Precision medicine to be covered by MediShield Life; new law mooted to govern genetic test use

Precision medicine therapies will be covered under MediShield Life as part of ongoing measures to keep such treatments affordable for Singaporeans, said Health Minister Ong Ye Kung on Oct 10.

The Ministry of Health (MOH) is also working on new legislation to govern the use of genetic and genomic test data, including the discriminatory use of genetic information in insurance and employment.

The twin measures are key to countering escalating healthcare costs and mitigating the ethical risks of new technologies, which Mr Ong said could be a “double-edged sword”.

Healthcare is on the verge of a historical technological breakthrough, he added.

“The unprecedented availability of data can fundamentally transform healthcare,” Mr Ong said at the opening ceremony of the 22nd Singapore Health & Biomedical Congress, organised by the National Healthcare Group.

“We are seeing a convergence of three very powerful scientific and policy forces.

“What are they? No. 1, genomics. No. 2, AI, or artificial intelligence. And No. 3, a focus on preventive care. 

“And these will all have a profound impact on healthcare when they come together,” he said.

He said the MediShield Life Council is releasing its recommendations on precision medicine therapies next week, and will call for coverage under the national insurance plan to be extended to such approved therapies.

Precision medicine refers to the tailoring of treatments to meet the specific needs of patients, based on factors such as genetics, lifestyle and environment.

MOH intends to accept the recommendation to extend insurance coverage to such therapies, Mr Ong said.

He added that this will allow approved therapies to be brought into the subsidy, MediShield Life and MediSave support framework.

He noted that while precision medicine will become mainstream clinical practice over time, healthcare financing systems are not designed to fully fund such treatments.

This will lead to serious inequity in healthcare as only the wealthy will be able to afford such treatments, said Mr Ong.

The authorities are therefore taking steps to embrace precision medicine in a sustainable manner, such as by investing in local capabilities to develop such treatments, thus shortening their production times and lowering costs.

Health technology assessment has also been enhanced to “robustly evaluate” the cost-effectiveness of high-cost treatments, including precision medicine, Mr Ong said.

“We have strengthened health technology assessment to robustly evaluate the cost-effectiveness of high-cost treatments, including precision medicine,” he said.

“Where they are proven to be clinically (effective) and cost-effective, we will subsidise these therapies.”

The Straits Times reported in September that since August, cell, tissue and gene therapy products have been eligible for subsidies.

The first product eligible for such subsidies is Kymriah, which is used to treat certain types of leukaemia and lymphoma.

Mr Ong also spoke of the need to mitigate the risks posed by healthcare technology, noting that while genes can now be edited to treat disease, such technology could also, in theory, be used to design babies before they are born or allow companies to select employees based on genetic qualities.

MOH has thus worked with the Life Insurance Association to put in place a moratorium on the use of genetic test results for insurance underwriting.

The Health Minister added that MOH is also working on new legislation to govern the use of genetic and genomic test data, with the aim of addressing potential undesirable outcomes such as discriminatory use of genetic information in insurance and employment.

“We will conduct broad consultations and hope to submit the Bill to Parliament in the next one to two years,” said Mr Ong.

Source: Straits Times © SPH Media Limited. Permission required for reproduction.

The art of transforming lawyers into directors on receptive boards: Opinion Singtel outage: Experts call for review of emergency hotline contingency plans