About this article:
- Understand what the Cancer Drug List (CDL) is and why it was introduced in Singapore.
- Learn how CDL affects MediShield Life and Integrated Shield Plan claims.
- Find out what happens if your treatment is not on the CDL or exceeds claim limits.
- Discover how riders and non-CDL classifications (A–F) may affect coverage.
- Explore how to plan a layered approach to manage cancer treatment costs.
Table of Contents
Cancer treatment in Singapore today is no longer like it was in the past, gone are the days where cancer treatment was one-size-fits-all. With newer, more advanced therapies offering personalised and targeted approaches, we now have access to a wider range of cancer treatment options in Singapore than ever before.
However, alongside these medical advances, the way cancer treatment is covered by insurance has also evolved, and one key change that patients are increasingly hearing about is the Cancer Drug List (CDL).
What is the Cancer Drug List (CDL) in Singapore?
The Cancer Drug List (CDL) is a list of cancer drugs approved in Singapore that are eligible for claims under our MediShield Life and most Integrated Shield Plans (IPs).
It was introduced by the Ministry of Health (MOH) to provide a more structured and sustainable way of funding cancer treatment.
Before the CDL, claims for cancer drugs were generally broader. However, as newer therapies such as immunotherapy and targeted treatments became more common, and significantly more expensive, the Government saw a need to balance:
- Access to effective treatments
- Affordability for patients
- Long-term sustainability of insurance systems
Each drug on the Cancer Drug List:
- Is approved for specific cancer types (indications)
- Comes with a monthly claim limit
- Is assessed based on clinical effectiveness and cost-value considerations
This means that cancer drug coverage in Singapore is now more structured and defined, rather than open-ended.
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Does the CDL only cover medication, or does it include cancer treatment technologies?
As its name suggests, the CDL focuses specifically only on drug-based cancer treatments.
This includes medication used in the following:
- Chemotherapy
- Targeted therapy
- Immunotherapy
The Cancer Drug List, however, does not cover other aspects of cancer treatment, such as:
- Surgery
- Radiotherapy
- Diagnostic imaging (e.g., MRI, CT scans, PET scans)
- Biopsies and laboratory tests
Though these therapies and treatment are not part of the Cancer Drug List, they are still claimable under your MediShield Life, Integrated Shield Plans and Riders, but they fall under separate claim frameworks. Additionally, if you have a Critical Illness Plan, you can use the lump sum payout to pay for any medication or treatment that is not covered by your standard hospitalisation (i.e., MediShield Life, Integrated Shield Plan) insurance.
This distinction is important because we tend to associate “cancer treatment” as one overall cost, when in reality:
Drug treatment and non-drug treatment are assessed and claimed differently.
What happens if my cancer cannot be treated with a drug on the CDL?
Unfortunately, sometimes we may encounter a type of cancer that cannot be treated by the drugs stipulated for it on the CDL. In this case, your doctor may recommend a drug that is not on the CDL. As such, your cancer treatment coverage situation may change significantly.
In general:
- MediShield Life does not cover non-CDL cancer drugs
- Integrated Shield Plans may limit or exclude claims for these drugs
- Riders may place a cap on coverage for non-CDL cancer drugs
This is why MediShield Life alone is insufficient for comprehensive care, a layered approach to health insurance is always the safest coverage option.
Basically, this means that if the recommended cancer drug necessary to treat your cancer is NOT on the CDL, it does not mean that you cannot receive the treatment. It simply means that you may need to pay a larger portion of the cost out-of-pocket.
If you have a Rider in addition to your Integrated Shield Plan, you may receive some level of support for non-CDL treatments, depending on your insurer’s policy terms, approval requirements, and whether the treatment meets their clinical criteria. In many cases, coverage for non-CDL drugs is more limited and subject to additional conditions compared to treatments already listed on the CDL.
In real-world scenarios, if you require non-CDL treatments, you may:
- Use MediSave (within limits)
- Pay the remaining amount in cash
- Explore whether there are clinically suitable alternatives on the CDL
This is where conversations between your doctor and you become more nuanced, balancing:
- Medical effectiveness
- Treatment goals
- Financial considerations
What if the drug is on the CDL, but not for my type of cancer?
This is one of the most important, and often misunderstood, aspects of the CDL.
A drug may be listed on the CDL, but only for specific indications. This means that if a drug is indicated for use in breast cancer, it will only be considered a CDL-approved drug for breast cancer. If this same medication is used for treatment in other types of cancer, it will be considered a non-CDL drug.
It may be considered off-label use.
In such cases:
- Claims under your MediShield Life and Integrated Shield Plan may not be approved under CDL rules.
- And you may need to bear a larger share of the cost.
This highlights an important point for us: CDL coverage depends not just on the drug itself, but how and what cancer it is used on.
Are all non-CDL cancer drugs treated the same?
Not all cancer drugs that are not on the Cancer Drug List (CDL) are treated equally.
In Singapore, the Life Insurance Association (LIA) introduced a Non-CDL Classification Framework, which categorises these treatments into different groups (Class A to F) based on clinical evidence and regulatory approval.
This framework helps insurers assess whether, and to what extent, a non-CDL drug may be covered under their clients’ Integrated Shield Plan riders.
In general:
- Class A to C drugs have stronger clinical evidence and are more widely recognised in treatment guidelines.
- Class D to E drugs may have emerging or moderate levels of supporting evidence.
- Class F drugs typically have limited clinical evidence or are considered more experimental.
What you need to remember is that from a coverage perspective:
- Class A to E drugs may be considered for coverage under certain riders, subject to policy terms, limits, and approval requirements.
- Class F drugs are generally not covered.
