LCQ19: Provision of drug subsidies for cancer patients
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Question:
The Hospital Authority (HA) regularly reviews and includes suitable new drugs in the Drug Formulary and the safety net coverage of HA's Drug Formulary, which cover various drugs for treating cancer. Regarding the criteria, mechanism and actual effectiveness of HA's introduction and subsidisation of new drugs for treating cancer, will the Government inform this Council:
(1) as the Government previously indicated that when considering the inclusion of a drug in the Drug Formulary or the coverage of the safety net (including the Samaritan Fund and the Community Care Fund Medical Assistance Programmes), HA's Drug Advisory Committee would take into account the safety, efficacy, cost-effectiveness of drugs and other relevant considerations, including international recommendations and practices, as well as professional views, and that the evaluation of drugs would be conducted based on medical evidence, clinical developments, and market dynamics, of the respective weightings of the various aforesaid criteria in the overall evaluation, as well as the methodology and considerations for determining cost-effectiveness;
(2) given that for lung cancer treatment, various advanced precision treatment drugs have emerged in recent years, e.g. the third-generation targeted therapy drugs for treating ALK (Anaplastic Lymphoma Kinase)-positive lung cancer, but it is learnt that patients are currently subsidised to use the aforesaid third-generation targeted therapy drugs only if they have developed brain metastasis, whether it knows if the HA will consider reviewing and adjusting the relevant subsidy criteria so that more eligible terminally-ill patients (including those who have not developed brain metastasis) can benefit at an early stage; if not, of the reasons for that;
(3) whether it knows the number of new drugs included by the HA in the Drug Formulary or the scope of subsidy under the safety net in the past five quarters; the respective numbers of patients who benefited from subsidies for drug expenses as a result and the total amount of subsidies involved (set out the relevant figures by quarter); and
(4) whether it knows, for the five types of cancer with the highest number of new cases recorded in the past year, the respective numbers of patients who received subsidies for cancer drug expenses for each of these cancer types, as well as the total amount of subsidies involved (with a breakdown by cancer type and cancer stage at the time of diagnosis of the patients)?
Reply:
President,
Pharmaceutical treatment constitutes an integral part of the medical services provided by the Hospital Authority (HA) for cancer patients. The HA is committed to providing appropriate treatment for all patients, including cancer patients, while ensuring equitable access to safe, effective, and cost-effective drugs prescribed under a highly subsidised public healthcare system.
Currently, the HA Drug Formulary (HADF) and the coverage of the safety net (including the Samaritan Fund and the Community Care Fund Medical Assistance Programmes) encompass a wide range of drugs for cancer treatment, which are categorised into (1) General Drugs, (2) Special Drugs, (3) Self-financed Items (SFIs) with Safety Net (Safety Net Drugs), or (4) SFIs without Safety Net. Among them, General Drugs, Special Drugs used under specific clinical applications, and Safety Net Drugs are heavily subsidised by the Government. Drugs classified as General Drugs or Special Drugs are provided to patients at standard fees highly subsidised by the Government. In addition, eligible patients prescribed with Safety Net Drugs may receive relevant financial assistance through the Samaritan Fund and/or the Community Care Fund Medical Assistance Programmes.
In formulating drug subsidisation policies, the Government must attain an overall balance among patient interests, clinical evidence, and the reasonable use of public healthcare resources, thereby ensuring that public resources benefit the greatest number of patients in need. On the basis of evidence-based medical practice and with reference to international evaluation frameworks, the HA’s established drug review mechanism engages experts to meticulously evaluate the introduction and subsidisation arrangements for each new drug using objective data, taking into comprehensive consideration core elements such as severity of illness, clinical efficacy and therapeutic value, unmet medical needs, cost-effectiveness and financial impact, as well as quality of evidence.
The fees and charges reform for public healthcare has been implemented since January 1, 2026. All the gains from the reform will be wholly utilised for public healthcare to enhance the protection for "poor, acute, serious, critical" patients, including further enhancing drug and medical device support for patients with critical illnesses, including cancer patients. On one hand, the reform relaxes the means test criteria for the Samaritan Fund. On the other hand, it accelerates the introduction of more effective and innovative drugs and medical devices by including new drugs under the standard fee coverage of the HADF, adding suitable Samaritan Fund-subsidised drugs to the Special Drugs category in an orderly manner, including more new drugs and medical devices in the Samaritan Fund safety net, and more. This initiative provides appropriate drug and medical device subsidies to more low-to-middle-income cancer patients, and enables patients who were already eligible for subsidies to receive a higher percentage of financial assistance for their drug and medical device expenses.
