More females using medical savings funds to pay for the vaccine
THE opening-up of Medisave funds to pay for the cervical cancer vaccine seems to have prompted young girls and women to take the course of three jabs against it. Since last November, 6,300 females aged nine to 26 have drawn on their immediate family members’ or their own Medisave funds for this.
As of the end of last month, about $1.6 million had been taken out of such medical savings accounts for injections of Gardasil and Cervarix. Each dose costs about $150, bringing the tab to about $450. The two vaccines give protection against two types of human papillomavirus (HPV), which is responsible for most cancers in the neck of the womb. Among Singapore women, cervical cancer is the sixth most common cancer, most of these caused by HPV.
Ms Cheo Ying Hui, 24, who works in publishing, said she went for the jabs primarily because she would not be out of pocket by having them: “If using my Medisave wasn’t allowed, I would have sat on it longer.” There are no official figures that show conclusively that freeing up Medisave funds has led to more women having the jabs, but recent sales figures hint at this.
Between last November and June this year, health-care institutions bought 30 per cent more doses of the two vaccines than in the preceding eight months. In raw numbers, about 35,800 doses were sold between last November and June this year, against 27,800 doses sold between March and October last year. This means an additional 1,000 doses were sold every month. At the National Skin Centre, the number of women taking the vaccine has doubled every year since 2008, said its director, Professor Roy Chan. And Dr Chee Jing Jye, medical director of The Obstetrics & Gynaecology Centre at Paragon Medical, said her clinic has seen 30 per cent more women receiving the jabs since last November. Raw numbers were unavailable from either establishment. The liberalisation of Medisave use has also made Cervarix available in polyclinics, said a spokesman for GlaxoSmithKline, manufacturer of the vaccine.
But a spokesman for Merck Sharp & Dohme, which makes Gardasil, noted that, despite promising sales figures, it is estimated that only 4 per cent of women here have had this vaccine. “This is extremely low compared to countries that have implemented a national immunisation programme,” she said. For example, in Australia, where such vaccines are given to girls aged 12 to 18 in schools, 80 per cent of them have received the protective jabs.
The Ministry of Health does not include this vaccine in the vaccination programme for Singapore schools. Separately, it has pointed out that the vaccines still offer no protection against 30 per cent of the viruses that can cause the cancer. The vaccines are mainly a protection against HPV types 16 and 18, which account for seven out of 10 cervical cancers. A spokesman said the ministry was nonetheless “encouraged” by the response to the vaccines so far, and has advised primary-care doctors to urge their young female patients to go for it; parents of young girls are also advised to let their daughters have the jabs. Doctors hope to see more women going for it. Said Dr Chee: “If there were a national vaccination programme with an opt-out, more girls would be covered.” Prof Chan called for the vaccine to be made more available to the young – that is, those who have not yet had sex – because “if you wait till you are older, you might miss the boat”.
The Health Ministry spokesman explained that the ministry’s war against cervical cancer is vested in the promotion of Pap smear screening instead of a national vaccination scheme. Pap smears, in which a small sample of cervical cells is taken for testing, can detect changes in the cervix, including early signs of cellular changes that signal cancer. The ministry said seven in 10 women who should have Pap smears have had them, half of them in the last three years, the recommended frequency for the test. From next year, the withdrawal limit for Medisave funds to pay for outpatient expenses, including the cervical cancer vaccine, will be raised from $300 to $400. The new ceiling will come with the launch of Medisave400, which is the renamed Medisave300.