Replies to LegCo questions
LCQ19: Management of drugs by public hospitals
Following is a question by the Hon Dr Law Chi-kwong and a written reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (June 30):
Question:
Regarding the management of drugs by public hospitals, will the Government inform this Council whether it knows:
(a) the total quantity and value of the drugs that were discarded by the pharmacies of public hospitals in each of the past three years because their validity had expired, together with a breakdown by the types of drugs;
(b) the details of the drugs with the largest quantity or highest value among those discarded by each hospital cluster in each of the past three years, including their names, the quantity discarded, the total value and the diseases they are prescribed to cure; and
(c) if the Hospital Authority(HA) has studied the reasons for the occurrence of the situation in which some drugs are not yet consumed upon the expiry of validity and have to be discarded, and the measures to avoid the occurrence of such situation?
Reply:
(a) The pharmacological classifications and total costs of drugs, which were condemned by the HA because their validity had expired, in each of the past three years are set out in Annex 1.
(b) The details of the drugs with the highest value among those condemned in each Hospital Cluster, including their pharmacological classifications, intended use, the quantity condemned and their value, are set out in Annex 2.
(c) In each of the past three years, the total value of expired drugs, which were condemned, constituted less than 0.1 per cent of the total value of drugs purchased. The main reasons for these drugs to remain unused until expiry are as follows -
(i) the need for keeping an adequate stock of "standby" drugs, such as antidotes, antivenoms and other emergency drugs for the treatment of poisoning and certain acute fatal diseases. The occurrences of poisoning cases and certain acute fatal diseases are rare, but once such conditions are diagnosed, the appropriate drugs have to be administered immediately. Many of these standby drugs are imported from overseas, which usually require a long lead-time for delivery. It is, therefore, both necessary and prudent for the HA to keep a sufficient stock of stand-by drugs at all times for emergency use. This type of drugs constitutes the largest portion of the total annual cost of expired drugs;
(ii) the need for stocking "second-line" drugs, which may be required by certain patients who are not responsive to the standard (or "first-line") drugs for particular diseases;
(iii) unused stock of drugs that are being phased out due to changes in medical practice or the introduction of more cost-effective alternatives; and
(iv) unused stock of drugs the use of which have to be reduced or stopped immediately due to reports of serious side-effects.
The HA has taken the following measures to minimise the quantity and value of expired drugs -
(i) improving liaison between pharmacy staff and physicians/nurses to determine the optimal stock level for each of the stand-by drug;
(ii) requiring suppliers of slow-moving drugs to supply stock with the longest possible shelf-life as far as possible;
(iii) enhancing the pharmacy computer system of hospitals for continuous monitoring of stock levels of all drugs in the pharmacy, whereby slow-moving drugs stocked in certain hospitals would be channeled for use in others;
