Standardise “non-standard drugs”

MOH’s reply

Zao Bao, 5 May 2014

不时检讨标准药物名单以满足国人需要

答复

谨答复《联合早报·交流站》于4月28日刊登的周全生读者投函《应尽早将“非标准药物”标准化》：

标准药物名单（Standard Drug List）和药物援助基金（Medication Assistance Fund）这两项名单上所列药物，是从医疗上来说具有成本效益和重要的药物。政府为这两个名单上的药物提供津贴，确保人们能负担得起。

周先生建议定期更新标准药物名单，并把高疗效的“非标准药物”归入标准药物名单。卫生部不时检讨这两项名单上的药物，并在检讨过程考虑最新的医疗发展和证据。对慢性病如糖尿病、高胆固醇及高血压最有成本效益的药物，已经在名单上并获得津贴。另外，13种新药物，包括用来治疗儿童白血病和类风湿关节炎的药物，已在今年4月1日被加入上述两项名单。

被诊断需要服用不在名单上的非标准药物的病患，可以通过我们的援助计划得到津贴。需要进一步协助的病患，也可以向公共医疗机构内的医药社工求助。

卫生部

企业通讯副司长

严健辉

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MOH’s reply (translated in English)

Standard Drug List reviewed regularly to meet essential needs of Singaporeans

The Standard Drug List (SDL) and the Medication Assistance Fund (MAF) are lists of medications that have been assessed to be cost-effective and essential for medical care. The Government subsidises the drugs on SDL and MAF to ensure affordability for Singaporeans.

Mr Zhou had suggested for the SDL to be reviewed regularly, and for non-standard drugs with high efficacy to be included in the SDL. We would like to assure the public that the SDL and MAF are already reviewed regularly to take into consideration the latest medical developments and evidence. The most cost-effective drugs for chronic conditions, such as diabetes, high cholesterol, and high blood pressure, are already on the SDL or MAF and subsidised. For example, 13 new drugs, including drugs used in the treatment of childhood leukaemia and rheumatoid arthritis, were added into the SDL and MAF on 1 April 2014.

For patients who have been clinically assessed to require non-standard drugs that are not on the SDL or MAF, they can still receive subsidies for the drugs through our assistance schemes. Patients can also approach the medical social workers in our public healthcare institutions should they need further assistance.

Ministry of Health

Deputy Director, Corporate Communications

Dennis Yim

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Zao Bao, 28 April 2014

应尽早将“非标准药物”标准化

2014年04月28日

周全生

全国职工总会在本月初向独立终身健保检讨委员会提交一份报告，针对改善终身健保所存在的保费增加问题，提出了三大建议：一、改善现有的“可转移医药福利”，让员工在转换工作后可持续受保；二、提高雇主为加入专为公务员设计的保健储蓄兼门诊津贴方案的雇员所获得的额外1%保健储蓄缴交率；三、扩大终身健保所涵盖的慢性病种类的门诊费。

这三大建议能让受保的员工得到实惠是不在话下。但除此之外，职总还在终身健保之外，吁请卫生部“定期更新标准药物名单”，让更多常见的药物获得津贴，从而让病患真正能对高昂而有效的药物费用“负担得起”。这就是本文所要讨论的课题。

所谓的“标准药物”和“非标准药物”，即英文的standard drug和non-standard drug。换句话说，前者是受“津贴”的药物，而后者则是“无津贴的药物”。对享有公务员医药福利的公务员（在职或退休）来说，他们一般上在诊病后可免费获得“标准药物”的配给，但对“非标准药物”就得自掏腰包了，理由很简单也很现实，在市场经济运作下，那就是“一分钱一分货”，要自个儿买单的“非标准药物”，无论在品质和疗效上都比“标准药物”要好得多，这是不争的事实，连看诊的医生也不会加以否认。

但从病人的角度来看，他们求的是“有高疗效”的药物，而如果他们因“药价”问题得不到“高疗效”的药物来去病，那他们就得忍受更长的病痛缠身时间，小处看是拖累个人的家计生活，大处看是影响国家的经济和劳动生产力。

卫生部当局何不来个改弦易辙下个狠招，早日把“非标准药物”标准化，让病人能获得疗效较高的药物，早日让病体康复，回到生产队伍，而对年长或退休病人而言，早日让他们康复也是间接减轻国家对他们的医疗负担。这其实对病人个人以及国家社会都未尝不是件好事。

总之，我个人支持职总呼吁卫生部“定期更新标准药物名单”，我更认为卫生部应尽早把非标准药物加以标准化，特别是长期病，如三高（高血糖、高胆固醇及高血压）需要长期服用的药物，让病人能取得免费或获得大幅津贴的有高疗效药物来治病，早日恢复健康身体，少受病魔的折腾，这才是政府对建国一代最大和最能立竿见影的医药福利照顾。

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(Summary of letter translated in English)

Standardise “non-standard drugs” 

Mr Zhou Quan Sheng (hanyu pinyin) commented on NTUC’s report to the MediShield Life Review Committee, and supported the NTUC’s suggestion to review the Standard Drug List (SDL) regularly. He opined that “non-standard drugs” seem to be better than “standard drugs” in terms of quality and outcomes. Patients hope for drugs with better outcomes, but if they are not able to get such drugs due to prices, they would have to bear with their medical conditions for a longer time, and this would not only affect their work, it might even affect the country’s economy and productivity. He suggested for MOH to include the “non-standard drugs” into the standard drug list, so that patients can get drugs with better outcomes and return to the workforce earlier. To the aged seniors or retirees, recovering sooner also mean easing their healthcare burden. He felt that MOH should include non-standard drugs in the SDL, especially those for chronic diseases.