Currently, in many countries around the world, medical technology assessment in general and pharmaceutical economic assessment in particular have been considered an important tool for priority setting and health policymaking, especially in the development of health insurance benefits packages. In Vietnam, in the context that resources for health are becoming increasingly scarce and the health insurance fund has to cover more and more health services, the assessment of medical technology needs to be developed and applied in the process of health policy making and health insurance policy.

Illustrative image (source: Internet)

According to MSc. Vu Nu Anh - Department of Health Insurance (Ministry of Health), before 2016, the collection of health insurance fund was always higher than the expenditure of health insurance fund with a balance. However, in the 2016-2019 period, the health insurance fund faced a huge revenue-expenditure imbalance. “If we continue with this momentum, we will gradually face a more serious imbalance of revenue and expenditure. In order to overcome this, the application of evidence to evaluate medical technology is an effective solution that contributes to controlling the problem of balance between revenue and expenditure of the health insurance fund." - MSc. Vu Nu Anh noted.

Deputy General Director of Vietnam Social Security (VSS) Pham Luong Son said that there are numerous causes leading to this situation. In terms of inputs, we are fixing a fixed rate of income. Meanwhile, in the output, the development of medical technology, the demand for medical care, the demand for high-tech services is constantly increasing, leading to the imbalance between revenue and expenditure of the health insurance fund becoming an inevitable problem.

Also according to Deputy General Director Pham Luong Son, the VSS and the Ministry of Health have predicted this possibility. "With the development and expansion of coverage to nearly 91% of the population, along with strengthening the control of revenue and expenditure, we already have a backup source available to compensate for the imbalance of funds." - Son emphasized and further analyzed: In 2020, the revenue is higher than the expenditure, but it is completely due to the COVID-19 epidemic and does not reflect the true nature of medical treatment and expenses. Therefore, we must exclude the above factor, when the health insurance fund reduces expenses due to the impact of the pandemic, and people do not have access to health services. From the perspective of health insurance policy, the state budget is having to bear the cost of natural disasters and global epidemics. The state budget shall pay for the treatment of COVID-19, the health insurance fund covers the costs of medical treatment under the health insurance benefit package.

Building a benefit package for health insurance participants

Sharing about the role of technology assessment in health policymaking, Deputy Minister of Health Nguyen Truong Son said: The national strategy to protect, care for and improve people's health for the period 2011- 2020, with a vision to 2030, clearly outlines the important task of the health system, which is to develop standards and conduct health technology assessment to identify effective health interventions, effective, low cost, quality assurance of medical services.

Illustrative image (source: Internet)

Accordingly, the assessment and forecasting of budgetary impacts are considered an effective tool that has been used in many countries around the world in the application of payment decisions. “In the coming time, the use of evidence on health technology assessment, evidence on budget impact assessment in formulating drug policy with health insurance will no longer be an incentive, but will certainly become a mandatory requirement, especially for new drugs proposed to be added to the list," emphasized Deputy Minister Nguyen Truong Son.

Deputy Minister Nguyen Truong Son also said that in order for the development of health policies, especially the development of the health insurance benefits package to experience breakthrough changes, increase transparency based on clear scientific evidence, and ensure the harmonization of interests of all stakeholders and the solvency of the health insurance fund, it is necessary to develop a medical technology assessment system. The Ministry of Health has been coordinating with relevant ministries and sectors to develop a draft revised Health Insurance Law, which emphasizes that the development of health insurance benefit packages should be based on evidence of medical technology assessment, especially evidence of cost-effectiveness and budgetary impact assessment./.