15 June 2021 | Tuesday | News
The launch of innovative drugs will drive growth in the market. Hong Kong is the leading choice for manufacturers of home-based equipment, hygiene-sterilized supplies, less-invasive procedure equipment, orthopedic tools and devices, as well as devices and supplies for high health-risk diseases and injuries.
Physician prescribed vs over-the-counter drugs
In a physician-dispensing market such as Hong Kong, retail pharmacists primarily focus on over-the-counter (OTC) drugs. The connection between drug prescribing and dispensing continues to be a lucrative source of income for physicians, clinics and hospitals. Separation between prescribing and dispensing is unlikely due to the powerful doctors’ lobby in the city.
Public vs private healthcare debate
The current healthcare system cannot continue to support the weight of the rapidly changing age demographic. Projections forecast that people over 65 years old in Hong Kong will more than double from 13% to 30% of the population by 2041. The strain of this increase will necessitate a 6.5% annual increase in public healthcare spending just to maintain services. The delicate balance between private and public healthcare will have to change.
Despite some resistance to change, there are innovative healthcare funding adjustments underway. These include tax rebates and deductions for enrolling in private healthcare insurance; allowing people of any age and in any health to take out insurance; guaranteed renewal for all members; and limiting of premiums for high-risk groups.
The government has set aside over US$1.6 billion to fund public hospital expansion and modernization, such as adding hospital beds and other treatment and diagnostic facilities. This will result in shorter waiting times for healthcare services, as well as additional mental health services.
The Hospital Authority will enhance its healthcare services for elderly patients, providing barrier-free hospital facilities by 2016. Improvements will include a joint replacement center, as well as enhanced geriatric rehabilitation and palliative care services. The Elderly Health Care Voucher Scheme doubled to US$256 last year and the number of vouchers increased to 640,000 for a total expenditure of US$70 million.
In 2014, the Hospital Authority launched pilot outpatient clinics in three districts to allow those with chronic diseases, such as hypertension or diabetes in a stable condition, to receive outpatient services from participating private doctors within their respective districts. The government plans to expand the program to the remaining 15 districts.
Emerging trends in Hong Kong healthcare
Hong Kong’s health indicators rank among the best in the world. Like other developed countries and regions, the burden of the healthcare system has shifted from communicable diseases to chronic diseases due to a more affluent lifestyle and medical advances. Recent data from the Department of Health’s Center for Health Protection concludes that over 28% of the population has a chronic illness such as hypertension (11%), diabetes (5%), high cholesterol (almost 4%), coronary heart disease (2%), asthma (1.1%), and stroke (0.6%). Over 36% of the population are considered obese and this trend continues to grow.
Cancer is by far the leading cause of death in the city, at 31%. Mortality rates from heart disease, cerebrovascular disease and chronic lower respiratory disease have all fallen in recent years. However, the infection rates of notifiable communicable diseases, such as HIV, continue to increase.
As the population ages, so will the demand for equipment that facilitates the prevention, detection, and management of illness. Treatment for cardiopulmonary disease, diabetes and neurological disorders will see rapid growth.
Hong Kong’s primary care system remains undeveloped. It will need to improve to address the needs of its aging population in disease prevention and management of chronic diseases.
The high burden of non-communicable diseases presents strong revenueearning opportunities for both pharmaceutical and medical devices firms, due to the need for increased diagnosis and treatment. The compound annual growth rate forecast from now until 2019 is 7.2%, reaching a total of US$2.2 billion.
The operating environment for the pharmaceutical industry in Hong Kong is likely to remain stable until 2018. Though market growth has slowed to single digits, Hong Kong will remain an attractive market, in large part due to its proximity to Mainland China.
Patented hi-tech drugs will continue to be imported and this sector is expected to grow. Hong Kong’s negative pharmaceutical trade balance is expected to widen over the next five years, with 7.2% imported and 3.9% exported by 2019. Cheap, off-patent drugs from Mainland China will increase this gap, highlighting Hong Kong’s need for less expensive pharmacueticals.
In contrast, pricing of generic drugs will continue to be forced down by the Hospital Authority’s volume purchasing and prescribing policies. Multinational generic drug-makers will dominate the generics market, as well as local firms with strict quality control. Eventually, generics from Mainland China will start to enter the market.
Retail pharmacists will continue to push for a greater role in healthcare, such as patient counseling and medication management. The government is looking for ways to increase pharmacist training and development. The Hong Kong Academy of Pharmacy is encouraging quality certification and a patient-centered approach to combat the sale of counterfeits.
Both cost and epidemiological considerations make Hong Kong an attractive base for clinical research and development and medical trials. According to data from Clinicaltrials.gov, Hong Kong hosted 82 clinical trials in 2013 and 91 in 2012. Of the 82 studies, there were 11 Phase I, 26 Phase II, 38 Phase III and seven Phase IV trials. However, Hong Kong is still considered a relatively small market with room for growth when compared to other markets such as Mainland China, Taiwan and South Korea.
Overcoming the challenge of regulatory changes
In response to a series of product scandals in 2009, Hong Kong enacted regulatory changes that affect the pharmaceutical market. In accordance with the Pharmacy and Poison Regulations Chapter 138A, Regulation 5, section 22, which went into effect on February 6, 2015, dealers licensed for wholesale are required to obtain a written order from the purchaser before completion of a sale of Part I poisons, dangerous drugs or antibiotics. The regulation is part of an effort to avoid ambiguity or miscommunication that could lead to wrongful delivery. The written order facilitates tracing the source of the drug, minimizes errors upon delivery, and combats the illegal sale of drugs, which enhances public safety.
The written order can be accepted in either paper or electronic format. Nevertheless, the impact of the mandatory requirement has been felt in the pharmaceutical field since most purchasers were used to ordering drugs via verbal orders. eZRx, one of ZPHK’s six eSolutions, provides an online ordering platform in full compliance with the written order ordinance.
Other regulatory changes in the pipeline include the Hong Kong Guide to GMP for Secondary Packaging, which will be implemented on October 1, 2015. The regulation states that secondary packaging can only be undertaken by licensed manufacturers, who comply with Good Manufacturing Practice requirements.