Following is a question by the Dr Hon Chiang Lai-wan and a reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (June 6):
 
Question:
 
​     Some patient groups have relayed that quite a number of new targeted therapy drugs with significant benefits in curing cancers have come onto the market in recent years, but most of them have not been incorporated into the list of Self-Financed Items (SFIs) under the Drug Formulary of the Hospital Authority (HA). This, coupled with the stringent eligibility criteria for applications under the Samaritan Fund and the Community Care Fund, has resulted in cancer patients who cannot afford the medication costs not being able to grasp the opportunities for treatments, thereby undermining patients' rights and interests.  In this connection, will the Government inform this Council:
 
(1) whether it will request the HA to expedite its appraisal procedure so as to incorporate those new targeted therapy drugs with significant benefits in curing cancers into the list of SFIs; if so, of the details; if not, the reasons for that;
 
(2) whether it will relax the eligibility criteria for applications under the two aforesaid relief funds and raise their subsidy ceilings, so that more cancer patients in need can obtain assistance; if so, of the details; if not, the reasons for that; and
 
(3) whether it will consider setting up a new dedicated fund to subsidise cancer patients with financial difficulties in receiving expensive treatments (including treatments with targeted therapy drugs); if so, of the details; if not, the reasons for that?
 
Reply:
 
President,
 
​     The Government and the Hospital Authority (HA) place high importance on providing optimal care for all patients, including cancer patients, and assuring patients of equitable access to safe, efficacious and cost-effective drugs under our highly subsidised public healthcare system. My consolidated reply to the various parts of the question raised by Dr the Hon Chiang Lai-wan is as follows.
 
​     The HA has an established mechanism for regular appraisal of new drugs and review of its Drug Formulary and the coverage of the safety net.  As pledged in last year's Policy Address, the Drug Management Committee under the HA and other committees concerned will more closely monitor the research developments and the accumulation of medical scientific evidence for new drugs so that needy patients could receive early treatment. The Drug Advisory Committee of the HA currently conducts meetings once every three months to appraise new drugs. The whole appraisal process follows the principles of evidence-based medical practice, rational use of public resources, targeted subsidy, opportunity cost consideration and facilitation of patients' choice, and takes into account the safety, efficacy and cost-effectiveness of drugs and other relevant factors, including international recommendations and practices, advance in technology, disease state, patient compliance, quality of life, actual experience in the use of drugs as well as the views of professionals and patient groups. In appraising new drugs, especially expensive ones, the HA will also carefully examine the long-term financial sustainability of the drug therapies with a view to providing all patients with appropriate treatments. The HA will include approved drugs in the Drug Formulary or under the coverage of the safety net as appropriate. 
 
​     Currently, the HA Drug Formulary includes effective drugs for the treatment of various diseases. These drugs, including targeted therapy drugs for treating cancer, are provided for patients at standard fees and charges. The HA has been extending the coverage of its Drug Formulary through regular review. Self-financed cancer drugs are incorporated into the Drug Formulary's special drug category in phases and provided for patients with specific clinical indications at standard fees and charges.
 
​     The HA provides a safety net for patients with financial difficulties in respect of specific self-financed items through the Samaritan Fund and the Community Care Fund (CCF) Medical Assistance Programmes, under which eligible patients are subsidised to purchase self-financed drugs covered by the safety net. As at April 2018, a total of 29 self-financed drugs proven to be of significant benefits were covered by the Samaritan Fund. Among them, 13 are for cancer treatment, of which 10 are targeted therapy drugs.
 
​     To provide cancer patients with more support, the Government and the HA launched the First Phase Programme of the CCF Medical Assistance Programmes in August 2011 to offer patients financial assistance to purchase specified self-financed cancer drugs which have not yet been brought into the Samaritan Fund safety net but have been rapidly accumulating medical scientific evidence and have relatively higher efficacy. As at April 2018, a total of 16 self-financed cancer drugs have been covered by this Programme and 13 of which are targeted therapy drugs. 
 
​     The appraisal of drugs is an on-going process driven by evolving medical evidence, latest clinical developments and market dynamics. At this stage, more scientific evidence is required to confirm the clinical efficacy and cost-effectiveness of most newly-developed drugs for cancer treatment and the actual benefits to patients. The HA will keep abreast of the latest development of clinical treatment and scientific evidence, heed the views and suggestions of patients' groups, and continue to review the Drug Formulary and the coverage of the safety net under the principle of rational use of limited public resources while maximising the health benefits for patients in need. The HA is also examining the extension of the coverage of the CCF Medical Assistance Programmes to provide patients with subsidies for specific drug treatments according to individual patients' special clinical needs, including subsidising eligible patients to participate in compassionate programmes of individual pharmaceutical companies.
 
​     To alleviate the financial burden on cancer patients, the HA has been in close liaison with pharmaceutical companies on the setting up of risk sharing programmes for specific cancer drugs. Under the programmes, the HA, patients and pharmaceutical companies will contribute to the drug costs in specific proportions within a defined period, or the drug treatment costs to be borne by patients will be capped. The aim is to facilitate patients' early access to drug treatments and provide the patients with sustainable, affordable and optimal drug treatments in the long term.
 
​     The HA has commissioned a consultancy study to review the current financial assessment and patient's co-payment mechanism under the Samaritan Fund and the CCF Medical Assistance Programmes. Improvement measures will be put forward in the light of the review findings with the aim of providing more appropriate assistance for patients in need. The Government has earmarked funding in the 2018-19 Budget for this purpose. Actual use of the funding will be subject to the review findings and recommendations.

Ends/Wednesday, June 6, 2018
Issued at HKT 14:28

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