Replies to LegCo questions
LCQ21: Treatment for psoriasis patients
Following is a question by the Hon Alice Mak and a written reply by the
Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today
(November 4):
Question:
It is learnt that psoriasis is a type of chronic inflammatory disease involving
complex pathology and is difficult to cure completely. Patients not only have to
endure prolonged pain caused by itchy and swollen skin, but also have to face
the great psychological stress arising from appearance issues caused by this
disease. Since 2002, the Hospital Authority (HA) has gradually taken over the
general outpatient clinics under the Department of Health (DH), with the
exception of skin clinics. On the other hand, HA added to the Drug Formulary in
2012 a type of biological agent effective for treating psoriasis, and brought
the drug into the Samaritan Fund safety net in 2013. However, skin clinics under
DH still do not provide such drug for psoriasis patients at present. In this
connection, will the Government inform this Council:
(1) whether it has compiled statistics on the current number of psoriasis
patients in Hong Kong; if it has, of the relevant statistics;
(2) of the number of new cases of psoriasis received by skin clinics in each of
the past five financial years (and set out a breakdown by age group in the table
below);
Age group Financial year
2010- 2011- 2012-
2013- 2014-
2011 2012 2013
2014 2015
Below 18
Between 18 and 64
65 or above
Total
(3) of the diseases that can be induced by psoriasis, and whether psoriasis will
induce mental illness; whether it has compiled statistics on the number of cases
in which diseases have been induced by psoriasis; if it has, of the details; if
not, whether it will consider compiling the relevant statistics;
(4) of the respective current numbers of psoriasis patients who regularly seek
follow-up consultations at skin clinics and general outpatient clinics;
(5) whether skin clinics will refer psoriasis patients to general outpatient
clinics for treatment; if so, of the relevant mechanism and the number of cases
referred in the past five financial years; if not, the reasons for that; and
(6) whether it will consider reviewing the list of drugs for treating psoriasis
at skin clinics, including whether it will align the list of drugs for treating
psoriasis at such clinics with that at general outpatient clinics?
Reply:
President,
(1) According to epidemic epidemiological research, the worldwide prevalence of
psoriasis is around 2% and the prevalence rate of psoriasis in Hong Kong is
around 0.3% to slightly less than 0.6%. Based on such information, the
Department of Health (DH) estimates that there are over 20 000 patients
suffering from psoriasis in Hong Kong.
(2) The DH does not maintain statistics on the breakdown of new cases of
psoriasis by age. The total number of new cases of psoriasis in specialist
dermatology services under DH in each of the past five years are set out as
follows:
2010 2011 2012
2013 2014
---- ----
---- ----
----
Total
636 598
588 516
513
(3) The DH does not maintain statistics on the number of cases of other diseases
induced by psoriasis. However, research in recent years found that psoriasis
patients have a higher chance of having metabolic syndrome and cardiovascular
diseases. Besides, about 5% to 30 % of psoriasis patients also suffer from
arthritis. The dermatological service of the DH conducted a survey in two
clinics from July 2007 to January 2008, assessing the depression rate of
psoriasis patients using the Hamilton Depression Rating Scale and self-rated
Beck Depression Inventory. Results showed that the point prevalence of any kind
of depressive disorder was 26%.
(4) The specialist dermatology services of the DH do not collect data on
psoriasis patients seeking follow-up consultation, hence the DH does not have
the relevant information. Moreover, as the Hospital Authority (HA) does not
assign codes to patients of specialist out-patient clinics (SOPCs) by disease
type, the statistics of psoriasis patients of SOPCs are not available.
(5) The DH has set up a referral mechanism in which serious psoriasis patients
will be referred to public hospitals under HA. Specific for biologic treatments,
the referral guidelines of Hong Kong was formulated by dermatologists of the DH
and the HA with reference to the guidelines formulated by the United Kingdom in
2009. Generally speaking, severe psoriasis patients whose condition cannot be
effectively controlled by conventional treatments like medicine for external use
or oral administration and phototherapy, or patients who have adverse effects
after treatments can be referred to designated hospitals of the HA for detailed
assessment and treatment, provided that they do not have any contraindications
to biologic treatments. The DH does not maintain statistics on the number of
referrals in the past five years.
(6) The specialist dermatology clinics of the DH will keep in view the latest
development in clinical application and scientific evidence, and continue to
make good use of public resources to treat as many patients as possible. DH will
review from time to time the dermatological drugs in its drug formulary,
including drugs for psoriasis. As mentioned above, the DH has set up a mechanism
to refer severe psoriasis patients to HA's designated hospitals for detailed
assessment and treatment with biologic agents included in the drug formulary of
the HA. The HA will review its drug formulary and the scope of assistance of the
safety net according to the stipulated mechanism from time to time.
Ends/Wednesday, November 4, 2015
Issued at HKT 17:55
NNNN