Subsidising new tumour-fighting drug depends on effectiveness not cost, says Hong Kong Hospital Authority
Single mother Chi Yin-lan died last week after failing to get a new and expensive medication subsidised
Hong Kong’s public health care authority has stood by its decision not to subsidise a new drug for a rare disease that recently took a woman’s life, saying its effectiveness, not the cost, still needs to be determined.
Single mother Chi Yin-lan, 36, died last month from a genetic disease called tuberous sclerosis complex (TSC), after failing to get a new and expensive medication called everolimus (Afinitor) subsidised. She left behind a 13-year-old daughter who has inherited the same condition.
TSC causes non-cancerous tumours to grow in many parts of the body, such as the skin, brain and kidneys. It can cause developmental issues or even life-threatening problems.
Critics slammed the Hong Kong government – known for having huge cash reserves – for spending millions of dollars on the 20th anniversary of the city’s handover in July, but not on patients suffering rare diseases.
“As health practitioners, we look at the clinical effectiveness and if the medication could cure a patient, any cost is worth it,” said Dr Ian Cheung, chief manager for cluster performance at the Hospital Authority.
“For example, we put a lot of resources into transplant operations, as they can help patients.”
Cheung said the medication in question had only been on the market for a short period of time, so data on its effectiveness was still being collected.
“We get a lot of resources from the government, but we have to use it appropriately,” he said.
Cheung said the Hospital Authority would collect information on the new drug from the Queen Mary Hospital and the University of Hong Kong’s faculty of medicine, both of which are conducting research on everolimus (Afinitor).
The drug, which was originally developed to treat cancer, was last year found to significantly reduce the frequency of seizures in some TSC patients. Cheung said clinical data showed 40 to 50 per cent of patients using the medication had lowered the growth rate or even reduced the size of tumours, but it could not fully cure the disease.
“Presently, the clinical data does not show that the drug can reduce the complications from the disease, such as bleeding and death,” Cheung said.
Costing around HK$20,000 a month, it is not listed under the city’s Drug Formulary of public hospitals – meaning it is not a standard drug subsidised by the government. However, from July, the drug will be subsidised for the treatment of a certain type of brain tumour under the Samaritan Fund.
Cheung said the drug could also be used for some kidney-related complications not requiring immediate surgery and that an expert committee was assessing possible treatment options.
Once the committee has decided on the treatment options, the drug might be added to the Samaritan Fund subsidy list for kidney-related issues. Cheung hoped the committee would reach a consensus in the next few months.