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Following is a question by the Hon Albert Ho Chun-yan and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung (in the absence of the Secretary for Food and Health) in the Legislative Council today (May 23):
Questions:
In 2010-2011, the safety net of the Samaritan Fund (SF) covered 17 self-financed drugs (the drugs) and the number of patients receiving SF subsidy on drugs was about 1 350 (with 720 of them receiving full subsidy and the other 630 receiving partial subsidy). The Government plans to revise the financial assessment criteria of SF, and it is estimated that this can benefit 2 300 patients (i.e. an additional 1 000 patients). In this connection, will the Government inform this Council whether it knows:
(a) the situation of provision of SF subsidy under the existing financial assessment criteria, including:
(i) in each of the past five years, the respective numbers of patients receiving full and partial subsidy, the total number of patients receiving subsidy, the average subsidy amount per patient, the average contribution amount per patient, as well as the total subsidy amount for each type of drug, broken down by drug type;
(ii) the number of patients receiving partial subsidy in each of the past five years, broken down by drug type and tier of maximum patient's contribution; and
(iii) how it has come to the projection that revising the financial assessment criteria may benefit an additional 1 000 patients; the numbers of patients receiving partial subsidy at present who will become eligible for full subsidy, those whose contribution to drug cost will decrease, and those who will become eligible for subsidy under SF, after the revision in the financial assessment criteria;
(b) the respective numbers of cases which had been formally rejected (i.e. cases of applicants being turned down after they had been assessed by medical practitioners as having a need for the aforesaid drugs, had been referred to medical social workers (MSWs) and had filled out and submitted application forms to SF with the assistance of MSWs) and cases which had been informally rejected (i.e. cases of applicants being verbally turned down by the MSWs concerned after they had been assessed by medical practitioners as having a need for the aforesaid drugs and had been referred to MSWs) in the past five years; and
(c) the clinical criteria adopted by medical practitioners for assessing patients' needs for the 17 drug items; whether the Hospital Authority had consulted any patient group in the course of formulating those criteria?
Reply:
President,
The Samaritan Fund (SF) provides financial assistance to needy patients who meet the specified clinical criteria and pass the financial test to meet expenses on self-financed drugs or privately purchased medical items needed in the course of medical treatment but are not covered by the standard fees and charges in public hospitals and clinics.
My reply to the various parts of the question is as follows:
(a) The number of patients suffering from illnesses which require the use of self-financed drugs covered by SF each year varies from several tens to a few hundred. The average amount of patients' contribution to drug expenses each year is affected by the patients' financial situation, clinical conditions and dosage used during the year. The relevant figures can only be used for reference and do not reflect the price of the drugs and its trend. As the relevant figures for 2007-08 and 2008-09 are kept in the archive of the Hospital Authority (HA), such figures are not readily available and will take time for compilation. Relevant figures for the past three years are provided.
(i) In each of the past three years, for patients receiving drug subsidy, the respective number of patients receiving full and partial subsidy and the total number of patients receiving subsidy, as well as the average amount of subsidy of each case approved, the average amount of patients' contribution of each case approved for partial subsidy and the total amount of subsidy approved, with breakdowns by drug type, are set out at Annex I.
(ii) In each of the past three years, for patients receiving partial drug subsidy, the patients' contribution with breakdowns by each tier of contribution amount and drug type are set out at Annex II.
(iii) The number of patients receiving SF subsidies on drug was about 1 350 in 2010-11 (with 720 receiving full subsidy and 630 partial subsidy). With the relaxation of the financial test, using the deductible allowance for a 4-member household (i.e. around $400,000) as the average for the purpose of estimation, it is estimated that about 2 300 patients using the 17 drugs covered by SF will be better off after the introduction of the deductible allowance for disposal capital. These 2 300 patients include patients who are receiving partial subsidy and will become fully subsidised, patients who will contribute a smaller amount of the drug cost, and patients who will become newly eligible for the SF subsidy. Moreover, those who are currently enjoying full subsidy from SF will continue to benefit. Since the number of patients who are receiving partial subsidy and will become fully subsidised, those who will contribute a smaller amount of the drug cost and those who will become newly eligible for subsidy will be affected by factors such as drug prices, clinical conditions of the patients and dosage used etc, HA is not able to estimate the distribution of these 2 300 patients among the above three categories of patients.
(b) The numbers of applications (including drug and non-drug subsidies) rejected in the past three years are set out below. As the assessment criteria for the financial test of SF had been relaxed in the past, there had been a continuous drop in the numbers of applications rejected over the past few years.
Numbers of applications rejected
2009-10 32
2010-11 23
2011-12 11
(c) In formulating clinical and medical criteria, HA will listen to the advice of the relevant healthcare expert teams and take into consideration scientific evidence of the relevant drugs, clinical experience, treatment outcomes, international recommendations and practices, as well as the views of patients.
Since the implementation of the Drug Formulary in 2005, HA has been maintaining liaison and communication with patient groups and proactively soliciting patients' feedback on the Drug Formulary. In order to further enhance transparency and engagement of patient groups, HA established in 2009 a formal consultation mechanism under which annual consultation meetings on the Drug Formulary and SF will be convened with patient groups. Patient groups will be invited to give their views after the meeting. Their views and suggestions will then be presented to the relevant drug committees for consideration.
To further enhance the engagement of patients, HA has since early 2011 established a new platform for the Chief Executive of HA to regularly meet with patient representatives to gauge their views on various areas of patient services. This new platform also serves as an additional liaison channel with patients on matters relating to the Drug Formulary.
Ends/Wednesday, May 23, 2012
Issued at HKT 12:04
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