Eligibility Criteria for MediShield Life claims for Proton Beam Therapy (PBT)
- Treatment should be given with a curative intent;
- Patient does not have metastatic disease or advanced stage disease, with the exception of tumours which remain curable when metastatic;
- Patient should have adequate performance status and is medically sufficiently stable to undergo PBT;
- PBT should be considered when the expected rate of severe side effects from other treatments are unacceptable; and
- Patient should have good prognosis, with an expected survival of more than five years after treatment with PBT. PBT is not allowed for palliative care cases.
MediSave claims are not subjected to the eligibility criteria.
MediShield Life Claim and MediSave Withdrawal Limits for Approved Proton Beam Therapy (PBT) Indications
|
S/N
|
Indication
|
PBT Category
|
MediShield Life Claim Limit
|
MediSave Withdrawal Limit
|
|
Cancer subtypes for patients of all ages
|
|
Musculoskeletal system
|
|
1
|
Base of Skull Chordoma
|
3
|
$1,800 per treatment
|
$2,800 per treatment
|
|
2
|
Base of Skull Chondrosarcoma
|
|
3
|
Spinal and Paraspinal Bone and Soft Tissue Sarcoma
|
1
|
$300 per treatment
|
$80 per treatment
|
|
4
|
Non-metastatic retroperitoneal sarcomas
|
|
Central and peripheral nervous system
|
|
5
|
Ependymoma
|
3
|
$1,800 per treatment
|
$2,800 per treatment
|
|
6
|
Pituitary adenoma
|
|
7
|
Base of skull meningioma
|
|
8a
|
Acoustic neuroma (when treated with PBT as stereotactic radiotherapy)
|
|
8b
|
Acoustic neuroma (when treated with PBT as radiosurgery)
|
4
|
$10,000 per course of treatment
|
$7,500 per course of treatment
|
|
Lymphatic system
|
|
9
|
Localised follicular lymphoma
|
1
|
$300 per treatment
|
$80 per treatment
|
|
Head and Neck
|
|
10
|
Advanced (eg, T4) and/or unresectable head and neck cancers
|
1
|
$300 per treatment
|
$80 per treatment
|
|
11
|
Cancers of the paranasal sinuses and other accessory sinuses
|
|
Others
|
|
12
|
Oesophageal cancer
|
1
|
$300 per treatment
|
$80 per treatment
|
|
13
|
Oropharyngeal cancer
|
|
14
|
Advanced high risk inoperable hepatocellular carcinoma
|
|
15
|
Locally advanced cancers undergoing concurrent chemoradiation therapy
|
|
16
|
Prostate cancer
|
|
Cancer subtypes for patients younger than 25 years
|
|
Central and peripheral nervous system
|
|
17
|
Retinoblastoma
|
2
|
$500 per treatment
|
$360 per treatment
|
|
18
|
Chordoma/ chondrosarcoma base of skull or spine
|
3
|
$1,800 per treatment
|
$2,800 per treatment
|
|
19
|
Ependymoma
|
|
20
|
Craniopharyngioma
|
|
21
|
Pineal parenchymal tumours (not pineoblastoma)
|
|
22
|
Medulloblastoma
|
1
|
$300 per treatment
|
$80 per treatment
|
|
23
|
Intracranial germ cell tumour
|
|
24
|
Primitive neuroectodermal tumours
|
|
25
|
Esthesioneuroblastoma
|
|
26
|
Neuroblastoma
|
|
27
|
Glioma
|
|
Musculoskeletal
|
|
28
|
Ewing sarcoma
|
1
|
$300 per treatment
|
$80 per treatment
|
|
29
|
Spinal/ paraspinal bone and soft tissue sarcoma
|
|
30
|
Rhabdomyosarcoma: orbit, parameningeal, head and neck, pelvis
|
|
31
|
Pelvic Sarcoma
|
|
32
|
Osteosarcoma
|
|
Others
|
|
33
|
Salivary gland cancer
|
1
|
$300 per treatment
|
$80 per treatment
|