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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):


     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

(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?



(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


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