Blood cancer patients could pay less for outpatient treatment

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Panel reviewing MediShield Life for blood cancer patients

Blood cancer patients may be able to pick a cheaper option for bone marrow transplants as a panel looks at whether MediShield Life should cover outpatient treatment.

Currently, many opt to stay in hospital for costlier treatment as the insurance covers only inpatient bone marrow transplants.

But the MediShield Life Review Committee will look at whether the cover should be extended to outpatient treatment, said the Ministry of Health (MOH).

The National University Cancer Institute Singapore has been offering outpatient stem cell transplant treatment for myeloma or blood cancer patients since 2011. But its director, Professor Chng Wee Joo, said the bulk of patients taking this up have been foreigners.

Locals have been deterred by the high out-of-pocket expense that comes with outpatient care.

Treatment for a private patient is $40,000 if he is warded, and $25,000 if it is done as an outpatient. For subsidised patients, these amounts drop to $12,000 and $8,000, respectively.

But only inpatient treatment is covered by MediShield Life (or an Integrated Shield Plan for private patients). The only outpatient cancer treatments that MediShield Life covers are chemotherapy and radiotherapy.


So for outpatient stem cell transplant, only the day surgery to insert a catheter is covered by insurance, and since the amount is less than the annual deductible, the patient is unlikely to get any coverage.

Since July 1 last year, Medisave allows up to $2,800 to be used for outpatient bone marrow transplant, which is needed for treatment of myeloma.

It was one of the tweaks MOH made to ensure that rules do not get in the way of, and regulations do not hinder, the better provision of healthcare.

But since no change was made to insurance coverage, most patients are still opting for the more expensive inpatient treatment as this requires no cash outlay.

The MOH spokesman told The Straits Times: "As outpatient bone marrow transplant has recently become a more established and safe substitute for inpatient cancer treatment, the MediShield Life Council will consider including coverage for such treatment, as part of their regular reviews."

But any change would take some time, as the next review is not expected soon.

Prof Chng plans to expand the outpatient stem cell treatment to lymphoma patients this year and hopes they will have insurance coverage. He also wants to shift more cancer treatments to the patient's home or to community settings, such as at polyclinics, as this benefits both hospital and patient.