Replies to LegCo questions
LCQ19: Samaritan Fund
Following is a question by the Hon Chan Yuen-han and a written reply by the
Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council
today (February 23):
Question :
It has been reported that "Glivec" for the treatment of gastrointestinal stromal
tumour and chronic myeloid leukaemia has been classified by the Hospital
Authority (HA) as first-line drug, and patients who have to take the drug and
have financial difficulties will be referred to apply for drug subsidy from the
Samaritan Fund. However, HA has not yet released details of the subsidy scheme.
In this connection, will the Government inform this Council whether it knows:
(a) when HA intends to release the details of the above scheme;
(b) as "Glivec" is very expensive and the existing eligibility criteria of the
Samaritan Fund are not reasonable to patients applying for drug subsidy from the
Fund, whether HA will revise the eligibility criteria of the Fund when drawing
up the details of the scheme, so that more patients who have to take the drug
can receive drug subsidy; and
(c) if HA has switched from its previous policy of bearing most of the expenses
for first-line drugs to arranging for the expenses of the existing and new
first-line drugs to be subsidised by charity funds, and to conducting income and
asset tests on the subsidy applicants?
Reply :
Madam President,
(a) The Hospital Authority (HA) announced on January 18, 2005 that commencing
from January 20, 2005, public hospitals would prescribe Imatinib (Glivec) for
patients with Gastrointestinal Stromal Tumour (GIST), and as first line
treatment for Chronic Myeloid Leukaemia (CML), in accordance with the patients'
clinical indications. Glivec belongs to a small group of drugs that are proven
to be of significant benefits but extremely expensive for the HA to provide as
part of its subsidised service. Drugs within this group are new and usually only
indicated in advanced stages of diseases and beyond currently available standard
modalities of treatment. In order to ensure the rational use of finite public
resources and to maximise the health benefits to the public as a whole, patients
requiring this expensive drug and can afford to pay will have to shoulder the
drug cost themselves under the targeted subsidy principle. Patients who have
difficulties in meeting the expenses may apply for assistance under the
Samaritan Fund, which is an existing scheme to provide public hospital patients
with a safety net. Depending on the patients' individual financial situation,
they may receive a partial subsidy or even full reimbursement for their expenses
on these drugs.
(b) Applications for assistance under the Samaritan Fund are assessed by Medical
Social Workers, who will make a comprehensive assessment of the patients'
eligibility for assistance. Factors of consideration include the patients'
family income and the actual cost of the required medical item. The Medical
Social Workers would also exercise discretion in determining eligibility, taking
into account special social factors and the circumstances of the patients'
family.
The existing assessment criteria for Samaritan Fund have been working well for
patients requiring Glivec. Before January 20, 2005, patients requiring this drug
as second line treatment for CML were already eligible to apply for assistance
under the Samaritan Fund. Up to the end of 2004, a total of 56 public hospital
patients who required Glivec as second line treatment for CML have received /
have been receiving assistance under the Fund. An additional 19 patients
received assistance from another charitable fund administered by the HA under
the same assessment criteria. The overall level of financial assistance for
these 75 patients is over 95 per cent. In HA's knowledge, only about 20 public
hospital patients requiring Glivec as second line treatment for CML had
shouldered the full cost of the drug themselves during the same time period.
(c) In developing the drug utilisation and payment policy, the HA has always
been guided by the principle that public resources should be utilized for the
maximum benefit for the public as a whole and that all patients should be given
equitable access to effective drug therapy. Other core values upheld by the HA
include evidence-based medical practice, rational use of public resources,
targeted subsidy and opportunity cost considerations, and facilitation of
patient's choice. The financial arrangement for Glivec is consistent with the
above long-standing principles and values, and does not indicate a change in
drug policy at the HA.
Ends/Wednesday, February 23, 2005
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