1. The Ministry of Health (MOH) will provide additional transitional support for cancer patients who have started treatment before 1 September 2022 and will be affected by the changes related to the financing for cancer drug treatments.
Healthcare Financing for Cancer Drug Treatments
2. Cancer drug spending grew 20% per year from 2016 to 2019. This is not sustainable. To address this, MOH announced changes in August 2021 to the MediShield Life, MediSave and Integrated Shield Plan (IP) coverage, and established a Cancer Drug List (CDL). From 1 September 2022, only treatments that are listed on the CDL are covered under MediShield Life and MediSave. IP coverage will also be adjusted from 1 April 2023 upon policy purchase or renewal.
3. Concurrently, to improve affordability for use of clinically- and cost-effective cancer drugs, MOH will extend drug subsidies through the Medication Assistance Fund (MAF) to more Singapore Residents at our Public Healthcare Institutions (PHIs). The changes have also taken effect on 1 September 2022. A summary of the financing changes is provided in the Annex.
4. These changes strengthen MOH’s ability to negotiate better prices for cancer drugs. Since the new policy was announced in August 2021, procurement prices have reduced by an average of 30%, and up to 65% for some drugs. Currently, more than 90% of Health Sciences Authority-approved cancer treatments are already on the CDL, which will continue to expand as we continue to engage drug companies, and new clinical evidence emerges.
5. Patients in public and private healthcare institutions who have started treatments that are (i) not on the CDL or (ii) on the CDL but not subsidised before 1 September 2022, may find themselves affected by the policy change, as out-of-pocket expenses may go up, until such time the drugs are included or subsidised on the CDL. We will provide additional support for this group of patients during this transition period so that their ongoing course of treatment is not disrupted.
6. The provisions to support these patients are:
a) Patients with IPs that currently cover their treatments will not see any change to their coverage from 1 September 2022, as the changes to IPs will only kick in on their policy renewal date from 1 April 2023 onwards, and all IP insurers have also committed to provide transitional support to IP policyholders undergoing cancer drug treatments beyond 1 April 2023. More details will be shared by the IP insurers.
b) Patients with MediShield Life only will receive additional financial support for their current course of treatment. Generally, they will not need to pay more cash as compared to before. Patients may approach their respective PHIs for more details.
7. In addition, cancer patients who are receiving private care and need further financial assistance may request to be directly referred to subsidised specialist care at the PHIs, where their treatment plan will be reviewed and they can apply for additional financial support.
8. Future patients, together with their oncologists, should consider treatment options on the CDL, which are clinically proven and more cost-effective, before considering alternatives.
9. Notwithstanding, IP insurers have decided that their riders’ coverage will continue to cover treatments beyond the CDL. This will provide greater choice for those who prefer and wish to pay for broader coverage. More details will be shared by the IP insurers.
MINISTRY OF HEALTH
2 SEPTEMBER 2022