals bills on time. The government has a bloody nerve, hectoring importers about the prices of medicines, when it owes those same importers millions of euros for the pharmaceuticals it bought and failed to pay for.]