Unwarranted Attack by Medical Association on Maltese Pharmacies in the Community

Mario Debono (Council Member and Pharmacies representative)

GRTU Malta Chamber of SME's as national representative of owners of Pharmacies in the Community strongly condemns the unwarranted attack by the Medical Association of Malta, the trade union representing medical professionals, on the pharmacy licence system operated in Malta. This is the system that has provided privately run and owned pharmacies in the community that has given excellent service to patients throughout Malta and Gozo and that has been solely responsible for the dispensing of medicine to most Maltese at no additional cost to patients, except the controlled price mark-up established at law.

Pharmacies in the Community have no economic power to impose prices that are above the margins marked on importers the wholesale price of medicine delivered to pharmacies and prices of medicines are the same all over Malta as competition at the pharmacy level does not, and cannot affect the price of medicines at the pharmacy level. It is therefore incredible that an association of professionals can be so naïve and ignorant of elementary facts of economics to issue a press release so infantile and replete of errors as the one issued by MAM to comment on an issue which is really far out of its remit.

The proposal by the Minister Of Health to allay the burden some doctors seem to be complaining about by allowing pharmacists to prescribe medicines, besides being a proposal, has absolutely nothing to do with the issue of pharmacy licences and pharmaceutical prices, and MAM is rushing into judgement on this proposal at the risk of downgrading the esteem the members of this Union have in the eyes of the public.

Licences of Pharmacies in the community are regulated by means of an agreement set up to include geographic and demographic principles. The system ensures that investors will not simply chose the most attractive and profitable locations for investment in complete disregard of other localities which being small, remote or not representative of affluent sectors of the community would otherwise have to remain either without a pharmacy service or need to cause the government to invest taxpayers money in a state owned pharmacy service. It is absolutely untrue, and a figment of one's imagination, to declare that more pharmacies would mean more competition that would drive down the cost of medicines.  In countries like Iceland, and Norway, the free market was allowed to reign and governments did not impose a system similar to Malta the result has been that pharmacies in the peripheries closed down leaving business to flow to pharmacies in the centres with the resultant hardship to the patients in the suburbs and peripheries, who suffered as a result of their lack of accessibility to medicines.

Incredibly the Medical Association also links unsafe practices to the prices of medicines. This is a rather puerile way of putting forward an argument. There is simply no basis for this assertion.

It is incredible that an association of medical professionals expresses publicly their ignorance of their understanding of the pharmaceutical market in Malta. They have no idea as to how the pharmaceutical supply chain operates and the economics of such a chain and the huge responsibilities of pharmacists, their fellow professionals. Unlike doctors, pharmacies have to earn their professional income from the small and controlled margin that remains after they deduct all expenses of running a modern pharmacy fully equipped to meet current market expectations pay all charges, pay all salaries and all costs of medicines and unlike other professionals all professional pharmacists employed in private pharmacies do not charge a professional fee to patients. Often enough, unfortunately pharmacies in the community have to suffer the illicit competition of medicines sold on the market by medical practitioners who sell medicine to patients which medicine is not in their possession for sale and effecting sale for which they are not licence

In other countries there are situations where both dispensing pharmacists and dispensing doctors operate on the same market and this is especially true in remote rural areas but the reasons for this dual licensing system has nothing whatsoever to do with the arguments presented illogically by MAM is presenting itself as dogmatic and not interested in fruitful dialogue to ensure the best service to patience on the issue of efficient dispensing of medicine in the community. GRTU on the contrary has consistently participated with the Ministry and the Medicine Authority on all proposals that aim at reforming and upgrading the system, however GRTU seeks first and foremost to base its arguments on facts and scientific evidence rather than on emotional and ill-conceived arguments negligent of the real fact

Notwithstanding this uncalled for diatribe by MAM against the professionals who own and manage the Pharmacies in the Community in Malta and Gozo, GRTU on behalf of its members state the professionals managing the pharmacies are more than happy to work with the many  doctors they host, in a meaningful relationship where the patient benefit.