Financial crisis to put strain on drug subsidies
The financial crisis is expected to put extra stress on a fund that subsidises public patients' drugs - including cancer drugs - and expensive medical equipment, the Hospital Authority and patients groups said.
More patients are expected to seek help from the authority's Samaritan Fund to buy medicines not covered by the public hospitals' standard list. The fund also helps patients buy items such as pacemakers, prostheses and wheelchairs.
The expected pressure comes at a time when patients' groups are fighting for more subsidies for new medicines, especially molecular-targeted drugs, which can better control growth of cancer cells and have fewer side effects. The fund provides about HK$100 million a year to more than 4,000 patients.
Drugs on the standard list are charged at only HK$10 an item at public hospitals. Patients have to pay for medicines not on the list. Of these, 10 are covered by the Samaritan Fund, three of which were added to the safety net this month.
Financial Secretary John Tsang Chun-wah allocated HK$1 billion to the fund in this year's budget. The authority will later seek funding approval from the Legislative Council Finance Committee.
Hospital Authority chief manager Beatrice Cheng Shun-yan said about 20 medicines were being considered by the fund, but only 'two to three' items could be added to the safety net every year, even with the extra HK$1 billion, due to the rising cost and number of needy patients.
Most of the drugs that would be added in the coming years would be cancer treatments, she added.
The fund has no regular source of income. The government injects money occasionally and part of the funding comes from donations.
Dr Cheng said subsidies under the fund were 'snowballing' because chronic patients would probably be on medication and pacemakers for life, and there would be an increasing number of new cases.
'With the financial turmoil, we think more patients will need help from the fund. The demand will increase not only for very expensive but also the average-priced items,' she said. 'Heart disease is also a very heavy financial burden. In the past, some heart patients had no cure, but now they can be treated by advanced operations and implants of pacemakers. They will also relapse from time to time.'
The price of the drugs covered by the fund ranges from interferon, costing about HK$50,000 a year per patient, to Imatinib, about HK$300,000 a year per patient. Interferon can enhance the immune system, while Imatinib is used for leukaemia and stomach tumours.
Pacemakers cost between HK$100,000 and HK$200,000 each, and some need to be replaced every three to five years.
Patients' Rights Association spokesman Tim Pang Hung-cheong said the means test for the fund should be relaxed so patients paid no more than 10 per cent of their disposable income on medicines.
He also said there was a lack of transparency on how safety-net drugs were chosen. 'There is no voice of patients in the whole process.'
Dr Cheng said the authority took into account both the patients' financial situations and the cost-effectiveness of the drugs.
'Some new cancer drugs are still in the clinical trial stage and their effectiveness is marginal,' she said. 'Patients may have to spend a lot for an extra few weeks' survival.'
Cash buffer
As of the end of March 2008, the Samaritan Fund had a balance of HK$338 million. In 2007-08, the fund approved a total of 4,328 applications, including 691 for drugs costing HK$63 million. The fund also approved 3,637 applications for medical equipment or operations, costing another HK$79 million.
Source: Hospital Authority
