Drug Review and Selection Mechanism

Hospital Authority (HA) has implemented its Drug Formulary since July 2005 with a view to ensuring equitable access by patients to cost effective drugs of proven safety and efficacy through standardization of policies on drugs and drug utilization in all public hospitals and clinics. The Drug Formulary is supported by on-going evaluation of available new drugs and regular review of the prevailing list of drugs by relevant experts. At present, there are four categories of drugs in the HA Drug Formulary:

• General Drugs – These are drugs with well-established indications and cost-effectiveness which are available for general use as indicated by patients with relevant clinical indications and provided at standard fees and charges in public hospitals and clinics.
• Special Drugs – These are drugs used under specific clinical conditions with specific specialist authorisation. Special drugs are provided at standard fees and charges in public hospitals and clinics when prescribed under specific clinical conditions. Patients who do not meet the specified clinical conditions but choose to use Special drugs are required to pay for the drugs.
• Self-financed Items (SFIs) with Safety Net – These are drugs which are proven to be of significant clinical benefits but are very expensive for HA to provide as part of its standard services. These drugs are not covered by the standard fees and charges in public hospitals and clinics. Patients who require these drugs and can afford the costs have to purchase the drugs at their own expense. A safety net is provided through relevant funds, including the Samaritan Fund (SF) and the Community Care Fund (CCF) Medical Assistance Programmes, to subsidize the drug expenses of patients who have financial difficulties.
• SFIs without Safety Net – These include drugs with preliminary medical evidence only, drugs with marginal benefits over available alternatives but at significant higher costs, and lifestyle drugs (e.g. anti-obesity drugs). These drugs are not provided as part of HA’s standard services nor covered by the standard fees and charges in public hospitals and clinics. Patients who choose to use these drugs must purchase them at their own expense.

To keep clinical practice and drug use in sync with medical technology advancements and the latest scientific evidence, HA has mechanisms in place to conduct ad hoc and regular reviews of the HA Drug Formulary. The review process follows an evidence-based approach, having regard to the safety, efficacy and cost-effectiveness of drugs while taking into account the latest international practice as well as views of professionals and patient groups.

HA reviews the need for expanding the safety net quarterly to cover additional self-financed drugs, relaxing the prescribing indications for existing Safety Net drugs and repositioning drugs covered by the Community Care Fund Medical Assistance Programme to be under the coverage of the Samaritan Fund.

For more information of HA Drug Formulary, please refer to the website of HA Drug Formulary.