Replies to LegCo questions
LCQ7: Mechanism for drug procurement
Following is a question by the Hon Joseph Lee and a written reply by the
Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today
(November 12):
Question:
It is learnt that at present, some patients receiving public healthcare services
are dispensed tablets in dosages which do not match those prescribed by doctors.
As such, they need to cut the tablets to the required dosages by themselves
before taking them. Some patients have relayed that patients' cutting the
tablets by themselves often results in inconsistent dosages or even crumbling of
the tablets, and elderly patients or patients with disabilities also lack the
skills to cut the tablets by themselves. This has resulted in patients taking
inaccurate dosages of medications. In this connection, will the Government
inform this Council whether it knows:
(1) in each of the past five years, the number of patients receiving public
healthcare services who were dispensed tablets that had to be cut by themselves
as well as the types and quantities of the medications involved, broken down by
hospital cluster and specialty;
(2) why the Hospital Authority (HA) and the Department of Health (DH) do not
dispense tablets of appropriate dosages to all patients;
(3) given that administration of medications in insufficient dosages will reduce
their efficacy while excessive dosages may lead to drug safety incidents, how HA
and DH ensure that patients are able to cut tablets accurately to the
appropriate dosages; and
(4) if HA and DH will review and improve the drug procurement system and procure
tablets of different dosage levels according to the dosages generally prescribed
by doctors to obviate the need for patients to cut the tablets themselves; if
they will, of the details and the resources involved each year; if not, the
reasons for that?
Reply:
President,
The Hospital Authority (HA) and the Department of Health (DH) have stringent
mechanisms in place to procure from the market and provide patients with
pharmaceutical products that meet quality requirements.
My reply to the various parts of the question is as follows:
(1) and (2) The HA and the DH procure drugs in appropriate dosages in accordance
with existing mechanisms for patients' use. However, for reason of clinical
needs, individual patients may require tablets in dosages that are not available
in the market. Under such circumstances, for tablets that can be split, patients
may need to split them before consumption. The HA and DH do not maintain any
statistics in relation to tablet splitting by patients themselves.
(3) and (4) At present, the HA has an established mechanism for drug
procurement, and the primary considerations are quality, safety and efficacy.
The HA will procure drugs registered with the DH through open tender. Drug
manufacturers, pharmaceutical companies and the drugs need to meet stringent
standards and regulations in order to ensure quality, safety and efficacy. While
observing this long-established procurement mechanism, the HA also keeps in view
the latest development in the pharmaceutical market so as to procure drugs in
appropriate dosages required for patients' use. To ensure that appropriate
dosage of drugs is taken by patients, for drugs that may require splitting
before use, the HA will state it as a tender requirement that pharmaceutical
companies should supply scored tablets such that patients may appropriately
split the tablets along the score line with tools such as a tablet-splitter.
The Drug Monitoring Committee (DMC) comprising doctors of different specialties
and pharmacists has been established under the DH to devise and update the Drug
Formulary of the department. The Formulary is reviewed on a regular basis
according to clinical needs. Pharmaceutical products of the required quality are
procured in accordance with the decisions of the DMC and the strict procedures
set out in the Stores and Procurement Regulations (SPR) promulgated by the
Government Logistics Department. When dispensing drugs to patients, the DH will
explain to patients the appropriate use and dosage of drugs according to the
guidelines on good dispensing practice. If splitting of tablets is required, the
DH will provide patients with specific reminders and recommend the use of a
tablet-splitter.
Ends/Wednesday, November 12, 2014
Issued at HKT 14:33
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