Understanding cancer treatments and the Cancer Drug List (CDL)

Cancer, a disease that impacts millions worldwide, is also a significant concern in Singapore, where two in five Singaporeans may face a cancer diagnosis at some points in their lives¹. The good news is that the recovery rates for cancer have improved over the years, indicating that overcoming cancer is possible with proper treatments.

In September 2022, the Ministry of Health (MOH) introduced a new Cancer Drug List (CDL) with the aim of making cancer treatments accessible and affordable in Singapore.

Let’s learn about cancer treatments and how the Cancer Drug List (CDL) has changed financing for different cancer treatments. We’ll also share what you can do if a particular cancer drug is not included in the Cancer Drug List.

Types of cancer treatments available for cancer patients

Today, doctors have a range of treatments to combat cancer, including chemotherapy, radiation therapy, surgery, hormone therapy and biological therapy².

When determining the appropriate course or combination of treatment, doctors consider various factors relating to the cancer, such as the type, location and stage of the cancer. Oftentimes, they also look at a patient’s age, general health and other relevant considerations to determine a treatment’s suitability.

Interestingly, treatment options can differ between patients who have the same or similar type of cancer. This is because each person’s cancer may have unique characteristics and subtypes, which therefore influence treatment recommendations³.

What is the Cancer Drug List

The cost of cancer care in Singapore has been on the rise. Between 2017 and 2020, the amount of money Singapore spent on cancer drugs increased by approximately 20 percent each year, and costs are projected to continue upwards⁴.

In response to this concern, the Ministry of Health (MOH) in Singapore introduced the Cancer Drug List (CDL)⁵, alongside other changes to the financing of outpatient cancer treatments, to help ensure cancer treatment costs and insurance premiums remain affordable for Singaporeans in the long run.

Based on the changes, only cancer drug treatments on the Cancer Drug List are eligible for claim under MediShield Life, MediSave and Integrated Shield Plans (IPs).

Additionally, the claim limits per month for these treatments are tiered to more accurately reflect the varying costs of different treatment options.

With the Cancer Drug List, MOH has been able to work with the pharmaceutical companies to secure better prices for commonly used and effective cancer drugs⁶.

Cancer treatment with approved Cancer Drug List (CDL)

The Cancer Drug List comprises clinically proven and more cost-effective cancer treatments for specific cancers. Presently, more than 90% of the drug treatments⁷ approved by the Health Sciences Authority (HSA) are listed on the CDL.

The health ministry will update the list every four months and continue to work with drug companies to expand the list of drug treatments on the CDL.

Why is my cancer drug not in the Cancer Drug List?

The exclusion of certain cancer drug treatments from the Cancer Drug List can be due to several reasons. These treatments have a range of clinical effectiveness, and/or varying levels of inclusions by drug regulators and clinical guidelines.

For instance, a particular cancer drug might be registered with HSA, granting its authorisation for use in Singapore. However, if it lacks registration for treating a particular type of cancer, it may not be listed in the Cancer Drug List for that specific indication.

As an illustration, in Singapore, it was reported that there is a brain cancer patient receiving treatment with a drug approved for lung cancer, not brain cancer. Under the new financing changes, this drug will no longer be covered for brain cancer.

In some cases, the exclusion could be a result of limited evidence supporting the drug’s clinical effectiveness or the treatment might be considered experimental in nature.

What should I do if my cancer drug treatment is not in the Cancer Drug List?

If you find yourself in a situation where your doctor suggests a cancer drug treatment that is not in the Cancer Drug List, you might wonder what steps to take next. MOH has provided a brief guideline on what you can do in such a situation.

These are some possibilities that might happen:

1. As the Cancer Drug List is regularly updated and expanded, your drug treatment could potentially be included in the list in the future.
2. If non-CDL treatments are still required, you may have private insurance plans, such as IPs or critical illness or cancer insurance that may provide you with payouts that could be used to cover the costs of your cancer treatment.
3. You may explore subsidised care options at Public Healthcare Institutions (PHI), where additional financial support, such as MediFund, is available.

Enhance your cancer coverage with critical illness insurance

Looking for additional financial protection for cancer? Critical illness insurance, such as cancer insurance, can serve as a safety net that alleviates the financial strains of cancer diagnosis and treatment.

In the event you get diagnosed with cancer, your critical illness or cancer insurance plan will usually pay out in a single lump sum and you can use it to supplement out-of-pocket medical bills not covered by MediShield or IPs, support you and your family as a form of income replacement, or meet other financial responsibilities. This way, you are supported financially and can focus fully on recovery.

FWD offers the most⁸ number of critical illness insurance plans available online, with a wide range of plans that provide coverage for cancer. Get a quote for any of FWD’s critical illness plans instantly and be covered in minutes.