Measures to be put in place for cancer patients affected by changes to treatment claim policies: MOH
SINGAPORE: The Ministry of Health (MOH) will put in place measures for a “small number of exceptional" cancer patients affected by a change to outpatient cancer drug treatment claims, said Senior Parliamentary Secretary for Health Rahayu Mahzam on Tuesday (Jul 5).
Announced last year, the changes focus MediShield Life and Integrated Shield Plans to cover a cancer drug list of clinically proven and more cost-effective cancer drug treatments. They will take effect in September this year.
Addressing questions from Members of Parliament (MPs) on assistance for patients who require non-standard treatment, Ms Rahayu noted that there could be exceptions where patients do not respond to treatments on the list and their doctors may exercise their clinical discretion to prescribe other treatments based on evidence of benefit.
“In these cases, doctors must be prepared to justify their clinical decisions to patients and their colleagues. Doctors must also counsel the patient on its risks, efficacy, and costs so that the patient may make an informed choice,” she said.
The current claim limit that is applied to all types of cancer drugs give pharmaceutical companies little or no reason to lower prices and takes away the Government’s negotiating power, she said.
“This has resulted in an unsustainable rise of cancer drug prices. If left unchecked, cancer drugs will eventually be unaffordable for the majority of cancer patients,” Ms Rahayu added.
PRICE REDUCTION FOR CANCER DRUGS
Ms Rahayu said that the changes will improve affordability by providing the incentive for pharmaceutical companies to price their drugs more reasonably to benefit from financing coverage. The list covers about 90 per cent of treatments used in the public sector.
"Since we announced the changes in 2021, we have managed to secure an average price reduction of 30 per cent," she said. "For some cancer drugs, the price reduction achieved was over 60 per cent."
The lower prices have made more cancer drugs cost-effective, enabling 66 more cancer drugs to be listed for subsidy, Ms Rahayu said.
“Nudging utilisation of cancer drugs towards proven and cost-effective care will ensure that treatment costs for the broad majority do not rise unsustainably as a result of liberal use of very expensive and novel cancer drugs,” she added.
“These changes will benefit thousands of patients and improve affordability of more cancer drugs for all Singaporeans.”
Ms Rahayu was responding to questions from MPs including that from Mr Yip Hon Weng (PAP-Yio Chu Kang) who asked how many cancer patients will be affected by the new policy. He also asked what is the recourse for patients who do not respond to these drugs and how often will the list of drugs be reviewed to ensure that it keeps up with medical developments especially for new and rare cancers.
The cancer drug list is extensive, Ms Rahayu said, noting that the ministry has a panel of experts comprising senior public and private oncologists and haematologists across various specialisations who recommend new treatments for inclusion in the list.
This panel has approved treatments that cover multiple lines of therapy (beyond first line treatment), as well as rare cancer treatments to the cancer drug list.
This has allowed the ministry to include around 50 more treatments on the list since it was announced in August last year, she said.
The list is updated every four months to keep up with medical advancements and latest clinical evidence.
Some patients may still be covered for treatments not on the cancer drug list by their private insurance such as riders or critical illness plans, Ms Rahayu said.
Private patients who have difficulty affording their bills may opt to be transferred to subsidised care at public healthcare institutions.
“Once patients are in subsidised care, they can benefit from more affordable drugs and medical fees, as well as access a range of financial assistance such as MediFund. All patients can also appeal to use more MediSave, she said.