Cancer Drug List (CDL) Singapore

Last updated: September 2026

The Cancer Drug List (CDL) is a Ministry of Health list of approved cancer drug treatments, each with its own specific claim limit, that determines how much a patient can claim under MediShield Life, MediSave, and most Integrated Shield Plans, meaning treatments using drugs not on the list receive sharply reduced or no coverage.

Not financial advice. All figures for educational reference only. Data as at September 2026.

Table of Contents

What Is Cancer Drug List (CDL)?

Before the Cancer Drug List existed, MediShield Life, MediSave, and Integrated Shield Plans in Singapore generally paid out for cancer drug treatment based on broad “as-charged” or benefit-limit structures, without a specific, itemised list dictating which individual drugs and treatment protocols were covered and at what amount. As newer, far more expensive cancer therapies, including advanced targeted therapies and immunotherapies, entered clinical use, healthcare costs for cancer treatment rose sharply, in some cases running into hundreds of thousands of dollars for treatments whose actual clinical benefit varied widely.

To manage this cost escalation while still ensuring patients had access to clinically effective treatments, the Ministry of Health introduced the Cancer Drug List, an itemised list of approved cancer drug treatments, each assigned its own specific claim limit. Coverage under MediShield Life and MediSave shifted to this list-based approach from 1 September 2022, and Integrated Shield Plans, the private plans that sit on top of MediShield Life offering higher coverage, followed suit from 1 April 2023, applying to policies upon purchase or renewal from that date.

The CDL is maintained and periodically updated by MOH’s Agency for Care Effectiveness (ACE), which evaluates cancer drugs for clinical effectiveness and cost-effectiveness before adding them, and their associated claim limits, to the list. This links the Cancer Drug List conceptually to related Integrated Shield Plan mechanics such as Table of Benefits structures and co-payment and co-insurance arrangements, all of which together determine how much of a cancer treatment bill a policyholder actually bears.

How It Works in Singapore

Each specific cancer drug treatment on the CDL, defined by the drug itself and often the specific cancer type and treatment protocol it is used for, carries its own individual MediShield Life claim limit and MediSave withdrawal limit. This is meaningfully different from a single blanket “cancer coverage” figure; two patients being treated for different cancers, or even the same cancer with different drug regimens, can face very different claim limits depending on which specific treatments appear on the list and at what amount.

If a prescribed cancer drug treatment is not on the CDL at all, MediShield Life and MediSave provide little to no coverage for that specific drug component of treatment, and most Integrated Shield Plans follow the same restriction for policies purchased or renewed after the April 2023 IP effective date. This can leave patients facing a stark choice between an off-list treatment their oncologist recommends, borne largely out of pocket, or a listed alternative that may have a different clinical profile.

Because MOH’s Agency for Care Effectiveness continuously reviews new cancer drugs entering the market, the CDL is a living document, updated periodically, with recorded updates as recent as 31 May 2026 and 1 September 2026. Patients, policyholders, and their oncologists are generally advised to check a treatment’s CDL status and its specific claim limit before committing to a particular drug regimen, since the financial exposure difference between a listed and unlisted option can be very large.

Worked Example

Consider a Singapore policyholder diagnosed with a cancer for which two treatment options exist: Drug A, which is on the Cancer Drug List with a MediShield Life claim limit of, say, S$3,000 per treatment cycle, and Drug B, a newer, more expensive therapy that is not yet on the CDL.

If the patient’s oncologist recommends Drug A, MediShield Life and MediSave provide coverage up to the specified claim and withdrawal limits for each treatment cycle, and the patient’s Integrated Shield Plan, if purchased or renewed after April 2023, layers additional coverage on top, subject to its own Table of Benefits and any co-payment arrangements.

If the patient instead opts for Drug B, which is not CDL-listed, MediShield Life and MediSave provide minimal or no coverage for that specific drug cost, and depending on the specific IP’s terms, the Integrated Shield Plan may similarly decline to cover, or only partially cover, that portion of the treatment, leaving the patient to bear a much larger share of what could be a very expensive course of treatment entirely out of pocket.

Advantages

• Predictable, itemised coverage. Patients and their families can look up a specific drug’s claim limit in advance, rather than relying on a vague, discretionary “as-charged” assessment after the fact.
• Encourages use of clinically and cost effective treatments. By linking coverage to drugs that MOH’s Agency for Care Effectiveness has reviewed for both clinical benefit and cost-effectiveness, the system channels healthcare spending toward treatments with demonstrated value.
• Helps contain overall premium inflation. By capping payouts to a defined, reviewed list rather than an open-ended “as-charged” cancer benefit, insurers can better manage claims costs, which in turn helps moderate Integrated Shield Plan premium increases over time.
• Living, periodically updated list. New, effective cancer drugs can be added to the CDL as clinical evidence and cost-effectiveness data mature, keeping the list responsive rather than static.

Risks and Limitations

• Newer or niche treatments may not yet be listed. A patient’s oncologist may recommend a drug that has not yet completed MOH’s review process, leaving the patient to bear that cost largely alone.
• Claim limits may not fully cover actual treatment cost. Even for listed drugs, the specified claim limit may be lower than the drug’s actual market price, especially for expensive newer therapies, leaving a coverage gap.
• Complexity for patients during an already stressful diagnosis. Having to check CDL status and specific claim limits adds an administrative burden at a time when patients are focused on treatment decisions, not paperwork.
• Policy purchase or renewal date matters. Integrated Shield Plan policies purchased or renewed before 1 April 2023 may have different, sometimes broader, terms than the CDL-restricted framework now standard on newer or renewed policies.
• Potential to influence, not just reflect, treatment choice. Because coverage differs so significantly between listed and unlisted drugs, the CDL can, in practice, steer some patients toward listed treatments even where an unlisted option might otherwise have been the oncologist’s first clinical preference.

Cancer Drug List (CDL) vs Pre-2022 As-Charged Cancer Coverage

The Bottom Line

For Singapore policyholders, the Cancer Drug List is arguably one of the most consequential but least understood mechanics in Integrated Shield Plan coverage, since it directly determines how much financial protection a cancer diagnosis actually receives, regardless of a plan’s headline coverage figures. Checking a prescribed treatment’s CDL status and specific claim limit early in the treatment planning process is a practical step every policyholder facing a cancer diagnosis should take.

Related Terms:

• Table of Benefits (Integrated Shield Plan) Singapore
• Co-Payment vs Co-Insurance Singapore
• Pre-Authorisation (Shield Plan) Singapore

Frequently Asked Questions