From 1 Oct 2009, Medisave can be used for the outpatient treatment of two more chronic diseases: schizophrenia and major depression.

2. In 2006/2007, the Chronic Disease Management Programme (CDMP) was launched to allow Medisave for the treatment of diabetes, hypertension, lipid disorders (e.g. high cholesterol) and stroke. In April 2008, asthma and chronic obstructive pulmonary disease (COPD) were added.

Disease Conditions

3. Schizophrenia and Major Depression are chronic mental diseases that can potentially cause significant burden and disability.  Schizophrenia, which affects nearly 1% of the population, is a chronic psychiatric disorder that requires long-term medication and treatment.  Major Depression is a more serious form of depression and may cause significant distress or impairment in the patients' daily activities, but is highly treatable once diagnosed.

4. With the establishment of evidence-based treatment and adequate support from caregivers and the community in their journey of rehabilitation, most patients can maintain and lead a near normal functioning or productive life.  Similar to other chronic diseases under CDMP currently, the goal is to achieve good control of the illnesses while minimising potential relapse or complications of their underlying conditions. At the same time, the extension of CDMP to mental diseases will help reduce out-of-pocket payments and also reduce the barriers for patients to seek medical treatment.

Shared Care / GP Partnership Programme

5. Under this new extension of the CDMP, general practitioners (GPs) who are interested to treat patients with schizophrenia or major depression will participate in a Shared Care or GP Partnership Programme with a restructured hospital.  This is to ensure quality and continuity of care for patients. Under this partnership programme, local hospitals will support GPs in training, professional support from nurses or psychologist and periodic review by the psychiatrists.

Educational Materials

6. MOH has developed a “Handbook for Healthcare Professionals” which provides detailed guidance on the treatment of these two psychiatric conditions. This Handbook will be a useful reference for doctors in diagnosing and treating patients with schizophrenia and major depression. MOH has also produced educational booklets on schizophrenia and major depression, for patients’ and caregivers’ reference.  These booklets contain relevant information on the disease symptoms, the treatment and help available and what one can do to help loved ones cope with these two diseases.

7. The extension of CDMP to these illnesses will potentially benefit many patients with Schizophrenia and Major Depression who can be managed effectively in the community by GPs and psychiatrists. 

Medisave Use

8. Medisave withdrawal rules under the CDMP will remain unchanged: withdrawals are capped at $300 per Medisave account per year. The existing deductible of $30 and co-payment of 15% will also apply.

MINISTRY OF HEALTH
25 SEPTEMBER 2009