Patients are entitled to free medicinal treatment by virtue of the 
Social Security Act Cap 318 Article 23 and the amendement of this act - Act No. I of 2012 and the Fifth Schedule to the same Act. The list of conditions that are covered by the Fifth Schedule covers a total of 83. Any patient suffering from a chronic condition which is listed under the second part of the Fifth Schedule of the Social Security Act is entitled to free medication for that specific disease and entitlement is based solely upon the presence of disease irrespective of means, income or age.
The process to become entitled to receive free medications under the Schedule V scheme starts by a visit at a medical professional who is responsible for assessing the patient and diagnosing the condition for which treatment is required. The medical professional follows the Government Formulary List which specifies the conditions and the associated treatment and then fills in the medicines request form. The medicines request form is brought to the MAS one-stop-shop where the official document listing the medicines required by the patient is issued.
In general for most conditions new applications must be made by consultants. However health centre doctors can apply for hypertension treatment as well as cholesterol treatment as per the Government formulary list. Private doctors who are specialists in family medicine (as per Specialist Medical Doctor register) can only apply for renewal of such treatment.
The Schedule V document cannot be transferred from one patient to another.
The MAS one-stop-shop is responsible for the co-ordination of the entitlement procedure in order to ensure conformity and guarantee that entitlement is universal in application. MAS receive and process requests for medical treatment including protocol regulated items and exceptional medical treatment requests.
Patients holding the Schedule V document are only entitled to those medicines listed on the valid document. This benefit is independent of financial means.
Protocol regulated items
Medical Professionals are requested to fill in correctly the Protocol Regulated Application Form or include the protocol number in the appropriate section of the Schedule V form which is now integrated in the new application form including the patients details and address, drug/s requested, dosage form and regimen, duration of therapy, reason/s for the drug being requested and any further documentation. The form should be endorsed by the Medical professional’s signature, name, date, e-mail and telephone number. The request is to be sent or brought by hand to the Medicines Approval Section (MAS) one stop shop. It is also possible for doctors can to apply by email by downloading the application form and sending to schedulev.poyc@gov.mt .
Applications including Protocol regulated formulary items are reviewed. Criteria which are reviewed are: indications, prescriber criteria, conditions qualifiying patients for receiving treatment, investigations required prior to starting treatment, objective indicators of efficacy and any need for a patient consent form or other declarations. The application is then approved or rejected. Whenever a request for a protocol regulated item is rejected a not entitled form letter is sent or given to the patient stating the reason for which the request was rejected. Once a request is accepted the permit is given to the patient or sent to the patient by post if the application is sent to the MAS.
Entitlement – Schedule V Diabetes Mellitus Condition
In line with the new Health Policy Strategy the diabetic patients holding a valid Schedule V (Yellow Card) shall be entitled to:
- New medicines introduced in the GFL which do not fall under Pink card (Gliptins)
- Blood Glucose Meter.
- Blood Sugar monitoring sticks
- Glasses
- Free Dental treatment
- Antibiotics
- Insulin Syringes
- Aqueous Cream
- Rebates on Telecare Services
Link to the Government Formulary list:
https://deputyprimeminister.gov.mt/en/pharmaceutical/Pages/formulary/formulary.aspx
Schedule II
People eligible for a Schedule II document (pink card) are as follows:
- Fall in the low-income group, as determined by a means test or a person who is in receipt of Social Assistance;
- Social Assistance for Single Parents,
- Unemployment Assistance
- Non Contributory Age Pension or Increased Severe Disability Assistance and Severe Disability Assistance.
These are entitled to free medicines from a restricted list of essential medicines specifically marked as pink card positive on the government formulary list as well as certain medical devices. The Social Security issues the pink card.
In order to receive free medical treatment with the pink card one must have a medical prescription and make sure to have a valid pink card. Once the patient has applied for the pharmacy of his/her choice he/she can consult the pharmacist in order to update the entitlement.
Other Pink Cards
Schedule V office issues Pink Medicine Entitlement Cards to persons residing in convents, monasteries or similar institutions (usually monks and nuns), and children residing in institutes (Children’s’ Homes). Supporting documentation may be requested to confirm that the person is residing in an institution. Once the cards are full, they can be issued a new one from the Schedule V offices.
Grey cards
Schedule V office issues Grey documents for staff working within Government entities.