Circumstances for Inclusion of More Efficacious Medicine in Rare Disease Fund

Ms Nadia Ahmad Samdin asked the Minister for Health (a) whether there are circumstances where the more efficacious rather than cheaper medicine can qualify for inclusion in the Rare Disease Fund; (b) if so, what are these circumstances; (c) what threshold of acceptable evidence that the medicine is likely to substantially extend a patient's lifespan and improve their quality of life is required; and (d) whether the Government will consider creating a tiered support model which provides partial support for treatments that can be more efficacious but may not be the cheapest available.

A small number of patients are, unfortunately, inflicted with rare diseases every year. The treatments are often expensive, lifelong, with varying efficacies.

Healthcare financing systems are not designed to support such treatments and, hence, the Government established the Rare Disease Fund (RDF) for these patients. It is a charity fund that provides long-term financial support for Singapore Citizens with rare genetic diseases. The Government tops up $3 for every $1 raised. It is overseen by an independent RDF Committee comprising community representatives and advised by a panel of medical experts which determines the medicines to list for coverage as well as the amount of financing support for each application.

A key consideration of the Committee when evaluating applications is the effectiveness of the treatment in extending a patient's lifespan and improve their quality of life. This can vary across each rare disease, given their uniqueness and complexity. Further, given the limited size of the fund, the benefits have to be weighed against the cost of the treatment.

For treatments that are supported, the Committee then determines the quantum of support. So, in effect, a tiered support model, as suggested by the Member, is in place.

As more funds will be needed to enable more medications to be listed and conditions covered, we encourage members of the public to support RDF with their donations. Donations attract three-for-one Government matching and are eligible for a tax deduction of 2.5 times the donation amount.