A new wave of cancer diagnoses is expected to sweep across Europe over the next 15 years, with experts predicting a staggering 38% increase in the cancer burden by 2040. This will result in over 3.4 million new cancer cases and 1.7 million deaths annually. While scientific progress in cancer research and treatment continues to accelerate, new findings show that these breakthroughs are not reaching patients equally—particularly in smaller EU states like Malta.
According to the European Federation of Pharmaceutical Industries and Associations (EFPIA) 2024 Patients W.A.I.T. Indicator published last week, the average time from European Medicines Agency (EMA) approval of a new treatment to patient access across Europe is 531 days. This delay is even longer in some regions, with wide disparities between countries. In Germany, patients typically wait just 128 days, while in Romania it takes nearly 900 days. However, in Malta, the problem is not just time—it’s availability.
Between 2020 and the end of 2023, 168 innovative medicines were approved for use across the EU. Malta had access to just 10 of these, the lowest number among all EU member states. This represents a sobering 6% of available treatments—far below the European average.
Of the ten medicines that were made available in Malta, only four were fully accessible to patients through the public health service. The remaining six were approved only on a case-by-case basis.
Further analysis paints an even bleaker picture.
An additional 40 medicines, roughly 24% of the total, were only available through the private sector, meaning patients had to pay out-of-pocket or rely on private insurance. In contrast, a staggering 118 of the 168 new pharmaceutical products (70%) were not available in Malta at all, either publicly or privately.
Cancer patients are among the hardest hit. Out of 46 new oncology products approved in Europe during the same period, just one was accessible in Malta. This was the lowest availability rate among the 37 countries surveyed, making Malta’s performance especially concerning given the increasing national cancer burden and the growing need for timely and effective treatment options.
The situation for patients with rare diseases, often reliant on orphan drugs, is similarly dire.
Of the 61 orphan medicines approved by the EMA between 2018 and 2021, only four were widely accessible through Malta’s public healthcare system. An additional 15 were available privately, meaning the majority of Maltese patients had limited or no access to treatments designed specifically for rare conditions.
Compounding these issues is the lack of transparency around the time it takes for a new medicine to become available in Malta. The EFPIA report was unable to provide reliable data on time to access for Malta, with information available for only two products, too small a sample to draw any meaningful conclusions.
“Malta’s small market size and limited negotiating power certainly pose challenges,” said a reliable source from the local healthcare sector.
“But when only one cancer medicine out of 46 is available, it raises serious concerns about equity, especially for vulnerable populations who cannot afford private healthcare.”
While budget constraints and market dynamics are often cited as barriers, the lack of access to essential, innovative medicines, particularly in the public sector, undermines the principle of universal healthcare. As cancer and chronic disease rates rise, the cost of inaction will not just be measured in euros, but in lives lost or diminished.
“The urgency of this matter is clear; Malta’s GDP is amongst the highest in Europe but this is not being reflected in the availability of important medicines. The country needs to invest more in smarter procurement, strengthen reimbursement pathways, and explore EU-wide collaborations to improve access.”
“For patients, time is not a luxury and access to life-saving innovation should not depend on geography or income,” he added.