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Forced to pay for cancer drug when rules changed after starting treatment

5 August 2024

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We refer to Mr Roy Tan Choon Kang’s letter “Forced to pay for cancer drug when rules changed after starting treatment” (July 31).


The Cancer Drug List (CDL) is a list of clinically proven and cost-effective treatments, introduced to keep cancer treatments affordable and enable the Ministry of Health (MOH) to negotiate better prices with drug companies. Some drugs may apply for a specified duration for specific conditions, beyond which, based on available studies, are not expected to continue to remain clinically effective. 


To clarify, MOH did not retrospectively apply the CDL policy. In fact, the policy applies only to prospective claims from the date of implementation – September 1, 2022, for MediShield Life, and Integrated Shield Plans (IP) renewed on or after April 1, 2023.


To support patients in transition who were already undergoing treatment at the time of implementation, IP insurers continued their coverage until September 30, 2023. Insurers will also extend support beyond this timeframe on a case-by-case basis.


Mr Tan was on a CDL treatment with a specified duration of effective use of two years. Hence, from March 2024, when he reached the two-year mark, continued coverage of the drug ceased. 


Nevertheless, his insurer reviewed his case and informed him on July 26 that it would provide partial support beyond the two-year mark. 


Mr Tan is being treated at a private clinic. If he requires further support, he can consider transferring to subsidised care, where treatment is more affordable and other support is available. 


The CDL is necessary to stem the escalating costs of cancer drugs, to keep them affordable for Singaporeans. Since its introduction, prices have fallen by 30 per cent on average, and over 60 per cent for some drugs. Manufacturers know insurers will no longer pay unless the drugs are priced fairly and administered appropriately.


Today, there are 376 clinical indications listed on the CDL, an increase of over 50 indications since it was introduced.


MOH will continue to encourage manufacturers to lower their prices, so that we can expand the CDL to benefit many more patients.


Sarah Leong

Director, Finance Partnerships and Governance

Ministry of Health