Some half a million dollars has been spent to treat a woman's cancer despite the hospitals where she sought treatment saying her illness was terminal (MOH, CPF Board correct misleading info, July 13).

New cancer treatments, such as immunotherapy and targeted therapy, incur very high costs.

Take metastatic liver cancer, for instance. The first-line systemic treatment is a class of medication called tyrokinase inhibitors. They have been shown to prolong the life of patients with advanced liver cancer, but cost about $3,000 to $5,000 a month.

Immunotherapy, the latest treatment for recalcitrant liver cancer, costs more than $10,000 a month.

Treatment typically goes on for at least six months.

It is hard to justify the high cost of cancer treatment for one patient when the money can be spent to help hundreds of patients with chronic diseases such as diabetes and hypertension.

Countries with lower gross domestic product than Singapore, such as Thailand, Bangladesh and India, try to cut costs with the following strategies.

Public hospitals use generic drugs, whose prices are a fraction of those of patented drugs.

The government would negotiate with big pharmaceutical companies for discounted prices when making bulk purchases.

To treat each type of cancer, the government would call for tenders from different pharmaceutical companies. The successful bidder then supplies cancer drugs for the whole country at the bid price for a period of time.

The high volume of drug use ensures that the pharmaceutical company will make a profit while patients pay less for their treatment.

Many more new (and probably more expensive) cancer treatments are undergoing clinical trials. Some will reach the market in the next few years.

To ensure cancer patients have a good chance to fight the disease, the Singapore Government must proactively work with pharmaceutical companies to lower the cost of treatment.

Desmond Wai (Dr)