190124_ Artwork Cost of Cancer Treatment

Can You Afford Cancer Treatment? An Insight On The True Cost Of Cancer Treatment In Singapore

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19 Jan 2024

When I accompanied my relative to the National Cancer Centre Singapore, I found myself sitting next to an elderly couple who was waiting to make payment at the registration counter.

While my relative was lucky enough to have her treatment covered by insurance, the elderly couple beside me was not so fortunate.

In his seventies, the man passed whatever debit card he could find in his wallet just to have them all rejected by the system.

“My CPF?” he asked hopefully.

Just to have the lady at the counter shake her head and apologise.

That was when it hit me. This SH*T is REAL.

Seedly’s Fight Against Cancer

As part of Seedly’s social outreach, we have decided to partner with the Singapore Cancer Society to help Singaporeans in need.

The Singapore Cancer Society is a community-based voluntary welfare organisation dedicated to maximising life by minimising the impact of cancer through advocacy, public education, screening, financial assistance, patient services and support, and rehabilitation.

You can support our social cause here.

Support our cause! It doesn’t matter if you have $1,000 or $1 to give.

Every dollar matters.

All donations are channelled directly to the Singapore Cancer Society.

TL;DR: Treatment of Cancer Costs $8,000 to $17,000 per Month

To provide you with a quick overview, we referenced the release of the Singapore Cancer Registry 50th Anniversary Monograph.

Here are some facts about cancer in Singapore:

46 Singaporeans get diagnosed with cancer every day
This means that 16,790 Singaporeans are diagnosed with cancer per year
16 people die of cancer every day
This means that 5,840 of our loved ones die of cancer each year
Treatment of cancer per month is estimated to be between $8,000 to $17,000

The statistics above mean that one in four people in Singapore may develop cancer in his or her lifetime.

Click here to jump:

Number of cancers diagnosed each year
Top 10 cancers in Singapore
How much does cancer treatment cost in Singapore?
Subsidies for cancer treatment in Singapore

Editor’s note: This article is part of Seedly’s Social Outreach Campaign to raise funds for the Singapore Cancer Society. In case you are wondering, we are not sponsored to do so. This is purely to shed light and hopefully garner help for some of the less fortunate Singaporeans.

16 Singaporeans Die From Cancer Every Day

Cancer is actually something that is very real and close to us Singaporeans. In fact, cancer takes away 5,840 loved ones from families on a yearly basis in Singapore.

For every 3 deaths, 1 is attributed to cancer, making it the lead cause of death in Singapore.

Here’s a closer look at the numbers:

16,790 Singaporeans are diagnosed with cancer each year
An average of 46 Singaporeans receive the news that they are diagnosed with cancer on a daily basis
And unfortunately, 16 people passed on from cancer every day

Top 10 Cancers Amongst Singaporeans: Lung Cancer, Breast Cancer Etc.

Different genders are more prone to different types of cancer.

The type of cancer will impact your chance of recovery and the cost that comes with it, depending on the procedures required.

Here’s a breakdown of the top 10 cancers among male and female Singaporeans:

Source: Singapore Cancer Registry Interim Annual Report

Later-stage Cancer Cost An Average $100,000 – $200,000 Per Year

While it only takes seconds to receive the news of getting diagnosed with cancer, their world will be changed forever. Any dream right up to the point of diagnosis will not matter anymore.

As we were covering the true cost of healthcare treatment in Singapore, we noticed that the average cost of treatment is not readily available.

We worked together with the Singapore Cancer Society to get more information on the treatment cost for later-stage cancer. We discovered that it can easily range from $100,000 to $200,000 yearly. That works out to be $8,400 to $16,700 per month.

But the gross median income of an average Singaporean? $4,752.

Treatment for Early-stage Cancer Costs At Least $8,654

Early-stage cancer may involve certain procedures, including biopsy tests, chemotherapy and/or surgeries. And the cost of undergoing these procedures is not cheap at all, though they are heavily subsidised in public hospitals.

