Following the introduction of the Cancer Drug List (CDL), the Ministry of Health (MOH) and the integrated shield plan (IP) insurers will offer additional support to patients and policyholders.

In a press release issued on Friday (Sep 2), MOH said that it will provide additional transitional support for cancer patients who have started treatment before Sep 1, 2022 and will be affected by the changes to the financing of cancer drug treatments. At the same time, MOH will extend drug subsidies through the Medication Assistance Fund (MAF) to more Singapore residents at public healthcare institutions here. 

From Sep 1, only treatments on the CDL – a list of clinically proven and more cost-effective cancer treatments – are covered by MediShield Life and MediSave. The policy change was first announced in August 2021 and came as spending on cancer drugs rose 20 per cent per year from 2016 to 2019.

MOH said: “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 per cent, and up to 65 per cent for some drugs.” It went on to highlight that, at present, more than 90 per cent of Health Sciences Authority-approved cancer treatments are on the CDL. The list is expected to grow as Singapore continues to engage pharmaceutical companies.

Patients in public and private healthcare institutions who have started treatments that are either not on the CDL, or on the CDL but not subsidised before Sep 1, 2022, may be affected by the change in policy. MOH said that it will provide additional support for this group of patients during the transition period so that their ongoing treatment is not disrupted. Patients with MediShield Life but no IP will receive additional financial support for their current course of treatment such that they will not have to pay more cash.. 

In a separate press release also issued on Friday, the Life Insurance Association (LIA), Singapore, said premium rates for IPs will be kept steady from Sep 2, 2022 to Aug 31, 2024. However, this will only apply to IPs, and not IP riders. 

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CDL for IPs will kick in for new IP policyholders who make a purchase from Apr 1, 2023; it will apply to existing IP policyholders from their respective policy renewal dates on or after Apr 1, 2023.

Until Sep 30, 2023, IP insurers will also provide transitional support for patients whose IPs are to be renewed between Apr 1, 2023 and Sep 30, 2023, and are actively undergoing cancer drug treatments as at Mar 31, 2023. The support is meant to give affected policyholders more time to review their treatment plans and adjust by switching to alternatives on the CDL, where suitable. More details will be provided by year-end.

In addition, from Apr 1, 2023, insurers will offer consumers the choice of getting coverage beyond the CDL via optional IP riders. LIA Singapore has developed a non-CDL classification framework – which is a standardised classification for cancer drug treatments that are not on the CDL. IP insurers will refer to the framework and decide which classes of non-CDL treatments will be covered within their respective IP riders.

Today, cancer claims account for a quarter of all IP claims, as the national crude cancer incidence rises in tandem with the ageing population, LIA Singapore highlighted. The increase in survival rates, along with longer treatment periods, are also expected to boost IP claim costs for cancer treatments.

Khor Hock Seng, president of LIA Singapore, said: “As we look to the longer term, we recognise that IP claims costs are likely to increase due to medical inflation. This will invariably result in the need for increased premiums in future so that IP insurers can continue to offer IPs.”

Khor added: “Nevertheless, IP insurers will continue to work closely with the MOH and others within the healthcare eco-system to achieve our joint commitment to providing quality and cost-effective treatments for cancer patients.”

IP insurers are expected to announce details on changes to their respective IPs and IP riders by year-end.