(iv) securing the agreement of some suppliers to take back expired drugs and replacing them with new ones.
Ends/Wednesday, June 30, 2004
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Annex 1
|
Classes |
Total Cost (HK$) |
||
|
2001-2002 |
2002-2003 |
2003-2004 |
|
|
Drugs for Gastrointestinal System |
17,003 |
19,860 |
14,944 |
|
Drugs for Cardiovascular System |
98,882 |
82,492 |
52,424 |
|
Drugs for Respiratory System |
36,975 |
37,243 |
34,612 |
|
Drugs for Central Nervous System |
95,078 |
100,680 |
129,608 |
|
Drugs for Infections |
91,744 |
91,992 |
86,607 |
|
Drugs for Endocrine System |
56,964 |
69,689 |
100,886 |
|
Drugs for O&G / Urinary Tract |
36,833 |
10,644 |
12,155 |
|
Cytotoxic & Immunosup Drugs |
136,005 |
44,423 |
54,181 |
|
Nitrition / Blood-related Drugs |
135,618 |
58,116 |
147,418 |
|
Drugs for Musculoskeletal Disorder |
12,340 |
7,580 |
10,433 |
|
Drugs for the Eye |
16,484 |
13,255 |
14,183 |
|
Drugs for Ear/ Nose/ Oropharynx |
3,484 |
2,260 |
1,625 |
|
Drugs for dermatologicals |
29,849 |
23,592 |
22,647 |
|
Drugs - Vaccines/ Immuologicals |
20,583 |
6,271 |
9,717 |
|
Anaesthetics/ Medical Gases |
50,626 |
31,275 |
54,196 |
|
Drugs for treating Poisoning and Emergency |
780,643 |
749,393 |
869,703 |
|
Others |
25,926 |
44,672 |
32,527 |
|
Total |
1,645,038 |
1,393,437 |
1,647,868 |
Annex 2
Year 2001-2002
|
Cluster |
Use |
Drug Name |
Quantity |
Base Unit |
Value (HK$)
|
|
HKE |
Immuno-suppressant |
CYCLOSPORIN A SOLUTION 100MG/ML |
5 |
Bottle |
13,041 |
|
HKW |
Antitoxin |
BOTULISM TRIVALENT ANTITOXIN INFUSION 250ML |
3 |
Bottle |
47,260 |
|
KE |
Anti- Psychotics |
MOLINDONE HCL TABLET 10MG |
676 |
Tablet |
11,945 |
|
KC |
Antitoxin |
BOTULISM TRIVALENT ANTITOXIN INFUSION 250ML |
2 |
Bottle |
33,300 |
|
KW |
Anti-Hypertherma |
DANTROLENE SODIUM INJECTION 20MG |
57 |
Ampoule |
20,954 |
|
NTE |
Anti-Hypertherma |
DANTROLENE SODIUM INJECTION 20MG |
73 |
Ampoule |
29,493 |
|
NTW |
Anti-Hypertherma |
DANTROLENE SODIUM INJECTION 20MG |
54 |
Ampoule |
23,986 |
Annex 2
Year 2002-2003
|
Cluster |
Use |
Drug Name |
Quantity |
Base Unit |
Value (HK$)
|
|
HKE |
Antidote |
CALCIUM DISODIUM VERSENATE INJECTION 200MG/ML 5ML |
30 |
Ampoule |
10,461 |
|
HKW |
Antibiotic |
SYNERCID (OR EQUIV) INFUSION 500MG |
67 |
Vial |
32,160 |
|
KE |
Anti-Haemophilia |
FACTOR IX COMPLEX (HUMAN) (RC) INJECTION 500 IU |
42 |
Bottle |
16,968 |
|
KC |
Anti-platelet |
STREPTOKINASE INJECTION 1500000U |
8 |
Vial |
7,480 |
|
KW |
Antidote |
DIMERCAPROL INJECTION 50MG/ML 2ML |
39 |
Ampoule |
24,346 |
|
NTE |
Antitoxin |
BOTULISM TRIVALENT ANTITOXIN INFUSION 250ML |
4 |
Bottle |
66,600 |
|
NTW |
Blood Product |
PLASMA PROTEIN FRACTION (RC) INJECTION 5% 250ML |
107 |
Bottle |
20,640 |
Annex 2
Year 2003-2004
|
Cluster |
Use |
Drug Name |
Quantity |
Base Unit |
Value (HK$)
|
|
HKE |
Antidote |
DIMERCAPROL INJECTION 50MG/ML 2ML |
20 |
Ampoule |
12,443 |
|
HKW |
Endocrinal |
BROMOCRIPTINE MESYLATE CAPSULE 10MG |
1028 |
Capsule |
5,140 |
|
KE |
Antidote |
PRALIDOXIME IODIDE INJECTION 25MG/ML 20ML |
128 |
Ampoule |
24,894 |
|
KC |
Anti-Haemophilia |
FACTOR XI CONCENTRATE INJECTION |
6300 |
Unit |
76,052 |
|
KW |
Anti-arrhythmia |
BRETYLIUM TOSYLATE INJECTION 50MG/ML 10ML |
180 |
Ampoule |
78,070 |
|
NTE |
Respiratory stimulant |
DOXAPRAM HCL INJECTION 20MG/ML 20ML |
62 |
Vial |
27,768 |
|
NTW |
Antidote |
DIMERCAPROL INJECTION 50MG/ML 2ML |
55 |
Ampole |
32,908 |