OBJECTIVES: Since 2015, the Agency for Care and Effectiveness (ACE) has aimed to drive better decision-making in healthcare in Singapore based on clinical effectiveness, safety, and cost-effectiveness. From September 2022, Singapore’s Ministry of Health (MOH) introduced the Cancer Drug List (CDL) to mitigate government spending on cancer drug treatments by allowing the latter to negotiate better prices and extend subsidies for more cancer drugs. This research aims to identify the number of publications in oncology in Singapore and their respective subsidy decisions to assess the impact of CDL on oncology product access.

METHODS: An analysis of reimbursement decisions from Singapore’s ACE (Agency for Care Effectiveness) was conducted, dating from 2017 to 2022 to identify the total number of publications and extract their respective subsidy decisions. Additionally, the number of CDL-included drugs was also extracted from the MOH website.

RESULTS: Between 2017 and 2021, ACE’s oncology evaluations were limited to 7 publications including 15 subsidy decisions. These were targeting mainly biosimilar and select oncology products with 60% leading to Standard Drug List (SDL) inclusion, 7% in Medicines Assistance Fund (MAF) inclusion, and 33% in non-recommendation. A noticeable uptrend was noted in 2022 with ACE releasing 31 publications involving 264 subsidy decisions. Out of these decisions, 18.6% led to SDL inclusion, 42.4% to MAF inclusion, and 39% in non-recommendation. This uptrend coincides with the CDL introduction of September 2022, which includes 181 products as of April 2023.

CONCLUSIONS: Our results demonstrate a significant rise in oncology publications in 2022 which coincides with the creation of CDL, coupled with a greater percentage of MAF inclusion. SDL inclusions, while lower in percentage, increased in absolute figures. Whilst evidence demonstrate a promising early start to the CDL, subsequent future evaluations will determine whether it has truly enabled broader access to oncology products in Singapore.