SPEECH BY MR ONG YE KUNG, MINISTER FOR HEALTH, AT THE SINGAPORE CANCER SOCIETY 60TH ANNIVERSARY, 17 FEBRUARY 2024, 2.45PM, OUR TAMPINES HUB

Dr Koh Poh Koon, Senior Minister of State, Ministry of Sustainability and the Environment & Ministry of Manpower

Mr Lee Meng Tat, Chairman, Singapore Cancer Society (SCS)

Mr Albert Ching, Chief Executive Officer, SCS

Dear friends and colleagues,

Good afternoon. We are in the midst of the Chinese New Year so I wish everybody a good Year of the Dragon, and good health and happiness.

2.             Most of us have met cancer. Some of you are fighting it and recovering from it, while others have lost their loved ones and friends, or seen them having to undergo cancer treatment and fighting the disease. All of us feel strongly about it. Cancer is the number one killer in Singapore. But as I listened to a very comprehensive report by Meng Tat, I think that in short, the way we tackle cancer going forward can be summarised in four ways - what I call ‘PASS’. I think we will pass this test.

Cancer Prevention

3.             The first ‘P’ is prevention. I think a lot more can be done for prevention. We launched Healthier SG, and I believe that with its momentum, it can help a lot of us prevent cancer. Take for example, a prostate cancer survivor whom I was just talking to about how to prevent prostate cancer. With Healthier SG, the doctor whom you have enrolled with will be nagging at you to go for your blood test once every two years, and the levels of prostate specific antigen (PSA) will be measured. For those with enlarged prostate, we will sieve out your results and ask you to go for further tests. For ladies of a certain age, a mammogram will also be encouraged.  Within the healthcare system, we are making these tests free of charge under Healthier SG. I believe that we can make a big difference in terms of preventive care.

4.             We ourselves can play a role. The steps are simple, cheap and money saving. Things like sleeping better costs you nothing. The second is eating better, which does not mean eating organic food. It means consuming less fat, salt and sugar, and eating more vegetables. If you eat like that, you will save money. Having friends, spending time, having a positive disposition – all these are very positive preventive steps. I hope that all of us can do it.

Affordable and Accessible Cancer Treatment

5.             ‘A’ is making cancer treatment accessible and affordable. We have good subsidy support for all cancer patients, including MediShield Life and insurance. At the same time, we have to make sure that the cost does not run away from us. For a long time, the cost of cancer treatment was running away from us. When we examined it, we realised that it was partly our fault because out of good heart and good intention, we decided to subsidise more and cover insurance more. But when you subsidise more and cover insurance more, the costs go up at the same time, and it negates the effect. We need to be quite careful where it comes to healthcare. Sometimes, more subsidies equal higher costs, and we will end up chasing our tail.

6.             Last year, we designed a policy on the Cancer Drug List. It is a very difficult policy to explain and implement, but we implemented it. How it works is that not all cancer treatments will have subsidies and insurance. They must be in the Cancer Drug List that the Ministry of Health (MOH) will draw up. How do drugs get into the List? Your price must be reasonable. There are some countries paying X dollars, but we are paying three times more. These will not be in the Cancer Drug List. Overnight, the prices started dropping, and the medications started getting into the Cancer Drug List.

7.             As a result, we are seeing a significant drop in cancer cost. Some of the treatments have dropped by as much as 60%. On average, the costs have dropped by about 30%. Of course, when we do that, some of the drugs that used to be supported are no longer in the Cancer Drug List.  We know that these transition cases are difficult. At MOH, we do what we can to support these patients.

8.             The Cancer Drug List started in August 2022. There were then 360 indications approved by the Health Sciences Authority (HSA), and supported by subsidies and insurance. Today, there are 365 indications in the Cancer Drug List with lower prices. Of course, this may not be an entirely fair comparison because some of the initial 360 drugs did not make it to the current Cancer Drug List. Nevertheless, what we are seeing is that there are more drugs, and more choices for patients and oncologists, and at lower prices. Hence, affordability is what we strive for, but the lesson here is that sometimes, we have to implement sensible but difficult policies in order to bring about affordability. Insurance does not always ensure affordability, and can in fact push up cost.

Cancer Science and Research

9.             The next ‘S’ is science. The National University Cancer Institute, Singapore (NCIS), National Cancer Centre Singapore (NCCS) and  our oncologists use science and medicine to give the best possible treatment for our cancer patients. But as President Tharman Shanmugaratnam said in the video earlier, we are at the cusp of a moonshot in medical science – one that we can possibly see within our lifetime. It is a quantum leap in the way cancer is treated, by using our own immune system to fight cancer. It means taking out your cells, putting in a weapon, cultivating the cells, and putting them back into the patient. The weapon will then kill the cancer cells but not your normal cells. All these will be possible.

10.          We are investing a lot in the science, as well as research and development for this sort of treatment. We call it cell, gene and tissue therapy, which is part and parcel of precision medicine. There is a lot of research money going into it, and we are developing the science as part of the global community. We have consolidated a production facility for Cell Therapy, which is in NCSS. We hope that by consolidating it, we can be a Centre for production for such therapy, and hopefully over time, bring the cost down.

11.          The new treatments are very expensive. Every treatment can cost millions of dollars. Hence we have to be very careful as science progresses where there are such possibilities and the cost of treatment is high. These treatments cannot become treatments only for the rich. That is not how we work in Singapore. We must make sure that whatever is available, that whatever science can offer us must be available to everyone. Hence we have to think through how to make expensive but potential genetic and cell treatments available to everyone. That is one major policy that we have to look into. 

Support for Cancer Patients

12.          Finally, the last ‘S’ is support. This is what patients need the most. Patients need not just medical support, but also moral support – support from friends, support from their family, support from the environment around them, and support from their employer.

13.          I am very glad that Singapore Cancer Society, as Meng Tat has mentioned, has done so much throughout the years. This year is your 60^th anniversary, and I am glad to be here to kickstart the celebrations. We will give you the full support that you need to continue your good work. Happy 60th Anniversary. I wish everybody once again, good health. Thank you.