Cancer patients 'can't afford' new drug
Patsy Moy and Alex Lo
Terminal cancer patients are frequently denied a life-prolonging drug because of tight budgets, medical professors say.
Under Hospital Authority rules, patients are also not given the option to buy the drug - even if they can afford to.
The drug CPT-11, or irinotecan, which was approved by the authority in October, is unlikely to benefit public hospital patients because of its high cost. The new drug can extend a patient's life by an average of two months or more.
Chinese University department of clinical oncology associate professor Dr Tony Mok Shu-kam said doctors did not like to prescribe such palliative drugs as they feared overspending their budget.
He urged the authority to allow dying patients the option of buying the drug, which also helps relieve pain. 'The existing system has put public doctors in a very difficult position - we know some new drugs are good for our patients, but the hospitals cannot afford to provide them to all patients,' Dr Mok said.
'Everyone on Earth is striving for a longer life. Cancer patients should also have the right to a longer life.'
The authority acknowledged patients were normally not allowed to buy drugs. But it said it was open to discussion on the issue, expected to be a part of the health care reform package to be announced tomorrow.
'Doctors will prescribe medication for patients according to their clinical needs. For treatment of terminally ill patients, various forms of palliative therapy, besides medication, are provided to address the patients' psychological and physical conditions,' a statement read.
'At present, drugs provided in public hospitals are normally not charged separately. We look forward to a participative discussion [involving] the public when the consultation paper of health care reform is released where allocation of public funding to health care could be discussed in depth.'
Palliative drugs cost an average $50,000 for a course of treatment. Some new advanced palliative medicine could be 20 to 40 times more expensive than curative drugs.
Dr Mok estimated about 60 per cent of cancer patients in hospitals fall into the palliative category.
Cancer kills more than 10,000 people in Hong Kong a year.
Public hospital spending on drugs jumped from $1.02 billion in 1995-1996 to $1.55 billion in 1999-2000. Separate spending costs for palliative medicine are unavailable.
As one of two teaching facilities, the Prince of Wales Hospital is often sponsored by drug manufacturers to test new and costly drugs which are otherwise unavailable. But this privilege is not enjoyed by other public hospitals, Dr Mok said.
The university's Dean of Medicine, Professor Sydney Chung Sheung-chee, said he recognised the problems but added it would become a 'highly sensitive issue' if taxpayers were made to pay the high costs of those who have been classified as incurable. 'As doctors, our responsibility is to provide the best treatment for patients in front of us. But resource constraints put us in a frustrating situation,' he said.
Professor Chung agreed relaxing the authority's rules could provide a solution for middle-class patients, but not those with lower incomes. He agreed the issue should be addressed in the long-awaited health care reforms.
Ho Hei-wah, director of the Society for Community Organisation, which runs the Patients Rights' Association, said the authority should consult the community on the amount of resources to be allocated to terminal patients.