New Approved Cancer Drug List: How Will it Affect Your Insurance Plans?

Cancer treatment is a big industry where pharmaceutical companies are constantly researching and developing new cancer drugs. This enables cancer patients to try out alternative drugs that may be beneficial for their cancer treatment.

However, what this implies is that cancer treatment will get increasingly expensive as time goes by. Patients who are not recovered will continue to find new drugs to treat their cancer and some of these drugs can get expensive.

To combat the rising cost of cancer treatment, Medishield life council proposed to create a list of clinically proven and cost-effective outpatient cancer drug treatments that can be claimed by the Integrated Shield Plan (IPs). What this means for cancer patients is that they can only obtain the off-label medication by paying upfront without insurance subsidies from April 2023 onwards.

How MediShield Life Payout Works

Before we dive into the impacts, we need to understand how MediShield life payout works. The payout essentially had a monthly maximum cap of S$3,000. This cap creates an upward pressure on drug prices which can make premiums more expensive in the long run.

The problem is that there are public hospitals, but drug companies are for-profit and it is beneficial for them to charge higher prices to maximise the monthly cap. As drug prices increase, this brings about hardship for patients. If the situation is permanent and drug prices are very high in the developed world, patients would have to pay more out of pocket and pay expensive premiums to cover the drug cost.

To control this effect, relevant authorities have to step in to ensure that prices do climb too much and healthcare is not discriminated against by the ability to pay.

More Patients Getting Cancer Treatment

As a result, the government has stepped up its subsidies effort to cover the drug bills of nearly 90% of subsidised patients. It aims to achieve this by changing MediShield Life payouts for drug costs from S$3,000 to a range of S$200 - S$9,600.

The approved drug list will also help to lower cancer drug costs as pharmaceutical companies will have to either lower their prices to make the list or stand to not earn from most cancer patients.

How This Can Be a Double-Edge Sword for Long-Term Patients

Some patients, however, will be disadvantaged. If the patient requires a different drug that is not under the approved list, they will not be able to claim from MediShield Life or IPs. This could mean coming up short on drugs which they have used previously due to the financial difficulty of obtaining them.

For example, Mr Zhang Chang Hua is a 42-year-old who has brain cancer. Over the years, he has relapsed twice and gone through three surgeries before his cancer became a high-grade cancer, spreading quicker than before.

They went to a private hospital since he has a private hospital IP. There, the doctor prescribed Dabrafenib for My Zhang. Dabrafenib was approved in Singapore for lung cancer, melanoma and thyroid cancer, but not brain cancer. The drug turned out to be effective for Mr Zhang and he has not relapsed in a year.

However, with the new policy in place, he will not be able to get an insurance claim for Dabrafenib and will have to fork out S$20,000 for his monthly treatment cost.

Mr Zhang’s situation is rare, but unfortunately, they do happen which will create a lot of financial and medical complications for the cancer patient.

What Does This Mean for You?

As any concerned individual, you may wonder what will be the effect of this change. Ultimately, the new system allows for more people to receive subsidised cancer drugs, which is beneficial. Chances are if you are down with cancer, some of the regular drugs on the list will be adequate for your healthcare needs.

However, most of us are not foreign to the stories of cancer relapse or poor response to treatment like in Mr Zhang’s case. What if situations like Mr Zhang were to happen to you? Can you live with the fact that should this situation arise, you may not get the alternative cancer treatment you want due to the cost? If not, should you do something about it?

What Should You Do If You Want Additional Coverage?

If you have purchased third-party IPs, you will not be covered for the differentiated drugs, not on the list. This is because IPs are paid with Medisave. You can opt to buy riders on top of your IPs. They will be covered for external drugs with the rider as the rider is paid by the policyholder in cash.

Other than riders, you can also purchase third-party critical illness or cancer insurance.

Read More: Best Critical Illness & Cancer Insurance in Singapore 2022

Recommended Insurance

FWD Cancer Insurance

FWD cancer insurance is an affordable yet high-value plan that will assure you 100% of your cancer treatment. Unlike traditional critical illness insurance, FWD provides high coverage for cancer-specific treatment. If you have private IPs but are currently looking for affordable cancer coverage, then FWD cancer insurance would be a great choice for you. FWD also has regular promotions to make your premiums more affordable.

Etiqa 3 Plus Critical Illness Plan

Etiqa Big 3 Critical Illness plan is unlike any other critical illness plan as it focuses on cancer, stroke and heart attacks. Its premiums are 50-66% cheaper than average compared to other standalone CI plans for most age groups. The unique selling point of Etiqa 3 Plus Critical Illness Plan lies in two areas: Complimentary Child cover and Special Conditions Benefits.

Critical Illness Riders

If you have a whole life or term life insurance, you can pair it with a critical illness to be covered for the various critical illnesses, especially cancer.

Etiqa Whole Life DPI Critical Illness Rider

Etiqa's critical illness rider is competitively priced compared to other whole life DPI and critical illness plan packages. For instance, the total cost of its up to age 70 whole life DPI and critical illness rider package is up to 15-20% cheaper than the industry average. Etiqa's critical illness rider covers 30 of the 37 critical illnesses.

FWD Term Life DPI Critical Illness Rider

Paired with FWD’s term life plan, the total premium will still be competitive. For instance, consumers looking for DPI plans with S$300,000-S$400,000 of death and terminal illness coverage will see base plan and rider premiums around 50% cheaper than the industry. Furthermore, FWD is also competitive for 20-year DPI plans, with its premiums around 25-35% cheaper compared to other 20-year plans on the market.

Conclusion

This new change is set to benefit more cancer patients by keeping drug costs down and increasing subsidies. What if the drugs on the current drug list don’t work? Imagine having to fork large sums of money out of your pocket for a different cancer treatment just because the drugs are not on the approved drugs list.

Let’s not leave any question marks on your health and insurance coverage by getting critical illness or cancer insurance. If you have life or IP insurance, consider purchasing a critical illness or cancer rider for your existing plans.

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