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Hong Kong health care and hospitals

Psoriasis patients in Hong Kong seek quicker access to better treatment – and more understanding of skin condition

They first have to try other less effective traditional drugs before they are moved on to biologic treatments at public clinics

PUBLISHED : Thursday, 18 October, 2018, 8:33am
UPDATED : Thursday, 18 October, 2018, 9:12am

Patients with psoriasis, an itchy and sometimes painful skin condition, have urged the Hong Kong government to raise public awareness about the disease and boost resources to allow them better access to more advanced and effective but costly biologic treatments.

They hoped they could receive such treatments at public clinics directly rather than first having to try other less effective traditional drugs, as current policy dictated.

The appeal came on Wednesday ahead of World Psoriasis Day on October 29.

“The current government policy is in effect forcing patients to suffer,” Hong Kong Psoriasis Patients Association chairman Gary Lai Hing-kwan said.

“We all know there are more effective drugs available. But because of the resources issue, public doctors will first ask patients to try other traditional drugs and it is only when all those treatments have been proven to not work, will patients be referred to receive the biologic treatments. And it can take as long as three years.”

Biologic treatments are available at private clinics but the drugs could cost as much as HK$15,000 (US$1,923) a month, Lai said.

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“Moreover, there is a serious shortage of skin doctors at public clinics,” Lai added. “There are more than 20,000 psoriasis patients in Hong Kong. But there are only around 20 doctors specialised in treating skin diseases in public clinics. They have to take care of all skin patients, not only those with psoriasis.”

A patient may have to wait two years before seeing a doctor at a public clinic, Lai said.

My colleagues thought it was contagious and no one wanted to get close to me
psoriasis patient surnamed Wong

Psoriasis is a chronic autoimmune condition. Even with treatment, it will not fully go away but it can be kept under control.

In psoriasis patients, skin cells grow too fast and rapidly pile up, forming red and inflamed scales or plaques that are itchy and at times painful. While cell reproduction in normal skin takes about four weeks, that process in psoriasis patients can take as little as four days.

The exact cause of the disease remains unknown. But doctors believe it is linked to the immune system in which a class of fighter cells attack the body’s own healthy skin cells by mistake.

Common treatments include using emollients that help control flare-ups, or steroids that help with inflammation and slow the growth of skin cells.

More advanced treatment uses biologics, which inhibit T cells in the immune system so as to reduce inflammation. T cells are a type of white blood cell involved in the inflammation in psoriasis.

Lai also said psoriasis patients often experienced discrimination.

“Many people misunderstand that it is contagious. Actually it is not. But when they see red patches on your face or hands, they are too afraid to get close to you. Such a bad experience will in turn cause emotional problems. One-fifth of psoriasis patients also develop signs of depression,” said Lai, who has had the condition for about 20 years.

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A psoriasis patient surnamed Wong started suffering from the condition about a year ago. “It started with red patches growing on my face. My colleagues thought it was contagious and no one wanted to get close to me,” said Wong, a marketing officer.

It affected his social life and work, and he went to see a private doctor.

“I tried the new treatment in July and my skin condition has much improved. Now I can live a normal life,” Wong said.

But money is an issue. “It costs over HK$10,000 a month. It is a financial burden for me and my family,” he added. “I am not sure how much longer I can afford to receive such treatment.”