Singapore Standard Drugs List

The Singapore Ministry of Health has added sixteen antiretroviral drugs used for the treatment of the human immunodeficiency virus (HIV) to the country’s Standard Drugs List (SDL). This is a list of subsidized drugs, modelled after the World Health Organization’s essential drugs list.  Advocacy groups and medical practitioners applaud this development as it helps reduce the stigma against people living with HIV and improves access to much needed care and treatment as well as reduce HIV transmission.

Other drugs on the SDL include those for patients suffering from acute migraine attacks, metastatic breast cancer and rheumatoid arthritis, atrial fibrillation, and type 2 diabetes mellitus. 

Singapore’s SDL is reviewed annually by a group of fifteen medical professionals on the Drug Advisory Committee (DAC) and they take into consideration changes in clinical practice and medical advances.  Standard drugs are assessed to be cost-effective and essential and include expensive drugs for cancer and heart failure that are needed for specific clinical indications.   These standard drugs account for up to 90% of the drugs used in Singapore’s public healthcare institutions.

Public healthcare institutions and hospitals must comply with the stipulated price ceilings.  With this value-based pricing, patients would pay less for some drugs and those who qualify for subsidies, would pay even less.
  
Each year, the Agency for Care Effectiveness (ACE) seeks feedback from public hospitals about the drugs that patients would like subsidies for and on average, they receive fifty submissions. Approximately twenty from this pool are chosen for evaluation for clinical and cost effectiveness. The agency then uses health-technology assessment (HTA) to compare their effectiveness and this process can take between six weeks for simpler assessments to nine months to complete more complex economic models, measuring the differences in health outcomes and costs of a new technology and those of the present standard of care over a certain timeframe for drugs. 

The agency looks at the clinical benefits for the patients relative to its cost.  Other health ministry units will then track their appropriate use to ensure compliance through audits. 

For more information contact Office.Singapore@trade.gov.