Here’s what the costs are:

Condition/Procedure	Median Costs	Remarks
Colonoscopy for diagnosis (with/without biopsy) Inpatient	$1,827 + Day Surgery: $576	Ward B2
	$1,365 + Day Surgery: $576	Ward C
	$7,063 + Day Surgery: $2,309	Private (Inpatient)
	$2,309 + Day Surgery: $2,309	Private (Clinic/Outpatient)
Day Surgery for Breast Cancer (Day surgery)	$958	Subsidised
Day Surgery for Breast Cancer (Day surgery)	$7,258	Private
Surgical Removal of Cancerous Growth in Breast and Underarm Lymph Nodes (Inpatient)	$2,339	Ward B2
	$1,709	Ward C
	$23,875	Private Hospital
Chemotherapy	$1,246 per cycle + Day Surgery: $75	Ward B2
Chemotherapy	$3,338 (Day Surgery)	Private
Radiation Therapy	$25,000 to $30,000	-
Immunotherapy	$9,000 per dose	Average cost for a year’s worth of treatment ranges between $156,000 and $234,000
Admission for Intestine/ Stomach, Gastrointestinal Cancer with surgery	$5,656	Ward B2
	$4,535	Ward C
	$39,796	Private
Admission for Intestine/ Stomach, Gastrointestinal Cancer to remove part of the end of the large intestine, and rectum	$5,972	Ward B2
	$4,641	Ward C
	$46,170	Private
Stomach, Liver or Pancreas cancer, but not very severe complications	$2,058 + Day Surgery: $902	Ward B2
	$1,451 + Day Surgery: $902	Ward C
	$7,461	Private
Surgery to remove entire prostate and surroundings	$9,182	Ward B2
	$10,324	Ward C
	$56,119	Private
Admission for Lung Cancer, but not very severe complications	$1,038	Ward B2
	$749	Ward C
	$8,841	Private
Admission for Lung Cancer, but not very severe complications	$2,889	Ward B2
	$2,374	Ward C
	$22,441	Private
Lung scope (Bronchoscopy) with biopsy and surgery to remove tissue	$2,997 + Day Surgery: $637	Ward B2
	$2,486 + Day Surgery: $637	Ward C
	$17,541 + Day Surgery: $4,258	Private
Endoscopy with/without biopsy	$1,655 + Day Surgery: $342	Ward B2
	$1,387 + Day Surgery: $342	Ward C
	$7,363 + Day Surgery: $1,850	Private (Inpatient)
	$2,139 + Day Surgery: $1,850	Private (Clinic/Outpatient)

Source: Ministry of Health, ‘Fee benchmarks and bill amount information’ published in 2021.

If someone you know was diagnosed with breast cancer, he/she would likely pay for the following:

Colonoscopy with a biopsy: $2,403 and $6,275 (depending on your choice of hospital)
Surgery: $958 to $23,875
Chemotherapy for residual cancer cells (and often requires multiple cycles): $1,321 and $3,338 per cycle. Typically, during a course of chemotherapy, the patient would have around four to eight cycles of treatment. And hypothetically, if one needs four cycles, the total cost would be $5,284 to $13,352.

It costs at least $8,654 when totalled up, not including other procedures such as endoscopy…

But Are You Financially Prepared for Cancer?

A recent joint study by DBS Bank, the National University Cancer Institute, Singapore (NCIS) and Research for Impact Singapore (RFI) on the financial readiness of Singapore residents to tackle cancer costs found that less than half of 1,200 Singaporeans (47%) surveyed feel they are not financially prepared to handle a cancer diagnosis.

The perception survey also found that less than a third of respondents (29%) are confident their existing insurance policies can cover the cost of cancer treatment.

The study’s researchers highlighted that a cancer diagnosis can have a substantial financial impact, particularly due to the costs incurred in medical care settings for treatments like chemotherapy, along with medications and procedures – which brings me to my next point.

Cancer Treatment Costs Still a Main Concern for Cancer Patients

In the field of oncology, financial toxicity refers to the adverse effects of the heightened financial burden brought on by a cancer diagnosis on the well-being of patients, their families, and society. This phenomenon is increasingly recognised as negatively influencing an individual’s quality of life.

It encompasses indirect costs such as income loss resulting from cancer-related disabilities, as well as the financial strain faced by family members providing care.

Why does this matter?

