Data on Out-of-Pocket Spending for Chronic Diseases by CHAS Card Tier and Income Decile and Plans for Further Subsidies

Dr Wan Rizal asked the Coordinating Minister for Social Policies and Minister for Health for CHAS cardholders with chronic diseases, (a) what is the distribution of annual out-of-pocket spending by card tier and income decile; (b) what are the current utilisation rates and average unused balances; (c) what proportion of common chronic medications are in the Standard Drug List; and (d) whether there are plans to expand subsidies or reference pricing.

The Ministry of Health (MOH) does not have readily available data on the distribution of annual out-of-pocket costs, that is, after CHAS subsidy and MediSave, at the Community Health Assist Scheme (CHAS) clinics, by income decile and card tier.

The table below shows the annual post-subsidy amount for CHAS cardholders that utilised CHAS chronic subsidies in 2024. These amounts can be further reduced by MediSave through the MediSave 500/700 scheme.

MOH does not have data specifically on the number of CHAS, Pioneer Generation or Merdeka Generation cardholders with chronic conditions. Nonetheless, we observe that around 14% of the 2.7 million cardholders utilised CHAS chronic subsidies in 2024. Not all CHAS cardholders require chronic disease management. Those who require chronic disease management may not tap on CHAS chronic subsidies as they may be managing their care at other settings or may tap on other payment arrangements, such as employee medical benefits.

MOH reviews CHAS subsidies regularly, taking into consideration the out-of-pocket costs for patients after MediSave, to ensure that they are adequate amid rising healthcare costs.

Most common chronic medications are subsidised under the Standard Drug List and Medication Assistance Fund List.