Price of medication for chronic diseases at GPs to be reduced, 'comparable' to polyclinics under Healthier SG initiative

SINGAPORE — Those suffering from chronic diseases such as high blood pressure or diabetes will soon find that the price of their medication at general practitioners (GPs) will be "comparable" to those at a polyclinic, according to a new White Paper submitted to Parliament on Wednesday (Sept 21).

The paper, which set out the Healthier SG strategy to "proactively" prevent people from falling ill, also proposes lowering the prices of such medication through a combination of introducing enhanced drug subsidies and imposing drug price limits.

This includes the introduction of a new subsidy tier to the Community Health Assist Scheme (Chas) to offset the costs of common chronic drugs at private GP clinics.

More details will be announced at a later date, and Parliament is expected to debate the proposals within the White Paper in October.

TODAY previously reported that the price gap between medicines at polyclinics and private GPs was a key concern raised by the medical community, as polyclinics could afford to charge lower prices for such drugs due to their higher purchasing power.

Three doctors TODAY spoke to on Wednesday highlighted the vast difference in price at polyclinics and private GPs.

Citing the cost of a generic drug as an example, Dr Theresa Yap, a family physician at Yang & Yap Clinic and Surgery, said patients could pay as little as three cents per tablet at a polyclinic, but as much as 30 cents per tablet at a private GP.

This price difference could throw a spanner in the works, as the Government looks to encourage Singaporeans to visit the same family physician clinics for all their needs and plan out their health goals.

On Wednesday, Health Minister Ong Ye Kung told reporters that it is “absolutely critical to mobilise” as many GPs to be part of Singapore’s Healthier SG initiative as they are “all in the community and they are the important touch points of every resident if we want to practise preventive care in a concerted strategic way”.

The Healthier SG strategy was first announced in Parliament during the debate on the Ministry of Health’s budget in March, and part of the programme includes having every household register with a family doctor of their choice.

Enrolment will open to residents aged 60 years and above in the second half of 2023, followed by those in the 40-59 age group in the next two years.

While it is not mandatory to participate in the programme, Mr Ong said on Wednesday that a family doctor “will really know your conditions well, and better still know the conditions of your family well”.

With such information on hand, Mr Ong said the doctors can then help their patients create a plan to stay healthy.

HEALTHIER SG’S BENEFITS

Under the Healthier SG programme, residents who enrol with a family doctor can schedule for a face-to-face onboarding health consultation which will be fully paid for by the Government.

However, if they opt to change the clinic they are enrolled in, these patients will have to pay for the second and subsequent onboarding health screenings.

Aside from this, the paper also said that other benefits for Singaporeans to enrol with a family doctor includes fully subsidised nationally-recommended vaccinations and screenings.

There will also be no need for cash co-payment when using MediSave for chronic care management.

ADDITIONAL FUNDING FOR ELIGIBLE FAMILY DOCTORS

As a means to compensate GPs for taking in residents as part of the Healthier SG programme, Mr Ong said they will be given capitation funding, which is a payment model used in the healthcare sector.

This means that GPs will receive an annual budget based on the total number of residents they are in charge of, and doctors will have to manage their operations within this budget. The paper did not state any numbers related to this funding.

Mr Ong stressed that this does not mean that the doctors will be paid to provide services such as conducting a health screening or administering a vaccination shot.

“We are trying (this payment model) for GPs as we bring them on to Healthier SG because it…simplifies the funding system, allowing us to implement at scale,” said Mr Ong.

“Secondly, because it's one bundled standard payment, it inherently balances between the GP providing what is needed for the residents, and at the same time observing cost discipline.”

Mr Ong also noted that most GPs are still using “pen and paper” for their administrative work, and are not linked up to the national information technology (IT) system.

To help them with the transition, the paper proposes offering a one-off grant which will allow GPs to offset the costs of upgrading their IT systems. ADDITIONAL REPORTING BY JANARTHANAN KRISHNASAMY