Cancer patients may have to pray, not just for them to get well but also that their treatment is included in the Cancer Drug List (CDL) after changes to the Integrated Shield Plans (IPs) take place this April or eventually.

This is what I understood from Health Minister Ong Ye Kung’s written reply to the parliamentary questions asked by Mr Chua Kheng Wee Louis, MP for Sengkang GRC on 23 February.

Mr Chua inquired about the CDL and the changes to IPs that would take effect on 1 April 2023. He also asked about the number of cancer patients currently on a course of cancer drug treatment based on drugs not on the CDL and the measures that would be put in place for such patients whose IPs’ coverage would cease from 30 September 2023.

In August 2021, the Ministry of Health (MOH) established a Cancer Drug List (CDL) that includes clinically proven and more cost-effective treatments, and made changes to MediShield Life, MediSave, and IP coverage.

From 1 September 2022, subsidies for clinically effective and cost-effective cancer drugs will be extended through the Medication Assistance Fund at Public Healthcare Institutions.

However, starting 1 April 2023, IPs will no longer provide coverage for cancer treatments beyond the CDL. This means that patients may need to switch to CDL treatments that are covered, purchase private insurance products such as IP riders or critical illness plans, or opt for subsidized care at Public Healthcare Institutions if they require non-CDL treatments and face affordability issues.

I am rather confused by Mr Ong’s reply on cancer treatment regarding the CDL.

The reply suggests that “most patients would have completed their treatment with non-CDL drugs by 30 September 2023.” However, it’s unclear what percentage of patients this statement is referring to.

According to Mr Ong, there are a few possibilities for those patients whose treatment will extend beyond 30 September 2023.

First, as the CDL continues to expand, it may include their treatment by then.

Second, doctors and patients may consider switching to CDL treatments that are clinically proven and more cost-effective.

Third, if non-CDL treatments are still needed, they may still be covered by private insurance products, such as IP riders or critical illness plans, that they previously purchased.

Fourth, patients who require non-CDL treatments and face affordability issues may opt for subsidized care at Public Healthcare Institutions. There, they may apply for additional support, such as MediFund.

I am confused by this reply.

Does this mean that I must hope that my “now excluded drugs” will become “included” by the end of September?

Does this mean that I must hope that I have the type of cancer that is eligible for “approved drugs”?

If I already have cancer, how is it possible to get any insurance company to cover my treatment through riders or critical illness plans?

Does this mean that patients who are currently in good health should purchase insurance coverage through riders or critical illness plans so that they will be covered if they are diagnosed with an eligible type of cancer in the future?

If a patient’s cancer is “not included” in the first place, how is it possible to opt for subsidized care? How is it possible to apply for support from MediFund?

Does MediFund provide support for “not included cancer drugs”? Or does it mean that if my cancer is “not included,” I should switch to “included” treatment, and if I am unable to pay, I can opt for subsidized treatment and apply for MediFund?

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