New drug for schizophrenia ‘can save Hong Kong government HK$398 million in medical costs’

Psychiatrists say hospitals should be prescribing more expensive treatment as it reduces the risks of relapses and works out cheaper in long run

PUBLISHED : Monday, 28 November, 2016, 7:02am
UPDATED : Monday, 28 November, 2016, 7:01am

A group of psychiatrists believes public hospitals should prescribe a new line of medicines.

The doctors claim such a move to treat the mentally ill would eventually cut medical ­expenditure by HK$398 million in two years by preventing relapses.

They also claim local guidelines on giving a new injectable drug to treat schizophrenia, which is at least 10 times more ­expensive but causes fewer side effects, is too rigid and outdated.

There are about 48,000 ­patients who suffer from ­schizophrenia, a mental disorder with symptoms such as difficulty in distinguishing between what is real and imaginary.

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But only 2.8 per cent of ­patients are given medication in the form of monthly injections, which replaces one with multiple side effects, and traditional oral medicine that patients must take daily or risk a relapse.

The Association of Psychosocial Rehabilitation, formed by a group of health workers, said the take-up rate for the monthly injection was shockingly low when compared to other affluent cities.

“It is mainly because the ­second generation of antipsychotics is much more expensive,” Dr Michael Wong Ming-cheuk, chairman of the group, said.

“Guidelines at public hospitals instruct doctors to prescribe the new drugs only after patients have tried the old ones and failed, or display very serious side effects.”

The cost of the new drugs is around HK$5,000 per month, while the old medication is about HK$200.

Spending per patient is ­expected to increase by HK$6,519 if they are switched to the new medication, the group said.

But Wong said hospitals may save HK$39,764 per patient if their conditions are properly handled and they are prevented from ­suffering a ­relapse that would ­require hospitalisation.

He expected HK$398 million could be saved in two years for every 10,000 schizophrenia sufferers who go for the new option.

The prescription rate for the drug in the form of a long injection was 82 per cent in Australia, 46 per cent in the US, and 18 per cent in the UK, compared to just 5 per cent in Hong Kong.

More than 70 per cent of ­patients who take the older ­version of the drug suffered from side effects such as involuntary movement, body stiffness, tremors and blurred vision.

But the rate can be reduced to just ­1 per cent with the second generation of drugs, three of which are available in Hong Kong.

It is also a trend for affluent places to give long injections to ­replace oral medication because it is common for patients to forget or stop taking the oral drugs ­regularly.

The group recommends the government allocate extra resources to expand the use of injectable second generation drugs to assist in the recovery of patients and achieve long-term savings in medical treatment.