Decoding the Cancer Drug List:
5 Key Impacts on Integrated Shield Plans
Written by Dave Tay
18 May 2023
Prefer a more visual explanation? Check out the video for a more interactive dive into the topic.
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This article aims to provide fair and balanced information on cancer treatment coverage under MediShield Life and IPs and explore the impacts of the CDL changes on IP coverage.
Cancer remains the leading cause of death in Singapore (National Registry of Diseases Office, 2022), affecting thousands of Singaporeans every year and underscoring the need for accessible and affordable cancer treatment options.
Recent changes to the Cancer Drug List (CDL) for Integrated Shield Plans (IPs) have altered cancer treatment coverage, which may affect out-of-pocket costs for IP holders.
When considering health insurance products, it's important to make informed decisions based on your unique needs and financial situation. Be aware of the potential for misrepresentation by insurance representatives or firms when it comes to the Cancer Drug List (CDL) and treatments outside of it.
By carefully reviewing your coverage needs, you can ensure that any solution proposed is sustainable and affordable for the long-term.
How will these changes affect you or your loved ones, and what steps can you take to ensure you're prepared for the future of cancer treatment coverage?
Let's dive into the 5 key impacts of the CDL changes on IP holders and explore how to enhance cancer treatment coverage.
Oh, and if you're having trouble sleeping at night, we've included a list of references at the end of the article for some light reading!
Key Impact 1
The Big Change – Cancer Drug List & Cancer Treatment Coverage
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Previously, IPs with attached riders provided "as charged" coverage for outpatient cancer treatment, subject to annual limits and co-payment. However, under the new CDL classification framework, coverage will be based on the CDL limits, potentially impacting the out-of-pocket costs for IP holders. The CDL is a list of cancer drugs and treatments that are eligible for MediShield Life coverage. The list is regularly updated by the Ministry of Health (MOH) to include new drugs and treatments that are deemed effective and cost-efficient (Ministry of Health, 2023).
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Key Impact 2
Navigating Changes in Existing IP Coverage
IP policyholders should review the updated terms and conditions in their policy renewal packs, as the implementation of the CDL may affect coverage for cancer treatment. Under the revised terms, IPs might not provide "as charged" coverage for cancer treatment, with coverage being based on the CDL limits instead.
To address potential coverage gaps, policyholders may need to consider seeking advice from a financial consultant and carefully evaluating their options. This process may involve assessing the costs and benefits of purchasing an additional rider or a standalone insurance plan, while keeping in mind that there might be no gaps if policyholders are content with the changes and are satisfied with the treatment options within the CDL framework.
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The CDL implementation may influence doctors' choices for cancer treatment options, as they now need to consider CDL-listed drugs along with other factors, including patients' budget and insurance coverage. This additional consideration could potentially constrain doctors' choices and affect patients' recovery, as not all drugs on the CDL may suit a specific condition.
Furthermore, it is uncertain whether the CDL will be able to keep pace with the rapid advancements in medical technology. For example, an AI platform suggesting drug cocktails for relapsed lymphoma patients is set for a clinical trial (Goh et al., 2022), potentially offering more tailored treatment options in the future.
Mr Zhang Chang Hua's case (Khalik, 2022) highlights potential CDL impacts on individuals' access to non-CDL drugs effective for their condition. Diagnosed with brain cancer, Mr Zhang turned to private specialist Dr Daniel Chan, who prescribed an off-label drug approved for lung cancer but not brain cancer. Although his insurer covered the drug under his IP, he will soon be affected by the CDL limits. The drug costs $20,000 per month, exceeding his income, raising concerns for patients relying on off-label cancer drugs when regulations take effect.
If you are interested in reading more about his story, we've provided the link in the references section.
Key Impact 3
The Effect on Treatment Options
Key Impact 4
Addressing Coverage Gaps in Integrated Shield Plans
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The Cancer Drug List (CDL) plays a vital role in promoting the use of clinically proven and cost-effective cancer treatments, helping to keep MediShield Life and Integrated Shield Plan (IP) premiums more affordable for all Singaporeans (Lee, 2023).
The CDL also serves to manage healthcare costs by encouraging patients and doctors to opt for clinically proven and cost-effective treatments. Although riders of IPs may cover non-cost-effective treatments, these costs will be reflected in the rider premiums, rather than in MediShield Life and IP premiums.
However, it is essential to understand that the CDL may not encompass all cancer treatments, potentially leading to gaps in coverage under IPs. While IPs and their attached riders may offer varying additional coverage for CDL and non-CDL drugs, gaps may still exist, depending on factors such as cancer severity, doctor's advice, the type of CDL and non-CDL drugs prescribed, and the treatment duration. As such, individuals should assess their needs and consider the long-term affordability of plans when deciding whether to purchase any product to address coverage gaps. In summary, the CDL balances the need for affordable healthcare while ensuring access to effective treatments. It is recommended to seek advice from a financial consultant and request a comparison of available products before making any decision. This approach allows individuals to make informed choices about their healthcare coverage, considering their unique needs and financial situation.
