Frequency of Cancer Drug List Reviews and Updates

11 Dr Hamid Razak asked the Coordinating Minister for Social Policies and Minister for Health (a) how frequently is the Cancer Drug List (CDL) reviewed and updated; and (b) what measures are in place to reduce the risk of Singapore lagging behind prevailing international standards of cancer care.

The Minister of State for Health (Ms Rahayu Mahzam) (for the Coordinating Minister for Social Policies and Minister for Health): Mr Speaker, my response will also cover Question No 93 raised by Mr Christopher de Souza from the 7 July 2026 Parliament Sitting.

The Cancer Drug List (CDL) mechanism enables the Ministry of Health (MOH) to negotiate better drug prices and keep cancer care affordable and sustainable for more patients over the longer term. Since the implementation of the CDL, we have managed to reduce cancer drug prices by an average of 30%, and up to 60% for some drugs.

MOH updates the CDL three times a year, in consultation with an expert committee comprising cancer specialists from public and private sectors. We take into consideration medical advancements, evolving evidence of clinical and cost-effectiveness and alignment with international standards of cancer care. Through this process, we have listed 400 drug-indication pairings, which is comparable to all the pairings approved in 2022, before CDL was implemented.

For patients that require cancer drugs not yet listed on CDL, there are avenues for financial assistance in public healthcare institutions on a case-by-case basis through MediFund.

Mr Speaker: Dr Hamid Razak.

Dr Hamid Razak (West Coast-Jurong West): Thank you, Mr Speaker. Sir, I ask this question because we know the statistics: one in four Singaporeans will be facing a cancer diagnosis by the age of 75.

I would like to ask if the Ministry tracks if there are cancer drugs, say, on a Food and Drug Administration- or European Medicines Agency-approved list that are currently not on our CDL, and also by extension of that, because companies may not be submitting some of these drugs because our market is small, whether there are other routes of applying for a drug to be evaluated for inclusion to the CDL, including that of clinician scientists locally or clinicians for their patients? Because they know that a particular recent trial or a research studies will be published, showing clinical benefit and efficacy for such drugs.

Also, by way of feedback, some clinicians have also given me feedback that despite drugs being on the CDL, some Shield providers and insurers are still asking our clinicians to go through onerous administrative processes of filling up forms and pre-approvals, which really takes time away from our clinicians from doing their clinical practice.

Ms Rahayu Mahzam: I note the Member's concerns and we are also equally concerned about the current situation of increasing prevalence of cancer. That is why we also put this in place to make sure that the cancer drug costs are kept in check.

On the question about tracking, yes, the Agency for Care Effectiveness (ACE) conducts horizon scanning to track approved drugs overseas and proactively identify priority drugs in consultation with the Cancer Drug Sub-committee and also engage companies to encourage them to put in the submissions.

On the other point, I also just want to highlight that, separately, we also have broader cancer research efforts to make sure that we are also kept abreast of development of new cancer drugs and treatments to keep pace with international standards. We have two National Cancer Centres – the National University Cancer Institute as well as the National Cancer Centre Singapore – so that we are kept abreast of some of the developments and new drugs that are in place.

I note the question about the submission aside from the default company submission. In certain instances, yes, the clinicians may directly submit requests to ACE to evaluate treatments for potential inclusion in the CDL. This is intended largely for treatments for very rare cancers, for example, where there are fewer than five to 10 patients per year where the treatment is not Health Sciences Authority-registered due to the very small patient numbers, but there is clinical need and the treatment has been approved by at least one reference overseas regulatory authority. In such cases, ACE may undertake an internal evaluation.

I also note the separate point the Member made about the administrative burden that the doctors and clinicians have to undertake. We could take that separately and we could see how best we could streamline those processes.