Replies to LegCo questions

LCQ10: Free trial of new drug for myelogenous leukaemia

Following is a question by Dr Hon Law Chi-kwong and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (November 27):

Question:

It has been reported that a pharmaceutical firm is supplying Queen Mary Hospital with a new drug specially for treatment of chronic myelogenous leukaemia for free trial. While the trial period will expire next month, the Hospital Authority ("HA") has no plans to purchase the drug for the patients taking part in the trial. Also, some other patients of HA are paying $20,000 per month for purchasing the drug. In this connection, will the Government inform this Council whether it knows:

(a) the countries in which the drug has been widely used by medical institutions;

(b) if HA has statistics on the number of patients who were fit to take the drug last year; and, among them, the number of patients who experienced a deterioration or a relapse of the illness after taking other drugs or regimen;

(c) if HA will negotiate with the pharmaceutical firm concerned, including requesting the continued supply of the drug free of charge to patients who have participated in the trial scheme until the completion of their whole regimen, or a reduction of the selling price of the drug; and, before the negotiation has been concluded, of the arrangements HA will make for those patients who are fit or need to take the drug; and

(d) if HA will purchase the drug to supply to the patients in need, particularly those who have no improvement after changing medication and receiving other regimens; if so, of the implementation timetable; if not, of the treatment to be provided by HA to the patients concerned so as to honour the policy that "no patients will be deprived of appropriate medical care because of financial hardship"?

Reply:

(a) The drug referred to in the question is "Imatinib". According to information available to the Hospital Authority ("HA"), Imatinib has been approved for use in Australia, the European Union, Japan, New Zealand, Singapore, Switzerland, Taiwan and the USA for the treatment of chronic myeloid leukaemia ("CML"). The extent of which the drug is used by medical institutions in these places depends on their respective licensing conditions for the use of the drug, health financing system and policies governing the cost-effective use of the drug having regard to the assessment of research evidence for the risks and benefits of using the drug under different clinical conditions.

(b) Imatinib was only registered in Hong Kong in 2002. Thus far, local experience on the use of the drug is limited to clinical trials. As such, HA has not estimated the number of patients who were fit to take Imatinib last year. Currently, 18 patients are participating in the clinical trial scheme operated by the Queen Mary Hospital on the use of Imatinib.

(c) HA is discussing with the pharmaceutical firm concerned to explore if a patient assistance scheme could be put in place to assist those patients who have participated in the clinical trial scheme and cannot afford to pay for the drug. Pending the outcome of discussions, HA is exploring with the firm the possibility of extension of the pilot scheme in the interim.

(d) It is Government's established policy that no one should be deprived of adequate medical care because of insufficient means. In the context of aiming to provide an adequate level of care for all Hong Kong citizens, public subsidies should be targeted towards providing cost-effective interventions having regard to the limited public resources available.

HA has, with the support of charitable trusts, developed a pilot scheme to expedite the introduction of medical items of new technology or technology-based new services into mainstream HA service. Patients who cannot afford to pay for new medical items or services would be offered financial assistance. HA is discussing with charitable organisations the possibility of including Imatinib under the pilot scheme. In the meantime, HA will continue to provide medical treatment to all CML patients.

End/Wednesday, November 27, 2002
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