Subsidies for recommended downstream interventions

Clinical indication

Intervention

Clinical criteria

MediSave / MediShield Life Coverage

Familial Hypercholesterolemia (FH)

Cholesterol-lowering drugs

Subsidised based on MOH List of Subsidised Drugs.

MediSave500/700 as part of chronic disease management under the Chronic Disease Management Programme.

No MediShield Life coverage.

Hereditary Breast Cancer

Risk-reducing mastectomy

Risk-reducing mastectomy (bilateral or contralateral) may be considered for breast cancer risk reduction, with or without breast reconstruction, in an individual who fulfils the following clinical criteria:

1.    The individual is 25 years and older;

2.    The individual has an increased risk of breast cancer due to pathogenic or likely pathogenic variant(s) in any of the following genes: ATM¹, BRCA1, BRCA2, CDH1, PALB2, PTEN, STK11 or TP53;

3.    The individual has received genetic counselling; 

4.    The individual has no competing comorbidities which could severely limit her life expectancy at the time of risk-reducing mastectomy; and

5.    The individual has received pre-operative counselling about psychosocial and sexual consequences of risk-reducing mastectomy. If there is a need for further counselling, the patient can be referred to a psychologist.

Risk-reducing mastectomy should only be considered after assessment of personal risk and family history of breast cancer, and recommendations of clinical practice guidelines.

¹ Risk-reducing mastectomy may be considered for carriers of the ATM c.7271T>G variant

MediSave and MediShield Life coverage under the relevant TOSP limit (SA826B or SA833B).

Chemoprevention drugs

Subsidised based on MOH List of Subsidised Drugs.

Flexi-MediSave scheme (for seniors who are age 60 and above)

Hereditary Ovarian Cancer

Risk-reducing bilateral salpingo-oophorectomy

Risk-reducing bilateral salpingo-oophorectomy may be considered for ovarian cancer risk reduction in an individual who fulfils the following clinical criteria: 

1.    The individual is 35 years and older, or earlier if there is a family history of earlier onset ovarian cancer;

2.    The individual is at increased risk of ovarian cancer due to pathogenic or likely pathogenic variant(s) in any of the following genes: BRCA1, BRCA2, BRIP1, EPCAM, MLH1, MSH2, PALB2, RAD51C or RAD51D;

3.    The individual has completed family planning and considered their reproductive decisions;

 4.    The individual has received genetic counselling; 

5.    The individual has no competing comorbidities which could severely limit her life expectancy at the time of risk-reducing bilateral salpingo-oophorectomy; and

6.    The individual has received pre-operative counselling about psychosocial and sexual consequences of risk-reducing bilateral salpingo-oophorectomy. If there is a need for further counselling, the patient can be referred to a psychologist.

Risk-reducing bilateral salpingo-oophorectomy should only be considered after assessment of personal risk and family history of ovarian cancer, and recommendations of clinical practice guidelines.

MediSave and MediShield Life coverage under the relevant TOSP limit. SI700L will serve as the interim proxy code for risk reducing bilateral salpingo-oophorectomy for Hereditary Breast and Ovarian Cancer patients who fulfil the criteria outlined, pending the introduction of a dedicated RRBSO code in the 2028 TOSP booklet.

Chemoprevention drugs

Subsidised based on MOH List of Subsidised Drugs.

Flexi-MediSave scheme (for seniors who are age 60 and above)