On this basis, the HA established the Office for Introducing Innovative Drugs and Medical Devices (the Office) on June 8, 2026. The Office takes the initiative to identify local patients' needs for innovative drug treatments, proactively engages with pharmaceutical companies on the Mainland and in other regions, and takes the initiative to initiate the introduction process for new drugs. It also conducts early price negotiations and comprehensive assessments with pharmaceutical companies during the registration and approval process of new drugs. The first phase focuses on cancer treatment drugs to provide patients with more treatment options. For new drugs recommended by the Office, the time required to complete the registration and assessment process in Hong Kong will be significantly shortened from a maximum of 150 working days to no more than 100 working days, further accelerating the delivery of innovative drugs to benefit patients.
Furthermore, to expedite the inclusion of suitable new drugs into the HADF and the safety net coverage, the HA has optimised the application procedures for introducing new drugs into the HADF since late 2024, allowing doctors and pharmaceutical companies to submit drug inclusion applications directly to the Drug Advisory Committee (the Committee). Meanwhile, the prioritisation exercise for incorporating new drugs into the safety net has been increased from twice a year to four times a year. The target is to halve the time required to introduce new drugs with proven clinical efficacy into the HADF or the subsidisation scope of the safety net, shortening the timeframes from the original 10 months to five months, and from 18 months to nine months respectively.
In consultation with the HA, the consolidated reply to the question raised by Dr the Hon Chan Han-pan is as follows:
(1) Under the current drug review mechanism, the HA regularly evaluates newly registered drugs or indications, and reviews the coverage of the HADF and the safety net to align with current and evolving service needs.
The review process is evidence-based. When considering the introduction of new drugs, apart from evaluating their efficacy and safety through clinical evidence from local and other regions, as well as referencing the prescribing guidelines, disease management protocols, and drug subsidy schemes of relevant diseases from various advanced healthcare systems, the HA has also introduced health economics evaluation and a horizon scanning mechanism—referencing health technology assessments, clinical trials, and real-world data—to analyse the cost-effectiveness and opportunity costs of drugs, with a view to ensuring all patients are prescribed safe, effective, and cost-effective drugs, and can continue to receive appropriate treatment.
When conducting drug reviews, the HA places patient interests as its primary consideration, taking into account the quality of evidence, clinical demand, and developmental landscape of individual drugs. Concurrently, it maintains an overall balance by considering the rationality of resource allocation and the long-term sustainability of the public healthcare system. Therefore, the aforementioned evaluation criteria are not allocated based on fixed weightings.
(2) Drug review is an ongoing process that must be conducted in response to evolving medical evidence, the latest clinical developments, and market changes.
Regarding Lorlatinib, a third-generation targeted drug for Anaplastic Lymphoma Kinase (ALK)-positive lung cancer mentioned by the Hon Chan, the drug has currently been included in the subsidy scope of the Samaritan Fund safety net for use by patients who meet specific clinical criteria. The HA is currently deliberating the proposal to expand the subsidy scope to advanced-stage patients who have not yet developed brain metastasis.
(3) At present, the HADF encompasses 169 drugs for the treatment of various cancers, half of which have been listed under the General or Special Drug categories and are prescribed to patients at standard fees.
Regarding drugs subsidised by the safety net, during the past five quarters (i.e. from January 2025 to March 2026), the HA included 10 and seven cancer drugs into the subsidisation scopes of the Samaritan Fund and the Community Care Fund Medical Assistance Programmes safety nets respectively. Among these, three drugs from each safety net were included after the implementation of the fees and charges reform for public healthcare in January 2026. The aforementioned drugs newly included in the safety net subsidisation scopes recorded a total of 381 approved subsidy cases over the past five quarters, involving a total approved subsidy amount of approximately $96 million. The number of approved subsidy applications and the approved subsidy amounts for each drug over the past five quarters are set out in the table below:
Samaritan Fund
| Drug | Approved subsidy cases | Approved subsidy amount ($ million) |
| Included in the second Quarter of 2025 | ||
| Asciminib | 27 | 7.39 |
| Azacitidine (Oral) | 9 | 2.24 |
| Belzutifan | 18 | 17.40 |
| Ixazomib (Note 1) (in combination with Lenalidomide (Note 2)) | 46 | 11.62 |
