Reasons for Decline in Cancer Mortality despite Rising Diagnoses

Mr Yip Hon Weng asked the Coordinating Minister for Social Policies and Minister for Health regarding the 21% decline in cancer mortality since 2012 despite rising diagnoses (a) what specific policy decisions or healthcare investments does the Ministry assess as most responsible for this improvement; and (b) how has the Ministry ensured these benefits reached lower-income and less health-literate Singaporeans equally.

The Minister of State for Health (Ms Rahayu Mahzam) (for the Coordinating Minister for Social Policies and Minister for Health): Mr Speaker, advances in healthcare have led to earlier cancer detection and better treatment. They have lowered cancer mortality and have benefited all cancer patients, especially in systems like Singapore, where there is universal access to healthcare.

That said, more work needs to be done especially in cancer prevention to modify risk factors such as smoking, unhealthy diet, lack of physical activity and alcohol consumption, encourage vaccinations that reduce the risk of specific cancers and detect the onset of cancer early through screening.

Mr Speaker: Mr Yip.

Mr Yip Hon Weng (Yio Chu Kang): Thank you, Mr Speaker. I thank the Minister of State for her reply. I understand that drugs included on the Cancer Drug List (CDL) are based on cost effectiveness thresholds. Can the Ministry clarify how these thresholds are set and how often are they reviewed? And secondly, has the Ministry assessed whether the access gap between patients relying on subsidies and those who can pay privately is widening and what would it cost to narrow the gap.

Ms Rahayu Mahzam: Mr Speaker, on the first question, the Member has already rightly pointed out that we assess for clinical and cost effectiveness of the treatments as well as clinical needs. We do not publish the thresholds as this will have impact on our negotiating leverage with the industry.

On the second question, actually, our subsidy framework is already poised and framed to support those from the lower-income groups. Those from the lower-income groups would already get a higher means-tested subsidy. This is the whole point of the CDL because it is really nudging towards affordability. We have already seen very good early results, we have seen a reduction in the price by about 30% on average and for some treatments, 60%. So, we already are seeing very good results. It means that there is more accessibility to these drugs.

There is nothing stopping the higher-income individuals from loading themselves with expensive insurance that actually covers all drugs. We cannot stop that from happening, that is a fact of life. But what we can do is to ensure that the most clinically effective, the most cost effective drugs are available to all.