Web Stories Wednesday, February 28

SINGAPORE — Nearly half of Singaporeans (43 per cent) who have never had cancer believe that they are not financially well-prepared to manage the disease if they are diagnosed with it, a local study has found.

Almost one in three (32 per cent) also expressed concerns over the cost of cancer care, which may significantly impact their decisions about whether to delay or receive treatment, the study’s researchers said.

Such concerns are not limited to those in lower income brackets but also extend to middle income respondents, they said in a press release on Monday (Jan 15).

These results were part of a “perception survey” conducted during the initial phase of an ongoing three-part study sponsored by DBS Bank and designed by the National University Cancer Institute, Singapore (NCIS) and the local thinktank Research for Impact Singapore (RFI).

Around 1,200 respondents were surveyed online by Blackbox Research from August to September last year, which researchers say is representative of Singapore’s population.

The study aims to assess how aware people are of potential costs associated with a cancer diagnosis. Its researchers seek to shed light on how financial knowledge can influence one’s ability to cope with the challenges posed by cancer treatment and care, they said. 

Early survey data suggest that a significant share of Singapore resident households may feel underprepared financially to cope with shocks such as cancer, and more specifically, are unclear of what cancer entails – from disease incidence to treatment costs and healthcare financing.

WHY IT MATTERS

Cancer was the leading cause of death in Singapore in 2022, making up 23.9 per cent of all 26,891 recorded deaths that year.

But researchers from the study stated that the financial impact of cancer diagnosis can be significant, given the expenses in medical care settings on medications and procedures like chemotherapy.

Indirect costs also contribute to “financial toxicity”, they said.

Such “toxicity” includes income loss experienced by the patient from cancer-related disabilities and by family members providing caregiving.

In oncology practice, financial toxicity is used to describe the detrimental effects of the excess financial strain caused by the diagnosis of cancer on the well-being of patients, their families and society — and is increasingly recognised to adversely affect a person’s quality of life.

Dr Jen Wei Ying, the clinical lead of the study and a consultant at NCIS’ department of haematology-oncology said that the financial impact of cancer is “a real but poorly understood and infrequently acknowledged concern” in cancer care and survivorship. 

“The data presented here show that cost concerns are prevalent, even in respondents who do not have a cancer diagnosis,” she said, adding that such concerns may significantly impact their decisions about whether to delay or receive treatment.

WHAT THE STUDY FOUND

  • Around half (47 per cent) of respondents with no history of cancer feel financially prepared for a cancer diagnosis, with many (30 per cent) saying that they were “moderately well” prepared for the disease
  • Conversely, around 42 per cent of respondents believed they would be ill-prepared, with 14 per cent of respondents perceiving that they are “not well at all” financially prepared for such a diagnosis
  • When asked how confident they were that their existing health and/or critical illness insurance policies would fully cover the cost of cancer treatment in the future, 43 per cent of respondents said they were slightly confident, while 29 per cent said they had no confidence their insurance would be able to cover the full cost of treatment
  • Only 33 per cent of the 1,200 respondents were aware of the recent changes to the financing of outpatient cancer treatment based on the Cancer Drug List (CDL), which had been announced prior to the survey

In addition, the study’s researchers also made the following preliminary observations, although they did not provide specific numbers:

  • Respondents without critical illness insurance coverage cited unaffordable premiums as a key reason for not purchasing policies
  • Respondents with insurance coverage may not be knowledgeable about their own insurance plans, specifically policy benefits, exclusions, co-pays and claim amounts
  • Respondents who perceived themselves as “highly financial literate” were less likely to anticipate delaying or foregoing cancer treatment due to cost concerns 
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