Cancer patients affected by insurance coverage changes to get help for treatment: Ong Ye Kung

Singapore has made significant changes to cancer insurance coverage. ST PHOTO: LIM YAOHUI

SINGAPORE - Cancer patients who are on drugs not on the Cancer Drug List, and hence no longer insurable by MediShield Life since Thursday, will get support from the Government to complete their treatment.

Health Minister Ong Ye Kung gave this commitment to patients who had started on such treatments on or before Wednesday.

"We should avoid the situation where they will find the cost of their cancer drugs shoot up suddenly. We should make provisions, so that the impact on them should be minimal, or even better, zero," he said at the Singapore Cancer Society's gala dinner on Friday.

Singapore has made significant changes to cancer insurance coverage. While it has reduced the number of drugs that can be covered by insurance, it has increased government subsidy from $12 million to $80 million a year.

The jump comes from both more drugs getting subsidies and more people qualifying for subsidies because the per capita household income threshold was raised from $2,800 to $6,500.

But for the first time, the Ministry of Health has told insurance companies that provide Integrated Shield Plans (IPs), which pay for non-subsidised treatments, what they can or cannot cover.

This move is an attempt to stem the soaring cost of cancer treatment here.

Mr Ong said spending on cancer drugs has more than doubled from $110 million to $275 million over the past five years.

"If left unchecked, it is expected to grow at 20 per cent per year, which means further doubling every three to four years," he said.

Hence the introduction of the list of drugs that are effective, as well as cost-effective.

Only drugs and indications (a drug might be approved for use for one cancer, but not for another cancer) on the Cancer Drug List can be insured by MediShield Life from Sept 1, and by IPs from April 1 next year.

Mr Ong said limiting insurance coverage to the Cancer Drug List has had an "immediate effect", with prices of cancer drugs that made it to the list dropping by 30 per cent on average, and as much as 65 per cent in some cases.

The list covers more than 90 per cent of cancer drugs approved for use here. Drugs excluded are generally those where incremental benefit does not justify the price charged.

Mr Ong is optimistic that most, if not all, of the drugs not currently on the Cancer Drug List, will make it to the list in the coming months or years as prices are reduced.

Singapore has been paying far more for cancer treatment than other developed places such as South Korea, Taiwan, Australia and Britain.

He said: "As a small market, it is difficult for us to summon enough negotiating power to bargain the price down."

Mr Ong gave the example of Lonsurf, a colorectal cancer drug from Taiho Pharma from Japan. Patients in Australia pay $2,500. Those at public hospitals here pay more than $4,500, while the private sector charges up to $10,000.

Some time back, the Government realised that the way pharmaceutical companies price their products, charging affluent countries more, coupled with policies in place here, has pushed up treatment costs.

For example, because MediShield Life used to provide $3,000 a month for cancer treatment, "there was no incentive for the supplier to charge anything less than $3,000" even if it could have cost only $500. Patients in the private sector with IPs that cover the full cost could be charged an even higher price.

So MediShield Life cancer coverage now ranges from $200 to $9,600 a month.

Mr Ong Ye Kung addressing the crowd at the Singapore Cancer Society's gala dinner at The Ritz-Carlton, Millenia Singapore on Friday. PHOTO: LIANHE ZAOBAO

From April next year, Mr Ong said: "Likewise, we will also require treatment-differentiated IP claim limits. Together, they will provide greater incentive for drug companies and providers to price more competitively."

The idea is "no financing for overpriced drugs".

Said Mr Ong: "The Cancer Drug List gives us negotiating leverage to bring down prices of cancer drugs based on available evidence."

However, the impact of list on patients was softened on Friday when the minister said IPs can continue to insure patients on non-Cancer Drug List drugs up till September next year if treatment has already started.

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