This is encouraging because it means that even if a treatment is not on the CDL, it does not automatically mean that there is no support available. Just bear in mind that, coverage for non-CDL drugs is often:
- More limited
- Subject to stricter conditions
- Assessed on a case-by-case basis
As cancer treatment becomes more personalised, these distinctions play an increasingly important role in how treatment decisions and financing come together.
What are CDL claim limits, and how do they affect out-of-pocket costs?
Each cancer drug on the CDL has a monthly claim limit. This is the maximum amount that can be claimed from your insurance (MediShield Life and Integrated Shield Plan) for that drug.
For example:
• Drug cost: $8,000/month
• CDL claim limit: $5,000/month
The remaining $3,000 may need to be covered using your:
• MediSave (subject to withdrawal limits)
• Cash
However, if you have a rider in addition to your Integrated Shield Plan, some policies may provide enhanced coverage by significantly increasing the claimable amount above the base CDL limit. This can help reduce the gap between the treatment cost and what is claimable under the base plan. That said, these enhancements:
- Vary across insurers
- May be subject to panel and pre-authorisation requirements
- Are still capped under the overall policy limits
This introduces a cost-sharing structure, especially for newer therapies, long-term treatments, and higher-cost drugs.
Does the CDL apply in private hospitals in Singapore?
Yes. The CDL framework applies regardless of whether treatment is received in public hospitals or in private hospitals. This means that CDL limits remain the same regardless of treatment hospital.
Can I increase my insurance coverage for CDL-related cancer treatment?
While we have no power to change the CDL list, we do have the power to manage how much we need to pay out-of-pocket.
1. Review your Integrated Shield Plan (IP)
Different insurers offer varying:
- Coverage structures
- Panel arrangements
- Pre-authorisation processes
Understanding your plan helps reduce uncertainty at the point of treatment.
2. Consider a rider (with updated rules)
Riders can help:
- Reduce co-insurance
- Cap out-of-pocket costs
- Multiply claim limits for CDL drugs
- Provide some coverage for non-CDL drugs
However, from April 2026:
- Riders must include co-payment requirements
- Deductibles are no longer fully covered
This means some level of out-of-pocket cost is now expected, even with a rider.
3. Check panel and pre-authorisation requirements
Remember to check your insurers’ list of panel doctors and hospitals. This can help ensure a smooth claim process and reduce unexpected costs pertaining to underwriting that you may not be aware of.
Before you seek treatment, speak to your agent or approach the Insurance Helpdesk (if accessible) within your treatment hospital.
4. Plan for a layered financing approach
Cancer treatment is expensive. Regardless of whether you receive treatment at a public or private hospital/clinic. The best approach to funding cancer treatment is through a combination of:
- MediShield Life
- Integrated Shield Plan
- Rider
- Critical Illness Insurance
- MediSave
- Corporate Insurance (if applicable)
MediShield Life provides a basic level of coverage for hospital bills. However, cancer care often involves ongoing treatment, long-term medication, and follow-up care, which can extend beyond initial hospitalisation. An Integrated Shield Plan, whether designed for public or private hospital care, plays an important role in enhancing this coverage.
For those who are able to afford it, a rider can provide additional financial support, helping to reduce co-payment and out-of-pocket costs, subject to policy terms and conditions.
Another important component is Critical Illness Insurance, which provides a lump sum payout upon diagnosis. This can be particularly valuable as cancer treatment may impact a patient’s ability to work. In some cases, patients or their caregivers may need to take time away from employment to focus on recovery and care needs. The payout from a critical illness policy offers flexibility, as it can be used for:
- Daily living expenses
- Additional treatment costs not covered by insurance
- Home modifications to support recovery
- Caregiving needs
- Other personal or family expenses
Your MediSave can also be used to offset certain treatment costs, within prevailing withdrawal limits.
In addition, individuals who are employed may have access to Corporate Insurance, which can provide supplementary support for selected treatments and outpatient care.
Understanding how these different layers work together allows us to better anticipate potential costs and make more informed decisions about our care and financial planning.
How can I check if my cancer treatment is covered under the CDL?
If you or a loved one is undergoing cancer treatment in Singapore and would like to find out if the cancer medication is under the CDL, you can:
- Speak with your oncologist about whether a drug is on the CDL
- Check with your insurer or financial consultant
- Review the Cancer Drug List and your coverage
The big picture: Why CDL awareness matters
After all that is said and done, if you are undergoing cancer treatment, remember that the Cancer Drug List does not decide what treatment you can receive.
But it does influence:
- How much can be claimed
- How costs are shared
- What your financial responsibility may be
Understanding the CDL can help you and your loved ones make more informed decisions, avoid unexpected costs, and plan ahead with greater clarity.
Take Our Quiz
Cancer Drug List (CDL) in Singapore Quiz
Question 1 of 10
What is the Cancer Drug List (CDL) in Singapore?
Question 2 of 10
Is immunotherapy covered under the CDL in Singapore?
Question 3 of 10
What happens if my cancer drug is not on the CDL?
Question 4 of 10
Does the CDL apply to private hospitals in Singapore?
Question 5 of 10
Can MediSave be used for cancer treatment not on the CDL?
Question 6 of 10
Will the Cancer Drug List change over time?
Question 7 of 10
Does the CDL cover non-drug cancer treatments like surgery or radiotherapy?
Question 8 of 10
What happens if a CDL drug is prescribed for a cancer type it is not specifically indicated for?
Question 9 of 10
How can patients cover the cost difference if their medication exceeds the monthly CDL claim limit?
Question 10 of 10
Why was the Cancer Drug List (CDL) introduced in Singapore?
Quiz Completed!
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