This directly affects available treatment options and, sometimes, for those who are struggling financially, whether to delay or receive treatments!

As Dr Jen Wei Ying, the clinical lead of the study and a consultant at NCIS’ Department of Haematology-Oncology, puts it:

“(The financial impact is) a real but poorly understood and infrequently acknowledged concern” in cancer care and survivorship.

Singapore Cancer Society And Government Subsidies for Cancer

MediFund

MediFund is designed to help Singaporeans who face difficulties with remaining medical bills after receiving government subsidies and other means of payment.

The assistance you receive depends on your financial status, the health conditions of you and your family members, social circumstances, and the medical expenses incurred.

To apply for MediFund assistance, you must:

be a Singapore Citizen
be a subsidised patient
have received or require treatment from a MediFund-approved institution and
be having difficulties paying for your healthcare bills after Government subsidies and other means, including MediShield Life, MediSave, and cash.

Medication Assistance Fund

The Medication Assistance Fund provides additional subsidies for costly medications not listed in the Standard Drug List but deemed medically necessary for eligible Singaporeans.

Here’s the current subsidy framework for drugs on the MAF list:

Revised MAF Drug Subsidy Levels
Monthly Per Capita Household Income (PCHI)*	SCs	PRs
$0 ≤ PCHI ≤ $2,000	75%	20%
$2,000 < PCHI ≤ $3,300	50%
$3,300 < PCHI ≤ $6,500	40%
PCHI > $6,500	0%*	0%*

*Monthly PCHI is computed as the total gross household monthly income divided by the total number of family members living together in the household. Gross monthly household income includes basic employment income, trade/self-employed income, overtime pay, allowances, cash awards, commissions, and bonuses.

Singapore Cancer Society Subsidies

After chatting with the Singapore Cancer Society, we managed to compile the average subsidies provided for cancer treatment.

Procedures/Medical Needs	Cost	Remarks
Surgery as part of cancer treatment	$3,000	This is excluding hospital stay. More complex organs and procedures may result in higher charges.
Chemotheraphy	$1,500 for 1 cycle	Each treatment involves a 3-4 cycle, followed by a CT scan to track progress of treatment.
Milk for patients under hospice care	$200	2 weeks supply
Adult diapers (if required)	$100	2 weeks supply
Ostomy Bags (for colorectal cancer survivor)	$50	1 week supply
Transportation to hospital for treatment	$20	1 trip

*Do note that the above numbers are based on the subsidies the Singapore Cancer Society provides to cancer patients who need them. It is not meant to be an exhaustive or definitive list of examples.

MediShield for Cancer Treatments

For someone who has just been diagnosed with cancer, the cost of treatment becomes an immediate concern.

Often, the victim of cancer is in a state of shock and confusion, and their priority is to not be a burden to their family members.

The disease poses two challenges – the lack of knowledge on the cost of cancer treatments and its affordability.

Despite the benefits of MediShield Life and Medisave being plastered all over hospital websites, it certainly did nothing to appease the many questions on a patient’s mind. (e.g. a $300 benefit is simply a dent in a $30,000 hospital bill)

These MediShield Life benefits typically cater to Government B2/C wards, and you will have to fork out more if you plan to opt for a Government A or private ward.

Understandably, the procedures differ from individual to individual, which further adds to the challenges of knowing the accurate estimation of the cost involved.

The cost of treatment depends on a few factors:

Patient’s body condition
Stage of the cancer
Type of cancer
Type of treatment that is required

But for the benefit of everyone, these are the benefits applicable for admissions or treatments received on or after 1 December 2023:

