Health authorities have reached out to the patient who allegedly resold the drug to a vendor and launched an investigation into whether it involved the illegal sale of unregistered pharmaceutical products.
The offence carries a maximum punishment of a HK$100,000 (US$12,840) fine and two years in jail.
The sale of drugs in the city is regulated by the Pharmacy and Poisons Ordinance and monitored by the Department of Health.
Drugs intended for more severe diseases and causing stronger side effects are required to be sold through prescription and at licensed pharmacies under the supervision of registered pharmacists.
The drug in question, Lactulose, was not in that category and could be distributed by regular businesses such as supermarkets and grocery stores.
However, it should still satisfy the safety, efficacy and quality standards and be registered with the pharmacy and poisons board before being sold or distributed under the law.
The Hospital Authority does not appear to have explicitly outlawed the resale of drugs it gives to patients either, according to its website.
Tim Pang Hung-cheong, a patients’ rights advocate with the Society for Community Organisation, said it was common for public hospitals to prescribe a longer duration of medication to ensure sufficient supply before the next appointment a few months later.
“Some of the drugs were only to be taken when required, like pain-relief medicine, so patients would have excessive amounts of drugs left, and some would choose to give them away or resell them to small pharmacies or online,” said Pang.
In early 2023, Covid-19 antiviral pills prescribed by public doctors – Paxlovid and Molnupiravir – were resold for as much as HK$5,000 on online marketplace Carousell as the drugs became a hot commodity in mainland China.
The phenomenon prompted hospital pharmacies to remove the packaging before dispensing.
In late June, an 83-year-old resident was given about 20 kinds of medication for 425 days, most of which were psychiatric drugs – a case that Henry Fan Hung-ling, chairman of the authority called “unacceptable”.
But Pang warned against taking a blanket approach to simply prescribing fewer drugs to crack down on the resale of drugs because it could impact those who genuinely needed the drugs daily.
Instead, health authorities could work with community pharmacies to let public hospital patients refill their drugs when necessary and consult pharmacists to better control the symptoms, he said.
Professor Ian Wong Chi-kei, head of the department of pharmacology and pharmacy at the University of Hong Kong, said the incident should serve as a wake-up call for authorities to update the drug regulatory regime.
For example, the government should impose stricter control on sellers to ensure the drugs being sold on the market were subjected to good quality control, especially storage conditions, and their sources be traceable.
Wong said drugs categorised as less dangerous, such as Lactulose, should also be subject to these rules because they could become defective or even toxic when stored improperly.
He added that online sales of drugs should only be allowed if they could guarantee quality and traceability as well, but it was hard for e-commerce platforms to police their merchants.
“Patient education is therefore very important because many are not aware of the potential health risks at all,” Wong said.
Medical sector lawmaker David Lam Tzit-yuen agreed the government could tighten the rules on where drugs could be sold.
“It is unreasonable for a registered drug to be sold like candies,” he said.
He said an immediate solution was requiring all drugs to be sold either at pharmacies or licensed medicine stores, but a comprehensive review was needed in the long run.
The alleged merchant was a start-up that sold health supplements. One of the directors shared the same name as a registered pharmacist. It remained unknown how the hospital drug ended up with the company.
Between 2020 and June 2024, the Department of Health handled 209 cases that led to convictions involving the illegal sale or possession of unregistered pharmaceutical products or Part 1 poisons. The cases resulted a maximum penalty of 10 months in jail and a HK$100,000 fine.
The Consumer Council received 330 complaints regarding the sale of drugs between 2020 and July 2024, but none of which involved the resale of public hospital drugs.
About a fourth of the cases were related to the quality and authenticity of the drugs.
