More subsidised cancer patients here will get help paying for their outpatient treatments from next year, with changes to the national health insurance scheme.
More cancer drugs will be subsidised and the income criteria will be raised so that more people can get subsidies for certain high-cost drugs under the Medication Assistance Fund (MAF).
With these changes to MediShield Life coverage, 90 per cent of subsidised cancer patients will have their outpatient treatments fully paid for by insurance and MediSave from September next year - up from 70 per cent today.
The move will also have the effect of reining in soaring cancer drug prices.
The MediShield Life Council had set up a committee to look into the high cost of cancer care, and had recommended that the Ministry of Health (MOH) create a list of cost-effective outpatient cancer drug treatments to be covered by MediShield Life.
About 90 per cent of existing treatments in the public sector have been included in the list.
Based on this list of clinically proven treatments, the revised claim limits can range from $200 to $9,600 a month - depending on the drug used - when the changes kick in.
Currently, patients can claim only up to $3,000 a month for all cancer outpatient treatments. "This has the unintended effect of raising cancer drug prices to maximise the claims," said MOH.
The ministry explained that since MediShield Life has been reimbursing $3,000 a month for outpatient cancer treatments, some drug companies have kept their prices high, knowing that the cost would be covered by insurance.
As a result, Singapore has been paying up to double the price paid by Australia, New Zealand, South Korea and Taiwan for some drugs.
Having differentiated cost limits has enabled Singapore to negotiate better rates. On average, cancer drug prices have gone down by about 30 per cent. One drug for kidney cancer dropped in price, from $22,570 a month to $11,340 a month.
The move will address the issue of rising costs, since spending on cancer drugs here has been rising at an annual average rate of 20 per cent, compared with 6 per cent for other drugs, said MOH.
MOH also said 55 more drugs will be eligible for subsidies, bringing the total to 150 drugs.
The subsidised list is published on the MOH website and updated every four months. Oncologists may ask for drugs not on the list to be evaluated.
Meanwhile, about 3,000 more people will become eligible for subsidies under MAF, with the criteria being raised from a per capita household income of $2,800 a month to $6,500 a month.
While most existing cancer drug treatments will continue to be covered, some patients may find they can no longer claim for their current medication. The changes will kick in only in September next year to allow such patients to complete their current course of treatment and adjust their plans.
Dr Tan Yew O, an oncologist in private practice who chaired the Cancer Drug Committee, said some drugs not on the list are novel therapies. "In some instances, there is currently insufficient clinical evidence that these drugs are effective in improving overall survival or duration of response," he added.
Meanwhile, from April 2023, patients undergoing private healthcare treatment covered by Integrated Shield Plans (IPs) will not be able to claim for drugs not on this list.
However, the new rules do not apply to riders, which about a third of IP policyholders have. Riders pay for part or all of a patient's share of the bill.
This is because IP premiums are paid with MediSave, while premiums for riders are paid for in cash.
Mrs Fang Ai Lian, chairman of the MediShield Life Council, said: "Focusing MediShield Life coverage on clinically proven and cost-effective cancer drug treatments will enable Singapore to negotiate for better drug prices and improve affordability for more patients."
She added that this will help to keep MediShield Life premiums affordable for all Singaporeans.
No revision of premiums is expected before the next review in 2024.
