Drugs to delay dementia are set to be included in the reformed free medicine schedule, Health Minister Joe Cassar has said, but it is not clear when patients will be able to benefit from them.

“Schedule V is being reformed and the list of illnesses that will benefit from free treatment will change, with conditions being phased in gradually. We obviously need to look at sustainability,” Dr Cassar told The Sunday Times.

Malta and Latvia remain the only two European countries where dementia and Alzheimer’s sufferers are not reimbursed for the treatment that can delay the disease’s onset and costs about €150 a month.

The situation was highlighted by Labour MEP Louis Grech in a parliamentary question he put to the European Commission, which he said “is violating the rights and needs of patients in Malta”.

He also called on the Commission to urge Malta to review and update Schedule V to ensure patients had the same access to medicine and treatment of their condition as patients in other EU countries.

Alzheimer’s is a progressive disease that destroys brain cells, causing behavioural problems and memory loss – it accounts for 50 to 60 per cent of dementia cases.

Using European data, the Malta Medical Journal estimates there are some 4,500 dementia sufferers in Malta and with an ageing population this figure is expected to double by 2035.

As World Alzheimer’s Day is marked on Tuesday, with the theme Dementia It’s Time For Action, Maltese sufferers feel they are being discriminated against.

Free medication is something the National Dementia Strategy Group has been pushing for because some patients, especially pensioners, are going without because they cannot afford it.

This is also one of 10 recommendations in a 310-page strategy, backed by a scientific study, which group chairman Charles Scerri presented to the government last January.

According to Alzheimer Europe, no drug treatment can provide a cure for this disease or other common forms of dementia. However, anti-dementia drugs can temporarily slow the progression of symptoms, while antipsychotics control the behavioural and psychological symptoms.

In a recent policy report, this NGO delved into the inequalities in access to Alzheimer and dementia treatments, which remained a key concern to European sufferers’ organisations.

Dr Scerri pointed out that the diseases listed on Schedule V were last updated in the 1980s when dementia was hardly spoken about and treatment was unheard of.

The study established that the cost of taking care of a patient with dementia could exceed €400 a month, with medicine being the biggest expense.

This financial aspect is what is stalling the government’s decision to make dementia one of the first conditions to be included in the reformed Schedule V.

A Health Ministry spokesman said the reform was “a very costly exercise”, but free medicine was still being considered within the framework of the national dementia strategy.

The ministry has also submitted a proposal to the EU Commission’s national reform programme to focus specifically on dementia to address the needs of the elderly as a vulnerable group.

The pre-budget document also refers to this strategy being drafted and says it will be “launched in 2011”. The document admits that this condition “places a heavy burden on family and state since dementia sufferers require special attention and treatment”.

Ministry officials said the strategy would include the “very valid work” of the group’s 310-page report, but the journey was just starting and it was still “a very early draft” because a detailed study was necessary to delve into the cost required.

“This is a very emotive subject and I understand people are impatient, but things don’t change overnight,” the officials said.

When asked how much it would cost to provide free medicine to dementia sufferers the officials said a very rough extrapolation using the British health care system could translate into something like €4 million. However, it was stressed that there was not enough data to predict the exact cost.

Community services and education – for carers on how to provide appropriate care, and for professionals and the public to diagnose the condition quicker – are two things Dr Scerri believes are crucial components of a national strategy.

“Free medicine remains an important part of any trategy. And the best treatment can only be received when you catch the condition in its early stages.”