We refer to Senior Health Correspondent Salma Khalik’s commentary, “Rules on cancer treatment funding can be improved” (June 13), and to subsequent Forum letters on the subject.
To ensure that cancer treatments remain affordable for most Singaporeans, where possible, we are focusing government grants, MediShield Life and Integrated Shield plans to cover clinically proven, cost-effective treatments on a new list of cancer drugs. . About 90% of cancer treatments used in public health facilities are on the list of cancer drugs.
If funding coverage were generously extended to very expensive and new cancer drugs, treatment costs would inevitably rise along with insurance premiums. This will make it less affordable for the broad masses.
Encouragingly, our latest policy prompted pharmaceuticals to reduce cancer drug prices by an average of 30% in order to qualify for subsidies, MediShield Life coverage and the Integrated Shield plan. This will benefit many patients and improve the affordability of more cancer drugs for all Singaporeans.
Some patients use unapproved cancer drugs. This means using a drug that has not been approved by the Health Sciences Authority for this purpose, usually because there is insufficient clinical evidence to determine their safety and effectiveness.
We understand that sometimes off-label medicines can bring much-needed hope to patients and their loved ones. Therefore, oncologists are allowed to prescribe such drugs, but without subsidies, MediShield Life or Integrated Shield Plan coverage. We also hope that patients weigh the risks and costs with their doctor and insurer to make an informed decision.
Nevertheless, it cannot be ruled out that off-label drugs will be covered by insurance and assistance. There are private insurance plans that cover off-label cancer drugs. Subsidized patients who are assessed by public health facilities as needing treatments not on the cancer drug list and who have difficulty paying for them can apply for MediFund and Medication Assistance Fund Plus, or appeal to use more MediSave .
The Ministry of Health will also facilitate the referral of private patients to subsidized care, to enable them to access this financial assistance in institutions.
When combinations of cancer treatments are needed, patients will indeed be able to claim up to the limit of the most expensive drug on the cancer drug list. Since many low-cost drugs are subsidized under the new policy, the cost of treatment should remain affordable.
Where more than one expensive drug is required and these combination therapies have been assessed as clinically proven and cost effective, a higher claim limit will be provided.
Director (Financial Policy)
Health Financing Division
Ministry of Health