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COMMON
MISCONCEPTIONS
Key Impact 5
Common Misconceptions about
IP Cancer Treatment Coverage
There are some misconceptions that may lead to misinformed decisions when it comes to cancer treatment coverage. Some of these misconceptions include:
Misconception 1
Assuming that all cancer treatments and insurancepolicies are created equal. Different cancer treatments have varying costs and effectiveness, and insurance policies from different insurers can vary significantly in terms of coverage, premiums, and other factors. It is important to discuss treatment options with a doctor and compare policies from different insurers to find the one that best meets your needs.
Misconception 2
Believing that insurance policies cover all cancer treatments and all costs. This is not always the case, as some insurance policies may have limitations on coverage or may only cover certain types of cancer treatments. Additionally, even with insurance coverage, there may still be out-of-pocket expenses, such as deductibles, co-payments, and non-covered services. It is important to carefully review the terms and conditions of an insurance policy before deciding and understand what expenses will be covered by insurance and what expenses you will be responsible for.
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Conclusion
Navigating the significant changes brought by the Cancer Drug List (CDL) is crucial for IP policyholders. Ensuring adequate coverage requires evaluating options, understanding potential coverage gaps, and seeking financial consultant advice. Staying aware of common misconceptions and regularly reviewing insurance policies is essential to avoid misinformed decisions.
With healthcare costs in Singapore expected to grow by 9.8% in 2023 (Singapore Business Review, 2022), taking proactive steps to protect yourself and your loved ones from the financial burden of cancer treatment is vital. We hope this article has provided valuable insights into managing these changes. Please share it to promote awareness and encourage informed decision-making.
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References
Goh, J., De Mel, S., Hoppe, M. M., Mohd Abdul Rashid, M. B., Zhang, X. Y., Jaynes, P., Ka Yan Ng, E., Rahmat, N. A. D., Jayalakshmi, Liu, C. X., Poon, L., Chan, E., Lee, J., Chee, Y. L., Koh, L. P., Tan, L. K., Soh, T. G., Yuen, Y. C., Loi, H.-Y., … Jeyasekharan, A. D. (2022). An ex vivo platform to guide drug combination treatment in relapsed/refractory lymphoma. Science Translational Medicine, 14(667). https://doi.org/10.1126/scitranslmed.abn7824
Khalik, S. (2022, June 27). Brain cancer patient treated with off-label drug frets over costs when insurance coverage stops in April 2023. The Straits Times. Retrieved April 19, 2023, from https://www.straitstimes.com/singapore/health/brain-cancer-patient-treated-with-off-label-drug-frets-over-costs-when-insurance-coverage-stops-in-april-2023
Lee, S. (2023, April 4). MOH WILL ACT TO MANAGE CANCER DRUG COSTS WHERE NECESSARY. Ministry of Health. Retrieved April 21, 2023, from https://www.moh.gov.sg/news-highlights/details/moh-will-act-to-manage-cancer-drug-costs-where-necessary
Ministry of Health. (2023, April 1). Cancer drug list. Ministry of Health. Retrieved April 19, 2023, from https://www.moh.gov.sg/home/our-healthcare-system/medishield-life/what-is-medishield-life/what-medishield-life-benefits/cancer-drug-list
National Registry of Diseases Office. (2022). (rep.). Singapore Cancer Registry Annual Report 2020. National Registry of Diseases Office. Retrieved April 19, 2023, from https://nrdo.gov.sg/publications/cancer.
Singapore Business Review. (2022, October 27). Rise in healthcare cost in Singapore expected to grow 9.8% in 2023: Report. Singapore Business Review. Retrieved April 19, 2023, from https://sbr.com.sg/healthcare/in-focus/rise-in-healthcare-cost-in-singapore-expected-grow-98-in-2023-report
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Important Notes and Disclaimers
This article aims to provide valuable insights on the changes to the Cancer Drug List and their impact on Integrated Shield Plans. However, it is not intended to be a substitute for professional advice. Before making any decisions, it is recommended to consult a qualified expert and refer to the latest terms and conditions of your policy.
Please be aware that the information provided is for general reference only and may not be exhaustive or up-to-date. While every effort has been made to ensure accuracy, errors and omissions are possible.
Furthermore, the article may not cover all the nuances of the Cancer Drug List and Integrated Shield Plans. For more detailed information, please refer to the Ministry of Health or contact your servicing Financial Consultant or financial institution directly.
By reading this article, you acknowledge and agree that you are solely responsible for your own decisions and actions, and that the author and publisher of this article shall not be held liable for any loss or damage arising from or in connection with the use or reliance on the information provided herein.
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