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Following is a question by the Hon Joseph Lee and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (November 12):
Question:
It is learnt that at present, some patients receiving public healthcare services are dispensed tablets in dosages which do not match those prescribed by doctors. As such, they need to cut the tablets to the required dosages by themselves before taking them. Some patients have relayed that patients' cutting the tablets by themselves often results in inconsistent dosages or even crumbling of the tablets, and elderly patients or patients with disabilities also lack the skills to cut the tablets by themselves. This has resulted in patients taking inaccurate dosages of medications. In this connection, will the Government inform this Council whether it knows:
(1) in each of the past five years, the number of patients receiving public healthcare services who were dispensed tablets that had to be cut by themselves as well as the types and quantities of the medications involved, broken down by hospital cluster and specialty;
(2) why the Hospital Authority (HA) and the Department of Health (DH) do not dispense tablets of appropriate dosages to all patients;
(3) given that administration of medications in insufficient dosages will reduce their efficacy while excessive dosages may lead to drug safety incidents, how HA and DH ensure that patients are able to cut tablets accurately to the appropriate dosages; and
(4) if HA and DH will review and improve the drug procurement system and procure tablets of different dosage levels according to the dosages generally prescribed by doctors to obviate the need for patients to cut the tablets themselves; if they will, of the details and the resources involved each year; if not, the reasons for that?
Reply:
President,
The Hospital Authority (HA) and the Department of Health (DH) have stringent mechanisms in place to procure from the market and provide patients with pharmaceutical products that meet quality requirements.
My reply to the various parts of the question is as follows:
(1) and (2) The HA and the DH procure drugs in appropriate dosages in accordance with existing mechanisms for patients' use. However, for reason of clinical needs, individual patients may require tablets in dosages that are not available in the market. Under such circumstances, for tablets that can be split, patients may need to split them before consumption. The HA and DH do not maintain any statistics in relation to tablet splitting by patients themselves.
(3) and (4) At present, the HA has an established mechanism for drug procurement, and the primary considerations are quality, safety and efficacy. The HA will procure drugs registered with the DH through open tender. Drug manufacturers, pharmaceutical companies and the drugs need to meet stringent standards and regulations in order to ensure quality, safety and efficacy. While observing this long-established procurement mechanism, the HA also keeps in view the latest development in the pharmaceutical market so as to procure drugs in appropriate dosages required for patients' use. To ensure that appropriate dosage of drugs is taken by patients, for drugs that may require splitting before use, the HA will state it as a tender requirement that pharmaceutical companies should supply scored tablets such that patients may appropriately split the tablets along the score line with tools such as a tablet-splitter.
The Drug Monitoring Committee (DMC) comprising doctors of different specialties and pharmacists has been established under the DH to devise and update the Drug Formulary of the department. The Formulary is reviewed on a regular basis according to clinical needs. Pharmaceutical products of the required quality are procured in accordance with the decisions of the DMC and the strict procedures set out in the Stores and Procurement Regulations (SPR) promulgated by the Government Logistics Department. When dispensing drugs to patients, the DH will explain to patients the appropriate use and dosage of drugs according to the guidelines on good dispensing practice. If splitting of tablets is required, the DH will provide patients with specific reminders and recommend the use of a tablet-splitter.
Ends/Wednesday, November 12, 2014
Issued at HKT 14:33
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