"I will have to die beyond my means" Oscar Wilde

Parliamentary Secretary for Consumers and Fair Competition Chris Said has a hard nut to crack when facing importers of medical products later on this month to discuss the high price of medicines in Malta.

Maltese consumers are paying through the nose for medicines which are essential and which they often need to take for the rest of their life. Drug companies claim that prices of medicinal products in Malta are higher than in the EU because economies of scale favour bigger markets. At the same time they cite the situation in Greece – a bigger market where Novo Nordisk, a Danish company, reacted to the Greek government’s demands to a 25% price cut by withdrawing from the market, abandoning diabetic patients relying on its products.

The Greek diabetes association called Nordisk’s actions pure and simple “blackmail" and "a violation of corporate social responsibility". Back to Malta, economies of scale may be one factor that affects the price of medicinals in Malta There are factors that contribute to the high cost of medical products in Malta. “Incentives” are one. Incentives-- a euphemism for the “commissions” given by drug companies to ensure that their product is prescribed or dispensed in preference to any other product – even if theirs is the worst product on the market.

These commissions have not been mentioned as a factor that contribute to the high cost of medical products in Malta.

You wonder why? These commissions are UTC not OTC --- under the counter not over the counter. They are hidden earnings and are not declared by the parties receiving them. Incentives form part of an extensive tax evasion system. Doctors by law are not allowed to accept commissions – nor incentives – to prescribe a particular product. Yet many doctors are falling prey to the system and are prescribing or using a particular product because of the tax-free money they receive.

Doctors have been tempted by drug companies to do so. Ah yes… the Medical Council: one member of the council once called me because he was not being referred patients.

I have no doubt that the “incentives” are also given for promoting or dispensing over the counter products (OTC). An extensive system of tax evasion has evolved over the years. It is time to call a spade a spade. How much tax evasion in this area alone – I am told by those in the business – perhaps €20 million annually. Do we need another czar? Yes, if we want to protect patients – but this time best provide him with a large rear view mirror.