No one will be denied appropriate cancer care due to an inability to pay

We thank The Straits Times for the askST report, “How will changes to cancer insurance affect patients? ↗ (opens in new tab)” (April 2). Let us also address a few common concerns that the Ministry of Health (MOH) has been receiving.

We think most people appreciate the objective of the Cancer Drug List (CDL), which aims to curb the unsustainable increase in cancer treatment costs and premiums for the majority.

The most common and immediate question is how the policy change to Integrated Shield Plan (IP) coverage from April 1 will affect patients who are currently undergoing treatment using a non-CDL drug.

In short, they will not be affected by the new policy. For patients who have an IP or rider that is currently covering their non-CDL treatment costs, the coverage will be preserved until Sept 30, or upon their next policy renewal, whichever is later.

There has been feedback that under the new policy, the coverage for cancer drug services was inadequate. MOH has taken in the feedback, reviewed the coverage, and tripled the MediShield Life coverage limit to $3,600 per year.

Another question is whether the new policy will cover combination treatments where a few drugs are used. For cost-effective combinations, the treatment is subsidised and the MediShield Life limit is sized to cover the entire combination, and not just one drug. 

However, combinations that are non-cost-effective are not subsidised and accorded MediShield Life claim limits which are typically pegged to the cost-effective alternative. Hence, if coverage for combination drugs is not adequate, it is because they are non-cost-effective, rather than due to a flaw in the policy design.

There is also a common concern that monthly MediShield Life limits are insufficient if treatments are, say, twice a month. In fact, for a cost-effective treatment, the current limit is already sized to cater to two cycles in a month.

Finally, should patients face affordability challenges, MOH will facilitate direct transfers of patients who wish to seek subsidised care at public healthcare institutions, where treatments would be more affordable. No one will be denied appropriate care due to an inability to pay.

Lydia Loh
Director (Finance Policy)
Healthcare Finance Group
Ministry of Health