Community Chest reduced to ‘finance’ house for chemotherapy, says doctor MP

Government should step up and start making available more treatments for cancer patients, to allow the Malta Community Chest Fund serve its core mission, not act as a financing house for oncology patients, Nationalist MP Stephen Spiteri has said.

The PN spokesman for health told MaltaToday it is high time that the government expand the national formulary to include new – and approved – cancer treatments and services.

“This would put a stop to patients having to beg the MCCF for funds to be able to pursue these treatments abroad or for medication that is not available in Malta,” he said. “Moreover, government would be able to purchase these services and medications for much less than the MCCF is currently paying.”

Nationalist MP Stephen Spiteri

The government formulary list includes medicinal products, vitamins, food supplements and borderline substances available for free to Maltese citizens.

But Spiteri insists that many cancer treatments on the formulary list – including chemotherapy treatments – have been superseded by newer and better treatments, approved by the European Medicines Agency and available in many European countries.

These same treatments are also approved by Maltese oncology specialists who often end up recommending them to their patients, who then turn to the MCCF for help.

“These treatments have less side-effects, and have higher success and survival rates than those currently offered in Malta,” Spiteri said. “The PN believes the government, irrespective of which party is in power, should offer the best biological treatments approved by the EMA.”

The formulary, for example, does offer treatment for renal cell carcinoma – kidney cancer – but more innovative treatments offered in Europe provide a higher success rate and less chance of relapse. This is why the PN is recommending the formulary list be reviewed and expanded.

Spiteri said that when a patient, or their family, turns to the MCCF for financial aid, the MCCF often ends up paying anything between €5,000 and €20,000 for one cycle of treatment for a single patient.

“What is worse is that the MCCF is procuring the treatment itself, approaching medical suppliers abroad and purchasing single doses of a treatment each time a patient needs assistance.

Last week, President George Vella who heads the MCCF, said that costs had risen to around €1.4 million a month – or €17 million annually – mainly due to chemotherapy for Maltese cancer patients,” Spiteri said.

He expressed hope that the MCCF would be able to find the funds necessary to continue to assist all those who needed help.

“Cancer patients and their patients should not have to go begging for assistance from the MCCF when EMA-approved treatments are available abroad,” Spiteri said. “Besides providing a crucial service to patients, expanding the formulary list would allow the MCCF to focusing once again on poverty and other social issues, instead of serving as a financial house for oncology patients.”

Spiteri said that if the government stepped up to provide these newer treatments, it would not need to spend as much as the MCCF was currently spending.

The MCCF pays full retail price each time it orders a cycle of treatment for a single patient. The government, on the other hand, would pay much-reduced wholesale prices since it would be able to order in bulk, having the means to securely store a steady number of treatments.

The PN is recommending the setting up of a Drugs Fund, which would continue accepting donations from willing parties, and administered by the government under strict, clear protocols. The fund would cover cancer treatments, as well as treatment for side effects like nausea and constipation.

Spiteri said that the Opposition's proposals also including expanding existing screening programmes to reach a higher percentage of the population.

“With newer treatments, the earlier you diagnose a cancer such as breast, colon and prostate cancer, the higher the success rates,” Spiteri said. “If this possibility exists, we should provide it to as many people as possible.”

More widely-available genetic testing programmes would also allow individuals with a strong family history of some types of cancer to seek early medical assistance.

Spiteri said that vast improvements had also been registered in radiotherapy, with new equipment available abroad having proven to be able to drastically limit the damage to healthy tissue. “Introducing the latest generation of radiotherapy equipment would therefore result in a better quality of life for patients after treatment,” he said.

The PN spokesman said the party was also proposing the setting up of a 24-hour walk-in clinic, possibly within the oncology centre at Mater Dei Hospital, where cancer patients would be able to seek immediate medical assistance, without having to go through the Emergency department.

Other proposals include providing cancer patients with specialised electronic devices that would allow them to contact a specialist directly in the case of a medical emergency.

Ambulatory chemotherapy should also be considered, the PN believes, in the case of patients who specialists believe are capable of administering the treatment themselves at home, under approved conditions, thus also easing the pressure on the oncology centre.

And Spiteri believes that expanding the country’s research and innovation capabilities, possibly developing a well-funded hub in Malta, would attract global financing as well as specialists in the field.

“Malta should also look to building solid bilateral relationships with other countries to ensure an exchange of treatments, equipment and research and to keep abreast of innovation in the field,” Spiteri said.

“Having such bilateral agreements with countries like Germany, Italy and Israel would allow us to offer cancer patients in Malta the best possible treatment available anywhere.”