Extending Medisave300 To HPV Vaccination

02 Oct 2010

1. Medisave was designed to help Singaporeans pay for their hospitalisation expenses. In recent years, we have liberalised it to help cover some costly vaccinations and the treatment of common chronic diseases at the outpatient level.

2. In order to preserve the original purpose of Medisave, we limit the withdrawal from Medisave for vaccination and chronic disease management to $300 per Medisave Account per year. We refer to this as Medisave300.

Positive results

3. Medisave300 has benefitted many Singaporeans. Last year, more than 100,000 patients withdrew more than $23 million from their Medisave accounts under Medisave300.

a. Outpatient Treatment of Chronic Diseases: Patients with any of the eight common chronic diseases (diabetes, high blood pressure, stroke, lipid disorder, COPD, asthma, schizophrenia and major depression) can use Medisave300 to help pay their outpatient bills. In 2009, 96,000 patients withdrew $22.5 million under Medisave300 for this purpose. This has reduced their out-of-pocket expenses. It has also enhanced their health outcomes, as their treatment must follow international best practices to be eligible for claims under this scheme.

b. Vaccinations: Singaporeans can withdraw under Medisave300 for the Hepatitis B and pneumococcal vaccinations. In the last two months of 2009, 5,570 patients withdrew $755,000 under Mediave300 for this purpose.

Human Papillomavirus vaccination

4. From Nov 1, Medisave300 will be further extended to cover the vaccination against the Human Papillomavirus (HPV) which causes cervical cancer. Among Singapore women, cervical cancer is the sixth most frequent cancer and eighth most frequent cause of cancer death. It is generally treatable when detected early. Most cervical cancer is caused by HPV, but not all.

5. The Expert Committee for Immunisation (ECI) has reviewed the HPV vaccines and has recommended the inclusion of the HPV vaccines in the National Childhood Immunisation Programme (NCIP) for women aged between 9 and 26 years (age range as recommended by the vaccine manufacturers) as a preventive measure against cervical cancer. The recommendations were based on the fact that HPV vaccination has been internationally proven to be clinically effective and safe. Each HPV vaccination will require three doses. A/Prof Helen Oh, then Chairperson of the ECI said: “The Committee has reviewed the evidence and recommends HPV vaccination to prevent cervical cancer. However, women who have been vaccinated should still go for regular Pap smears, as vaccine protection is only about 70%.”

6. School-based immunisation will however not be offered. Instead, we will advise the primary care doctors to raise the ECI recommendation with young female patients and parents with young girls. Immunisation can be done at GPs and polyclinics.

7. Under the Medisave300 scheme, patients can use up to $300 per Medisave account per year to pay for HPV vaccines. Patients can use their own Medisave or that of their immediate family members (e.g. parents or spouse) to help pay for the vaccination. Needy patients with insufficient Medisave balances can seek special financial assistance at the polyclinics.

MINISTRY OF HEALTH