Update on Work of Agency for Care Effectiveness

Prof Fatimah Lateef asked the Minister for Health (a) whether he can provide an update on the work of the Agency for Care Effectiveness (ACE), in particular, how the appropriate care bundles and drug guidance have been implemented; and (b) how many issues have the agency reviewed since 2015.

The Agency for Care Effectiveness (ACE) was established in 2015 as our national health technology assessment agency to facilitate the adoption of clinically effective and cost-effective care. ACE's evaluations are published as Drug or Medical Technology Guidances, as well as Appropriate Care Guides for doctors and patients. Its evaluations are also taken into account in the Ministry of Health's (MOH’s) decision on the extension of public healthcare subsidies. Drugs and medical technologies evaluated to be both clinically effective and cost-effective are subsidised.

Over the last three years, ACE has completed 62 technical evaluations of health technologies. ACE also published 28 Drug Guidances, and two Medical Technology Guidances. In addition, ACE produced nine Appropriate Care Guides focused on effective primary care for chronic diseases, such as diabetes and chronic obstructive pulmonary disease. ACE has prioritised health technologies and medical conditions which are of high impact to patients and our healthcare system.

MOH tracks the uptake of health technologies that have been evaluated to be clinically effective and cost-effective, and it has been on an uptrend versus alternatives that are less effective. For example, dapagliflozin was evaluated by ACE and subsequently included as a subsidised drug for Type 2 diabetes in early 2017. The usage share of dapagliflozin relative to alternatives increased from 40% in 2016, to 65% in 2017.

In addition to their work in health technology assessment, ACE also negotiates with manufacturers for fair prices for selected health technologies. ACE’s work in this area has helped to improve access and affordability of healthcare services.

ACE will continue to work on increasing the impact of its work so as to enable Singaporeans to have access to clinically effective and cost-effective health technologies.