Drug suppliers can play a role in keeping cancer treatments affordable

We refer to Mr How Ti Hwei's letter, "MediShield Life changes may lead to some trade-offs in cancer care" (Sept 2).

From September next year, patients will pay less for clinically proven and cost-effective cancer drug treatments. This is achieved through the MediShield Life changes which have strengthened our ability to negotiate with drug suppliers for better drug prices, and the Government's extension of subsidies to more cancer drugs and more patients.

However, not all drug suppliers have been willing to offer fairer prices that are commensurate with the health benefits that the drugs offer. Their prices remain higher than in other countries.

While MediShield Life will continue to cover some of these non- cost-effective treatments, they will remain unsubsidised.

We urge drug suppliers to lower their prices to cost-effective levels, so that together, we can keep cancer drug treatments affordable and sustainable for Singaporeans.

Patients who are on these treatments may wish to discuss with their doctors switching to alternative treatments which will be covered by subsidies and MediShield Life, should prices remain non-cost-effective.

The small proportion of patients who are unable to switch due to special circumstances may approach medical social workers for financial assistance if they face difficulty in affording their treatments.

Cham Dao Song

Director (Finance Policy)

Healthcare Finance Division

Ministry of Health

======

Forum Letter

MediShield Life changes may lead to some trade-offs in cancer care

I would like to expand on my position on the upcoming changes to MediShield Life that was presented to Straits Times political correspondent Linette Lai for her article, "For all, for life? MediShield Life changes for cancer treatments explained" (Aug 28).

The article carried my quotes on the increase in Integrated Shield Plan (IP) premiums and how it would affect other healthcare coverage.

I also made the argument that any premium increase for those with IPs, or increased out-of-pocket costs for those without IPs, would be a direct consequence of reduced funding for some cancer treatment.

While the upcoming changes will lower the cost of some cancer treatments, others will become more expensive for patients.

Specifically, there are 94 (or one-third) out of the 274 treatments in the newly created Outpatient Cancer Drug List that will have no subsidies and have MediShield Life monthly claim limits reduced to below the existing $3,000 ceiling. Of the one-third of treatments, many are considered the standard-of-care for treating specific cancers and they may become more costly after the changes kick in.

Cancer is a heterogeneous disease where the type of tumour, condition of the patient, presence of other health conditions, and even the composition of the germs in our gut, can result in different responses to a particular treatment.

For patients not covered by IPs, a simple and speedy appeal process for special circumstances, as suggested by other commentators in the same article, would be crucial to ensure that every patient gets a fair fight against cancer.

How Ti Hwei

Vice-President, International Oncology and Market Access,

AstraZeneca