In July 2005, the Hong Kong Hospital Authority began implementation of its Drug Formulary, a list of over 1,200 standard drugs to be prescribed by doctors in public hospitals and clinics. Most drugs will not be affected by the Formulary, but there are approximately 70 non-standard drugs not on the Formulary that will no longer be subsidized by the Hospital Authority (HA). These include drugs that provide marginal benefits over currently available drugs at much higher cost; “lifestyle” drugs like impotence medication; drugs supported only by preliminary evidence; and drugs, such as cancer treatments, that have great benefit but are too expensive to be subsidized by a public health program. Patients who choose to take drugs not on the Formulary will either have to pay for them on their own or seek financial assistance from the Samaritan Fund, a government-funded safety net.
The Drug Formulary was created “to ensure equitable access to cost-effective drugs of proven efficacy and safety” while maintaining rational use of public resources. Between FY2003-04 and FY2004-05, the HA increased its drug spending by about HK$200 million (US$26 million), due in part to the rising costs of newly developed drugs and an aging population that incurs high medical expenses. It is too expensive for the HA to subsidize every new drug on the market. Standardization of drug policy and usage in HA hospitals and clinics will serve the public interest. Although a select minority of patients will be negatively impacted, the majority of the Hong Kong population will still have access to affordable, effective drugs. The Formulary will be implemented in phases across all HA hospitals over the next several months, and will be subject to review on a regular basis.