Form is to be filled in by any of the marketing authorisation holders (MAHs) or their representative local agents, when making a request for new pharmaceutical products to be considered for inclusion on to the Government Formulary List. This form also needs to be filled in for those items which are already available on the formulary but for which a new indication is being considered. All the products have to be licensed for use in the Maltese market and the indications must be in line with the entitlement procedure for free medicines that are currently in place.

What you'll get

If the request for the inclusion of a new medicine or indication on the formulary is accepted, patients will benefit from free treatment.


Any MAHs or local pharmaceutical agents acting on behalf of the MAHs.

How to apply

Fill in the online form, print it, sign it, and send to:

The Superintendent of Public Health
St Luke's Hospital

This form cannot be submitted online due to the requirement of an original signature.