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Charge for specialist drugs to be reviewed

The Hospital Authority has promised to review a four-year-old scheme governing the use of expensive drugs in public hospitals after it asked the family of a road accident victim to pay HK$21,000 for - possibly lifesaving - specialist medicine.

The authority's chief executive Shane Solomon yesterday admitted the incident revealed 'a grey area' in the policy and vowed to come up quickly with guidelines ensuring that 'beneficial drugs are made available in life-threatening emergency situations without cost to the patient'.

The matter erupted after a 26-year-old woman, Wong Pui, was admitted to Queen Elizabeth Hospital after being seriously injured by a minibus on Friday night.

The victim was suffering from serious internal bleeding and doctors proposed the use of NovoSeven, which is mainly used to control bleeding in haemophiliacs.

The family had to pay HK$21,000 first for four doses before the drug - a dose of which costs up to HK$9,000 in some private hospitals - could be used because, under the 2005 scheme, such an expensive drug would not be given free in case of 'off-label' use.

Ms Wong's father paid but said the policy was preventing doctors from doing their best to save patients.

'It will prevent doctors from concentrating on saving lives. With the policy in place, a doctor could be hesitant about using some drugs, or may procrastinate because he is unsure if the family would be willing to pay. This will result in delay in treatment,' Mr Wong told Now TV.

Kwok Ka-ki, a former legislator for the medical sector, was shocked to see a 'pay-first' culture developing in public hospitals.

'What about if the patient's family are not there? What about if the family does not have enough money? Will the doctor give up using better drugs just to save money instead of saving the patient? It is totally unacceptable,' Dr Kwok said.

Cheung Tak-hai, chairman of the Alliance for Patients' Mutual Help Organisations, also expressed disappointment. 'It seems the authority now cares more about money than patients.'

A Hospital Authority spokesman said it would make a full refund to Mr Wong.

The authority launched a central drug formulary in 2005 under which some drugs not on the authority's standard drug list have to be bought.

A Queen Elizabeth Hosptial spokesman last night said the hospital had apologised to the relatives for any confusion over the incident. The patient is still in critical condition and under close monitoring.

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