Inpatient/Day Surgery	MediShield Life Claim Limits
Daily Ward and Treatment Chargers
Normal ward	$800/day
Intensive care unit ward	$2,200/day
*Additional claim limit of $200/day applies for the first two inpatient days
Psychiatric (up to 60 days per policy year)
Community hospital (Rehabilitative)
Community hospital (Sub-acute)
Inpatient palliative care service (General)
Inpatient palliative care service (Specialised)
Surgical procedures
Table 1 A/B/C (less complex procedures)	$240 - $340
Table 2 A/B/C	$580 - $760
Table 3 A/B/C	$1,060 - $1,280
Table 4 A/B/C	$1,540 - $1,640
Table 5 A/B/C	$1,800 - $2,180
Table 6 A/B/C	$2,360
Table 7 A/B/C (more complex procedures)	$2,600
Implants	$7,000 per treatment
Radiosurgery, including proton beam therapy - Category 4	$10,000 per treatment course
Continuation of autologous bone marrow transplant treatment for multiple myeloma	$,6000 per treatment
Outpatient Treatments: Patients receiving treatment for one primary cancer
Cancer drug treatment	$200 - $9,600 per month depending on cancer drug treatment
Cancer drug services	$3,600 per year
Outpatient Treatments: Patients receiving treatment for multiple primary cancers
Cancer drug treatment	Sum of the highest cancer drug treatment limit amongst the claimable treatments received for each primary cancer each month
Cancer drug services	$7,200 per year
Radiotherapy for cancer
External (except Hemi-body)	$300 per treatment
Brachytherapy	$500 per treatment
Hemi-body	$900 per treatment
Stereotactic	$1,800 per treatment
Proton beam therapy - Category 1	$300 per treatment
Proton beam therapy - Category 2	$500 per treatment
Proton beam therapy - Category 3	$1,800 per treatment
Kidney dialysis	$1,100 per month
Immunosuppressants for organ transplant	$550 per month
Erythropoietin for chronic kidney failure	$200 per month
Long-term parenteral nutrition	$1,700 per month
Maximum Claim Limit
Per Policy Year	$150,000
Lifetime	No limit

Integrated Shield Plans & Singapore Cancer Drug List

For the uninitiated, from 1 April 2023, the Integrated Shield Plan (IP) will have a cap and overall cancer treatment coverage has been lowered.

MOH-Approved Outpatient Cancer Treatment Drug List

Anyone who’s purchased an IP knows that it rides on top of your existing MediShield Life to provide additional coverage for Class B1 or A wards, even for private hospitals and is managed by private insurers. Premiums are typically payable using MediSave up to your annual limits.

But since last April, except for IP riders, your IP will not cover cancer drugs not on the list, as IPs will be required to only cover treatments on the MediShield Life Cancer Drugs List and set claim limits for each cancer drug treatment.

Further to that, IP will increase their coverage for cancer treatments up to a maximum of five times the coverage provided by basic MediShield Life.

The change will apply to all IP policyholders regardless of their ward class or plan type upon renewal. Those currently undergoing cancer treatment will receive an extension of their current coverage for an additional six months to complete their regimen.

This is a marked change from the status quo as most IPs provide “as-charged” coverage for outpatient cancer drug treatments, subject to an overall policy year limit, which could exceed $2 million.

Critical Illness Plans

Another health insurance to be considered is to opt for a critical illness plan, which offers a lump sum payment in the event of a cancer diagnosis.

This amount can be utilised at the individual’s discretion, whether to cover bills not included in insurance or to address daily living expenses. Like IP plans, securing this coverage while in good health proves more advantageous.

Rooms For Improvement For Singapore’s Healthcare Ecosystem

We know that healthcare costs are increasing, but it’s still shocking.

While the availability of grants and MediSave benefits are plastered all over the websites of hospitals, the actual cost of each treatment can differ, especially when it’s a rare cancer.

Similarly, it is not immediately obvious to consumers.

This means that I can go all day highlighting the benefits one can receive from MediSave without realising that the cost to fork out in cash is still pretty high.

Another cost-related concern is the public confidence in whether existing insurance is able to cover cancer treatments, which the perception survey found that less than a third of respondents (29%) had no confidence their insurance can cover the full cost of cancer treatment.

This means that people might have purchased insurance without knowing how much to set aside for certain cancers, and sometimes, insurance terms such as exclusions, deductibles, co-payments and claim amounts.

That said, there is a lot that can be done to bridge these knowledge gaps and improve financial literacy as a whole – how can we make this information more accessible, let policy wording be easily interpretable, and, most importantly, know that help is available.

About Ming Feng

A stint in Bloomberg gifted me with a beer belly, which only grew larger when I moved on to become a Professional Trader. Now I turn caffeine into digestible finance-related content.

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