SINGAPORE Law and Practice Contributed by: Tony Yeo and Benjamin Gaw, Drew & Napier LLC
8.4 Cost-Benefit Analyses The Agency for Care Effectiveness (ACE), under the purview of the MOH, is the national health technology assessment agency in Singapore and works to lower the prices of health technologies, including drugs, medical devices and medical services, by evaluating their clinical and cost-effectiveness and negotiating with companies based on their proven outcomes. The evaluations made by the ACE also guide policy- makers in making subsidy decisions. Summaries of the rationale for subsidy decisions, as well as the key clinical and economic evidence supporting such rec- ommendations, are published by the ACE to increase the level of transparency in decision-making. 8.5 Regulation of Prescriptions and Dispensing by Pharmacies There are generally no regulations restricting phar- maceutical spending with regard to prescriptions by physicians and dispensing by pharmacies. However, medical practitioners are increasingly reminded to prescribe medications which are the most cost-effec- tive for patients.
on trade/regulatory facilitation with numerous jurisdic- tions, including the European Union, China and New Zealand. 8. Pharmaceutical and Medical Device Pricing and Reimbursement 8.1 Price Control for Pharmaceuticals and Medical Devices In general, prices for therapeutic products and medi- cal devices are not regulated in Singapore. However, it should be noted that public healthcare institutions in Singapore procure medicinal products in bulk by way of tender contracts through Group Procurement Offices to achieve economies of scale. 8.2 Price Levels of Pharmaceuticals or Medical Devices Price levels of therapeutic products and medical devices generally do not depend on the prices for the same product in other countries, as prices are gener- ally not regulated in Singapore. However, this may be a factor considered in negotiations with drug com- panies. 8.3 Reimbursement From Public Funds The Singapore government provides direct subsidies of up to 75% for subsidised medications at special- ist outpatient clinics and polyclinics. Patients receive drug subsidies and assistance based on their subsidy and means-test status, and the scheme under which the drug is covered (eg, Standard Drug List, Medica- tion Assistance Fund). The Singapore government has also implemented the Seniors’ Mobility and Enabling Fund, which provides subsidies to offset the costs of assistive devices and home healthcare items. The government also provides multiple tiers of financ- ing for Singapore citizens and permanent residents for their healthcare expenditure, which includes a basic health insurance plan and a medical endowment fund.
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