Replies to LegCo questions

LCQ18: Standard Drug Formulary

Following is a question by the Dr Hon Fernando Cheung and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (February 23):


Question :


Regarding the introduction of a Standard Drug Formulary proposed by the Hospital Authority, will the Government inform this Council of:


(a) the number of types of prescription drugs currently paid for by patients at standard fees and charges which will not be included in the future Formulary, together with a breakdown by the classification below, as well as the diseases to be treated by each type of drug:


(i) drugs which have been proven to be of significant benefits but are extremely expensive;


(ii) drugs whose efficacy have only been preliminarily verified;


(iii) drugs which have marginal benefits over available alternatives but are at significantly higher costs; and


(iv) drugs for the satisfaction of life-style purpose; and


(b) the estimated annual number of public hospital patients who have to purchase drugs at their own expenses as a result of the introduction of the Formulary and the total amount of additional expenses to be incurred by them?


Reply:


Madam President,


(a) To cater for advances in technology, there is an existing mechanism within the Hospital Authority (HA) for the introduction and withdrawal of drugs for use in public hospitals and clinics. Factors that are taken into account include scientific evidence, availability of alternatives, accumulation of clinical evidence, cost effectiveness and price competition for drugs of similar efficacy.


The draft Standard Drug Formulary made public by the HA on 18 February contains a total of 1 273 different drugs. Of the drugs that are currently available to patients at the standard fees and charges, 32 of them are excluded from the draft Standard Drug Formulary. These drugs can be broken down into two categories, namely drugs with marginal benefits over existing alternatives but at a significantly higher cost, and lifestyle drugs, as shown in Annex 1 and Annex 2.


(b) Since effective alternative drugs are available in the Standard Drug Formulary, it is not possible to estimate the number of public hospital patients who would purchase drugs at their own expenses after the introduction of the Standard Drug Formulary, or the amount of additional expenditure that would be incurred by these patients. In addition, it is difficult to predict how patients would make their choices, for instance on lifestyle drugs which are mainly optional items.



Ends/Wednesday, February 23, 2005

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Legislative Council Q18

Annex 1

Drugs with marginal benefits over existing alternatives but at a significantly higher cost:

Drug Type	Drug Entity	Number of Alternatives Available within the Standard Drug Formulary
Drugs for hypertension	- Cilazapril - Quinapril - Isradipine - Nitrendipine SR	31
Anti-platelet drugs	- Ticlopidine	3
Statins	- Pravastatin - Lovastatin	4
Respiratory drugs	- Cromoglycate - Procaterol	8
Fibrates	- Bezafibrate - Omega-3-marine triglycerides - Nicotinic Acid - Alpha tocopherol nicotinate	4
Antihistamine	- Acrivastine - Azatadine	13
Non-steroidal Anti-inflammatory drugs and Drugs for Osteoarthritis	- Glucosamine Sulphate - Diclofenac & Misoprostol - Ketoprofen SR - Proglumetacin - Tenoxicam	12
Drugs for Soft tissue inflammation	- Hyaluronidase	1
Topical analgesic	- Diclofenanc - Piroxiciam - Rubesal	1

 

Legislative Council Q18

Annex 2

Life Style Drugs

 

Drug Type	Drug Entity
Hormonal replacement Therapy	- Tibolone - Raloxifene
Drugs for In-vitro-fertilisation	- Chorionic Gonadotrophin - Follitropin Alfa - Follitropin Beta - Pergonal
Emollient bath	- Oilatum - Keri