The Background
Cancer is a critical illness in which some of the body’s damaged cells grow uncontrollably and spread to other parts of the body. It can start almost anywhere in the human body, which is made up of trillions of cells. Unfortunately, we are witnessing an increasing occurrence of cancer cases around the world over the years. During the period from 2014-2018, 74,536 cancer cases were reported in Singapore, according to National Cancer Centre Singapore.
Depending on the type of cancer you have and how advanced it is, the types of treatment you will have can vary. Some patients with cancer will have only one treatment. However, most patients have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. You may also have immunotherapy, targeted therapy, or hormone therapy. Regardless of which type of cancer treatment the person is subjected to, the medical costs can be huge and devastating. With MediShield Life, many Singaporeans patients can be relieved from the financial burdens resulting from these costly treatments.
The Changes
1) MORE CANCER DRUG TREATMENTS CLAIMABLE UNDER MEDISHIELD LIFE
As of 17 August 2021, the Singapore government had accepted some of the recommendations proposed by the MediShield Life Council, which was set up to review the MediShield Life scheme to ensure that it is in line with the intent of the scheme. These are the accepted recommendations:
- Creation of a positive list of clinically proven and cost-effective outpatient cancer drug treatments,
- Enable the list of cancer drug treatments to be claimable under MediShield Life, and
- Implement a granular scale of claim limits to provide better coverage based on the cost of each treatment.
These recommendations which will be effective in
September 2022, help to align the MediShield Life’s objectives to provide affordable healthcare services to Singaporeans by defraying high medical costs relating to cancer treatments. Insurers of Integrated Shield plans can ONLY cover treatments that are on the positive list and set claim limits for each cancer drug treatment. They must study their cost structures and adjusted to these changes by April 2023.
By creating this positive list of clinically proven and cost-effective outpatient cancer drug treatments and allow for the patients to claim the costs of these treatments from MediShield Life, this will allow these drugs to be purchased by Singapore from the drug manufacturers at more affordable prices so that the medical claim experiences can be managed more effectively. As a result of this cost management, it can further help us to maintain sustainable premium rates over time for MediShield Life coverage. This will slow down the pressure to increase the premiums of MediShield Life for future generations to come. Many developed countries had also adopted this approach to manage their own healthcare system.
These enhancements will cover 90% of existing treatments and will investigate treatments which are currently used commonly in the public, and yet to be registered with the Health Sciences Authority or are regarded as not cost-effective.
2) ALLOW MORE SINGAPOREANS TO PURCHASE SUBSIDISED CANCER DRUGS
Most Singaporean patients can purchase cancer drugs listed under the Standard Drug List (SDL) and Medication Assistance Fund (MAF) at subsidised rates. The Ministry of Health (MOH) set up MAF scheme to help patients who are facing challenges in paying for selected high-cost medications for certain medical conditions, including some cancer drugs. 55 more cancer drugs will be added into the SDL/MAF for Singaporeans to enjoy subsidised rates.
On top of this, there will be changes regarding the subsidy tiers to allow more eligible Singaporeans (in particular, those who fall under the monthly per capita household income between $2,800 to $6,500) to purchase approved drugs at subsidised rates. Please refer to the diagram below for further details.
(Source: MOH)
3) ADJUSTED CLAIM/WITHDRAWAL LIMITS FOR MEDISHIELD LIFE AND MEDISAVE
The claim/withdrawal limits for cancer drug treatments and services within MediShield Life and MediSave will also be adjusted respectively to allow more Singaporeans to afford costly cancer treatments.
Currently, a monthly claim limit of $3,000 had been imposed for all cancer drug treatments and services within MediShield Life. With effect from September 2022, the monthly claim limit will range from $200 to $9,600 to match the different types of cancer drug treatments administered based on the conditions and the positive list of clinically proven and cost-effective outpatient cancer drug treatments. An additional annual claim limit of $1,200 will be provided for cancer drug services such as scans, blood tests and doctor consultations.
The withdrawal limits under MediSave will be adjusted alongside with MediShield Life. The withdrawal limit for cancer drug treatments having a MediShield Life claim limit above $5,400 will be $1,200 per month, whereas the withdrawal limit for other treatments on the positive list will be $600 per month. An annual withdrawal limit of $600 will be provided for cancer drug services. For more details, please refer to the diagram below.
(Source: MOH)
The Impact
With the above changes to MediShield Life and MediSave, we will be expecting more Singaporeans be able to afford a wider range of cancer drug treatments at a lower cost to the claim experiences. This will help to lower the pressure to increase the premium rates to MediShield Life, extend the usage of MediSave withdrawals and will benefit everyone for the long-term sustainability in our national-wide healthcare system.