| Lapatinib (Note 1) | 8 | 0.63 |
| Pegylated Liposomal Doxorubicin (Note 1) | 33 | 0.88 |
| Included in the fourth Quarter of 2025 | ||
| Neratinib (Note 1) | 17 | 1.85 |
| Included in the first Quarter of 2026 | ||
| Polatuzumab Vedotin (Note 1) (in combination with Rituximab (Note 2); or in combination with Rituximab (Note 2) and Bendamustine (Note 2)) | 13 | 2.60 |
| Niraparib (Note 1) | 7 | 2.72 |
| Isatuximab (Note 1) (in combination with Pomalidomide (Note 2)) | 11 | 8.02 |
| Total | 189 | 55.35 |
Note 2: Existing drug under the Samaritan Fund
Community Care Fund Medical Assistance Programmes
| Drug | Approved subsidy cases | Approved subsidy amount ($ million) |
| Included in the second Quarter of 2025 | ||
| Abemaciclib | 153 | 27.55 |
| Selinexor | 5 | 2.22 |
| Included in the fourth Quarter of 2025 | ||
| Dabrafenib and Trametinib | 8 | 2.76 |
| Included in the first Quarter of 2026 | ||
| Elranatamab | 7 | 2.67 |
| Durvalumab | 2 | 0.32 |
| Toripalimab | 17 | 5.17 |
| Total | 192 | 40.69 |
Furthermore, the Committee of the HA regularly reviews cancer drugs already included in the HADF. In response to clinical data and healthcare demands of the drugs, the Committee transitions self-financed drugs for the treatment of various cancers into Special Drugs in an orderly manner, and provides them at standard fees to patients who meet specific clinical criteria. Taking Dasatinib, a drug used to treat leukaemia (i.e. blood cancer), as an example, the HA transitioned the drug from a self-financed drug to a Special Drug in April this year. Consequently, patients' drug expenses dropped significantly from approximately $20,000 to $40,000 per month to just $20 per four weeks, effectively alleviating the financial burden on patients. Following the transition of Dasatinib to a Special Drug, it is anticipated that over 400 patients will benefit from the arrangement, with the estimated additional expenditure involved being $49 million per annum.
(4) In the 2025-26 financial year, the total number of cancer patients receiving treatment under standard fees at the HA was approximately 169 600, involving a total drug expenditure exceeding $1.95 billion.
According to the latest data from the Hong Kong Cancer Registry, the five types of cancer with the highest number of new cases in 2023 were lung, breast, colorectal, prostate, and liver cancer. For the 2025-26, the Samaritan Fund and Community Care Fund Medical Assistance Programmes approved 4 865 cases for these types of cancer, totaling roughly $1.22 billion in subsidies. The number of approved subsidy applications and the approved subsidy amounts for abovementioned cancer types are set out in the table below:
| Cancer Type | Approved subsidy cases | Approved subsidy amount ($ million) |
| Lung Cancer | 1 912 | 632.37 |
| Breast Cancer | 1 421 | 293.38 |
| Colorectal Cancer | 736 | 141.24 |
| Prostate Cancer | 488 | 79.49 |
| Liver Cancer | 308 | 73.11 |
| Total | 4 865 | 1,219.59 |
As the condition and needs of each cancer patient vary, the HA cancer services are patient-centric and emphasise a personalised therapeutic approach. Given that clinical services are designed to focus on providing appropriate treatment and support for cancer patients, rather than being classified solely by the stage of cancer at the time of diagnosis, relevant statistics are not compiled on such a basis.
To further alleviate the financial burden on cancer and critical illness patients from low-to-middle-income families, the fees and charges reform for public healthcare has relaxed the means test criteria for the Samaritan Fund. Since the implementation of the reform, numerous cancer patients have benefited. Taking the case of a lung cancer patient as an example, the patient’s out-of-pocket treatment expenses decreased by more than $27,000 after the reform, representing a reduction of more than 75 per cent. In another case involving a leukaemia (blood cancer) patient, the treatment expenses to be borne by the patient were reduced by approximately $44,000 after the reform, representing a decrease of around 62.5 per cent. The above examples demonstrate that the reform can effectively ease the financial burden on cancer patients during their treatment process.
As the largest public cancer service provider in Hong Kong, the HA adopts an integrated and multidisciplinary approach to provide cancer treatment for patients, and arranges appropriate management according to individual clinical conditions, including clinical diagnosis and assessment, cross-specialty care (such as Family Medicine and Specialist Outpatient clinics, acute care, and palliative care services), rehabilitation services, and drug subsidies. Apart from drug subsidies, the HA also maintains an exceptionally high subsidy rate for non-drug subsidised treatment items.
The HA will continue to optimise the use of public healthcare resources and incorporate more innovative cancer drugs and medical devices into the HADF and safety net subsidisation scopes, thereby providing more comprehensive support for cancer patients.
Ends/Wednesday, June 24, 2026
Issued at HKT 17:25
Issued at HKT 17:25
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