SALE OF CYCLOSPORIN (Uniform pricing)

Mr Lau Ping Sum asked the Minister for Health whether a uniform pricing will be adopted for the sale of cyclosporin to all kidney transplant patients.

BG George Yong-Boon Yeo: Mr Speaker, Sir, only patients who had their kidney transplants done in the restructured hospitals and who are followed up as subsidised patients are subsidised for the cyclosporin prescribed to them to reduce the risk of organ rejection. Private patients who had their transplants done in the restructured hospitals as well as private hospitals are not eligible for the subsidy on cyclosporin.

Like all other medical services, the subsidy on cyclosporin is extended only to subsidised patients. There is no reason to extend the same subsidy to private patients who can afford to pay for the full cost of the kidney transplant either locally or overseas.

Mr Ling How Doong: Sir, my question is: why is there a distinction in Government policy in not subsidising people who have gone overseas for kidney transplants? It could be a case of hardship. Or they could have borrowed money and went for operation overseas and they came back. Why is there a distinction of not granting them subsidised cyclosporin?

BG George Yong-Boon Yeo: Sir, as I said earlier, if you are a private patient, whether in Singapore or overseas, then it is difficult for the Health Ministry to subsidise such patients. There is also a further reason why we do not encourage Singaporean patients to go overseas for kidney transplants. It is because there is a high risk involved. It is a known risk. For some of them, the operation goes bad. Some have died as a result. There is also HIV risk. And in many cases, we do not even know what are the sources of these kidneys. For this reason, it is not Government policy to encourage Singaporeans to go overseas to get kidney transplants done.

Mr Lau Ping Sum (Ang Mo Kio GRC): Sir, would the Minister agree that in some cases, the waiting period for transplants for dialysis patients is so long that they have very little choice but to go overseas? And in some cases, they have exhausted their savings in getting the overseas transplants. Would the Minister consider their application for subsidy more favourably?

BG George Yong-Boon Yeo: We have considered whether or not we should encourage Singaporean patients who are still waiting for kidney transplants to go overseas. But, on balance, we decided at the Health Ministry level that it is unwise to encourage Singaporeans to go overseas for such transplants, for reasons I have stated earlier. As for patients who could afford to go for overseas transplants and who come back and for reasons of life's fortunes are suddenly unable to pay for the unsubsidised cyclosporin, then they can always appeal for Medifund assistance.

Mr Heng Chiang Meng: Sir, may I ask the Minister what is the number of persons on the waiting list for subsidised kidney transplants?

BG George Yong-Boon Yeo: Sir, I do not have the number here. But if the Member were to table a Question, I will surely answer him.

Mr Heng Chiang Meng: Sir, may I presume that there is more than one person waiting, which means that not all people with kidney problems who want a transplant can get a transplant at subsidised levels. This means that some of them are forced to go to non-subsidised places. In such cases, may I ask the Minister to reconsider the policy of subsidy on cyclosporin?

BG George Yong-Boon Yeo: Sir, I think all over the world, in every country and in every society, there is a shortage in the supply of kidneys which are needed by renal patients. If we encourage Singaporeans to go overseas, say, to India or China or other countries, to get those kidneys, then obviously those kidneys are somehow diverted from their own societies to be given to Singaporeans. One can reasonably ask how such kidneys are obtained in the first place, because no Health Ministry in those countries is going to volunteer and offer such kidneys to Singaporeans for altruistic reasons.