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Following is a question by the Hon Audrey Eu and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (February 16):
Question:
The Government and the Hospital Authority (HA) need to handle expired drugs every year, such as the three million doses of Human Swine Influenza (HSI) vaccines purchased by the Government in the year before which needed to be disposed of upon their expiry in September and October last year. In this connection, will the Government inform this Council:
(a) of the quantity and value of expired drugs that needed to be disposed of by the Government and HA in the past three years;
(b) as at the expiry dates of the aforesaid HSI vaccines, of the total number of vaccinated persons, with a breakdown by target group;
(c) of the ways to deal with the remainder of the HSI vaccines as well as the progress and the costs involved;
(d) given that the Food and Health Bureau indicated in its paper provided to the Panel on Health Services of this Council on July 13, 2009 that in the procurement of HSI vaccines, the Government would include a clause in the tender conditions to the effect that any unused vaccines ordered and delivered could be returned to the manufacturer with refund, of the implementation of such clause; and
(e) of the total number of doses of vaccines ordered by the Government under the 2010-2011 Vaccination Programme; whether the "refund of unused vaccines" clause in (d) has been included in such orders; of the number of vaccinated persons in the current year to date, with a breakdown by target group?
Reply:
President,
The responsibility of the public healthcare system is to safeguard public health and ensure that the public and patients can be provided with timely treatment and necessary drugs. Professional and clinical judgement is needed in considering the types and quantity of drugs to be kept in stock, and factors such as the epidemic trends, patients' needs and technology development will also be taken into account. In this connection, besides the commonly-used drugs, the Government and the Hospital Authority (HA) will stockpile drugs (e.g. vaccines) for protection of public health and prevention of diseases, as well as drugs (e.g. antivenoms) for emergency treatment to ensure that appropriate and timely prevention and treatment can be provided to the public and patients in need. To ensure that there is sufficient stockpile of drugs for emergency, it is inevitable that some drugs kept in stock will need to be disposed of upon their expiry.
The replies to the five parts of the question are as follows:
(a) The Department of Health (DH) and HA have well-established mechanism to monitor and manage the safety and efficacy of drugs. In the procurement of drugs, suppliers are generally required to supply drugs with an expiry date beyond a minimum of 18 months. The drugs will also be issued for use on the "first-in-first-out" principle for stock management purpose. Staff of the pharmacies and wards will check the expiry dates of drugs from time to time, a list of drugs in HA that will soon expire will also be circulated in public hospitals and clinics so that these drugs will be distributed to various hospitals for use as appropriate. Therefore, disposal of these commonly-used drugs is seldom required.
As there are various different dosage forms and units of drugs (including tablets, syrup, capsules, ointment, drops, granules, aerosol, ampoule and other different dosage forms), we are not able to give an estimation of the quantity of all the expired drugs which have been disposed of. Generally speaking, expired drugs in DH that need to be disposed of are mainly vaccines stockpiled for protection of public health. The retention period of vaccines is generally shorter and their price is higher. On the other hand, most expired drugs in HA that need to be disposed of are drugs for emergency uses, such as antidotes and antivenoms, etc. that must be stockpiled. However, drugs of this kind only account for a relatively small portion of the total drugs used in HA.
In each of the past three years, the total value of expired drugs that have been disposed of by DH is shown in Annex 1. The total value of expired drugs that have been disposed of by HA is shown in Annex 2.
(b) A breakdown of the total number of human swine influenza (HSI) vaccine recipients by target group as at the expiry date is shown in Annex 3.
(c) According to the Waste Disposal Ordinance (Cap. 354), all vaccines including the HSI vaccines should be disposed of by the Environmental Protection Department (EPD) by way of incineration. With the approval of EPD, most of the remaining HSI vaccines were collected on December 21, 2010 and conveyed to the Chemical Waste Treatment Plant at Tsing Yi for incineration under the supervision of DH staff, and the incineration process was completed on January 8, 2011. The total expenditure incurred was $11,470. Besides, a small amount of the vaccines were disposed of by individual clinics through the aforesaid waste disposal process.
(d) In the first tender exercise for procurement of HSI vaccines, the Government included a clause in the tender conditions to the effect that any unused vaccines ordered and delivered could be returned to the manufacturer with refund. In this tender exercise, however, this clause was not accepted by the suppliers at that time. Only after the clause had been removed did the suppliers bid for the tender to supply the vaccines. To ensure timely supply of adequate vaccines for public use, the clause was not adopted in that procurement exercise.
When tendering for the procurement of vaccines (including seasonal influenza vaccines), the Government will normally include in the tender conditions a clause to the effect that any unused vaccines could be returned, and a flexibility clause on the quantity to be ordered. For instance, the Government and the suppliers fix the specific quantity of vaccines to be ordered first. The Government can then require the suppliers to increase/decrease the supply according to the actual needs, within an upper and lower limit of 30%.
(e) The Government has placed orders for 300,000 doses for the 2010/11 seasonal influenza vaccination. When tendering for the procurement of vaccines, the Government included a clause in the tender conditions to the effect that any unused vaccines ordered and delivered could be returned to the manufacturer with refund.
A breakdown of the number of vaccine recipients by target group as at February 6, 2011 is shown in Annex 4.
Ends/Wednesday, February 16, 2011
Issued at HKT 13:50
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