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Amid shortages, the government wants the private sector to be sole supplier of the drug for the coming flu season

Patients would have to meet strict criteria, pay $600 for a test and travel to designated private hospitals before  getting a supply of Tamiflu for the coming flu season, under a plan being discussed by the Hospital Authority and private doctors.

Several private hospitals have agreed to distribute the drugs to private doctors' patients. But the Private Hospitals Association has reservations about the plan, saying concentrating all flu patients in private hospitals would overwhelm the system and spread the virus.

Amid a shortage of Tamiflu on the private market, the authority, which has stockpiled 800,000 doses, agreed to provide the drug to the private sector for 'emergency use' on an on-loan or at-cost basis.

'Specific logistic arrangements for supplying Tamiflu to the private sector have been proposed by the HA,'  a spokesman said.

Tamiflu is the most effective medicine to treat or reduce the chance of complications arising from influenza. There has been a global rush for supplies in case of a bird flu pandemic.

Medical Association president Choi Kin  said most private doctors are out of stock of Tamiflu.

Under association guidelines, private doctors should only prescribe Tamiflu for high-risk groups, such as those aged over 65, patients with chronic illnesses such as heart disease and diabetes, or those with serious flu complications such as pneumonia and myocarditis.

Doctors who suspect a patient has flu have to take a nasal swab for a rapid test in private laboratories. The test takes from four to six hours and costs between $200 and $400 in private laboratories and about $600 in private hospitals. Patients have to take the drugs within 48 hours of the onset of the illness.

Dr Choi said doctors understand the requirements may cause inconvenience to patients but they are aimed at limiting the use of the drug, which is being reserved for a possible bird flu pandemic.

It is understood the authority does not want to dispense the drug through public clinics and community pharmacies.

'The authority worries that it cannot verify the prescriptions of all private doctors, and it will be better to use private hospitals as distributors. There are also too many community pharmacies in Hong Kong; it would be very difficult to decide which should be the distribution points,' Dr Choi said.

Private Hospitals Association president Walton Li Wai-tat  said the Hospital Authority should not disregard its responsibility of taking care of flu patients. He said not all private hospitals would join the programme in the first stage.

'We will closely monitor the situation. If the government does not share the responsibilities and sends out a message that only private hospitals have Tamiflu, the flu patients will  overwhelm the [private hospitals] system,' he said. 'And when we concentrate all  patients in several places, it will easily contaminate the private hospitals.'



Fears over Tamiflu dispensing plan