We can afford to err on side of compassion
- An extra HK$400 million of annual funding to expand the Hospital Authority’s prescription list will see about 50,000 patients benefiting from cheaper drugs
- While some of the new drugs are very expensive, the public purse can surely bear the cost
Few demands weigh on public finances as unrelentingly as health care. And even fewer are as pressing as those for expensive new drugs that save lives or improve the quality of life. The issue has been highlighted following the budget announcement by Financial Secretary Paul Chan Mo-po of an extra HK$400 million of annual funding for the Hospital Authority to expand the prescription list of its pharmacies.
As a result about 50,000 patients are expected to benefit from cheaper drugs from next month. Initially, the government is to subsidise 19 extra drugs, or which eight are new. Patients will have to pay only nominal fees. Some will be able to afford to move on to better drugs with fewer side effects. They suffer from a range of illnesses from common diseases like cancer and diabetes to rare afflictions. In some cases, however, the cost of the new drugs is very high and prescription restrictions limit the number who will benefit. An example we have reported involves everolimus, used to treat a rare genetic condition of multiple benign internal and skin tumours that can lead to seizures and developmental issues.
The drug, costing HK$230,000 per patient, will be dispensed at specialist clinics at a subsidised price of HK$15. But there is a catch. Under existing protocols, everolimus is given to patients with renal tumours exceeding 3cm in width. According to Rebecca Yuen Pui-ling, whose 21-year-old daughter has a 0.6cm renal tumour, 284 of 300-odd sufferers of the condition would miss out on that basis.
Most people would relate to the parental anxiety behind her rhetorical question: “Do I have to wait for her tumour to reach 3cm to get the drug?” But few would want to change places with the expert government advisers who have to weigh the cost and efficacy of new drugs against demand that always outstrips resources.
Social welfare sector lawmaker Fernando Cheung Chiu-hung says the international trend is to use the drug as early as possible. So it is good to hear from the chairman of the authority’s drug formulary committee Dr Wilson Lao Wai-cheung that doctors would have some flexibility in deciding whether the drug would be given to patients who might not meet the requirements. The public purse can surely bear the cost of erring on the side of compassion.