Following is a question by the Dr Hon Helena Wong and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (May 30):
Question:
The dermatology specialist outpatient clinics under the Department of Health (DH) provide treatment for psoriasis patients, and refer patients of serious cases to the dermatology biologic therapy (biologic therapy) outpatient clinic at the Prince of Wales Hospital (PWH) for treatment. DH enhanced the referral mechanism in June 2016, tasking a medical consultant with the responsibility for assessing whether the psoriasis patients of clinics under DH meet the criteria for receiving biologic therapy so as to expedite referrals. However, there are currently more than 3 000 patients in Hong Kong who are suitable for receiving biologic therapy, but the number of such patients so referred since 2012 has been few and far between. On the other hand, the authorities plan to offer biologic therapy outpatient service at the Pamela Youde Nethersole Eastern Hospital (Eastern Hospital) in the first quarter of 2018, but such plan has not yet been implemented. In this connection, will the Government inform this Council:
(1) of (i) the number of psoriasis patients referred by DH for receiving biologic therapy since the implementation of the aforesaid enhanced mechanism, and (ii) among such patients, the number of those who received biologic therapy subsequently and the percentage of this number in the number of serious psoriasis patients in Hong Kong;
(2) whether it knows the reasons why the Eastern Hospital has not yet introduced the biologic therapy outpatient service, and when such service will be introduced;
(3) whether it knows if the Hospital Authority will step up the service provided at PWH's dermatology biologic therapy outpatient clinic, including increasing the service hours and patient quota; and
(4) as a patient group has pointed out that psoriasis patients currently have to wait for 10 years on average before they receive treatment and thus will very likely miss the best timing for treatment, whether the authorities have comprehensively assessed the service needs of such patients; if so, of the assessment outcome; if not, whether they will conduct such assessment expeditiously?
Reply:
President,
Currently, treatment options for psoriasis are provided in accordance with evidence-based medical practice. The treatments include medicine for external use or oral administration, phototherapy and the newly introduced biologic therapy. Doctors will prescribe appropriate medicine according to the severity of patients' conditions, most of which can be controlled by using conventional treatment options (i.e. medicine for external use or oral administration and phototherapy).
Generally speaking, serious psoriasis patients seeking follow-up consultations at clinics providing specialist dermatology outpatient services under the Department of Health (DH) may be referred to the Hospital Authority (HA) for biologic therapy under the existing mechanism if their conditions cannot be effectively controlled by conventional treatments like medicine for external use or oral administration or phototherapy, or they have suffered from relatively serious adverse effects after receiving such treatments, provided that they do not have any contraindications to biologic therapy.
To provide appropriate treatments for serious psoriasis patients, the DH has enhanced the referral mechanism for these patients since June 2016. Under the enhanced mechanism, fast and direct referrals will be offered to serious psoriasis patients following the assessment by DH's specialists for appointments for the biologic therapy outpatient service at the Prince of Wales Hospital (PWH). Since the implementation of the enhanced mechanism, a total of four serious psoriasis patients have been referred by the DH to the PWH for biologic therapy.
To further enhance the existing service, the DH and the HA started to actively prepare for the provision of biologic therapy outpatient service at the Pamela Youde Nethersole Eastern Hospital (Eastern Hospital) in September 2017. Preliminary testing of workflows was completed in early 2018, which covers the application of computer systems for basic clinic facilities such as those for medicine prescription, patient registration and fee collection, and the formulation of case referral procedures. The outpatient service will be provided directly by experienced healthcare personnel of DH's Social Hygiene Service, who have completed the training on the application of the systems. The DH and the HA are finalising the detailed arrangements for the overall operation of the biologic therapy outpatient service. It is expected that the clinic will come into operation soon to provide services for psoriasis patients.
The DH will continue to keep abreast of international guidelines and review the treatment options for psoriasis from time to time according to the latest situation in Hong Kong. Apart from the existing biologic therapy outpatient service provided by the PWH, the biologic clinic of the Eastern Hospital will come into operation soon. The DH will maintain close liaison with the HA to explore the relevance and feasibility of introducing the service at the specialist outpatient clinics of other HA hospitals.
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