Expanding access to essential medications for health insurance patients
21/08/2024 08:38 AM
The implementation of the health insurance policy for the 2009-24 period has gained many achievements, with the goal of universal health insurance likely to be reached. Recently, The Ministry of Health (MoH) has responded to voter concerns regarding the limited availability of cancer treatment drugs covered by health insurance in public hospitals, medications that were once included but are now excluded.
The ministry has pledged to continue its efforts to expand the range of covered treatments and enhance the quality of care for patients.
In its commitment to universal health insurance, MoH has prioritised the development and improvement of policies, particularly those related to drug coverage.
Việt Nam is recognised as one of the few countries with a relatively comprehensive list of medications covered by health insurance, aligned with the premiums paid.
Under a circular issued on December 31, 2022, the ministry provided an updated list of chemical drugs, biological products, radiopharmaceuticals and markers eligible for insurance coverage.
This extensive list includes 1,037 active ingredients, divided into 27 major groups, along with 59 radiopharmaceuticals and markers.
Significantly, the list features 76 active ingredients specifically for cancer treatment and immunomodulatory drugs, underscoring the ministry's commitment to safeguarding the rights of cancer patients.
The list specifies medications by active ingredient rather than by brand name, ensuring flexibility in the selection of drugs covered by the Health Insurance Fund at medical facilities, regardless of treatment indications or specialities.
MoH plans to continue reviewing and amending the circular that governs the list of drugs covered by the Health Insurance Fund.
This ongoing effort aims to broaden treatment options and ensure high-quality care for patients.
Additionally, MoH is working with relevant agencies to establish regulations for the direct reimbursement of drug and medical device costs for insured patients.
This initiative is designed to address potential drug shortages caused by external factors, ensuring that patients' treatment needs and insurance rights are protected.
In a related response to voters in Cần Thơ City, the ministry highlighted that the insurance coverage extends beyond modern pharmaceutical drugs to include traditional medicines and herbal remedies.
A circular issued on March 17, 2015, outlines a list of 229 traditional medicines and herbal drugs, organised into 11 functional groups, and 349 traditional medicinal herbs, divided into 30 groups based on traditional medicine principles.
The current list of drugs covered by the Health Insurance Fund encompasses a wide range of treatments across various medical specialities, both in modern and traditional medicine, meeting patients' needs while aligning with the Fund’s payment capacity.
To further enhance medication availability and quality for insured patients, the ministry will periodically review and expand the list of covered drugs, with a particular focus on the needs of children, the elderly, and the economically disadvantaged, while maintaining the financial balance of the Health Insurance Fund.
Maintaining the pace of health insurance growth amid people's difficult living conditions has once again affirmed the steadfastness and determination of the political system in general and the social insurance sector in particular in effectively implementing the universal health insurance roadmap.
With the consistent viewpoint of taking people and businesses as the subject and centre of service, the Việt Nam Social Security (VSS) always strives to ensure full, timely and legitimate benefits for participants. The number of health insurance card holders going for medical examination and treatment increases rapidly year after year.
From 2009 to 2023, the average number of medical examinations and treatments covered by health insurance per year was over 141 million, an increase of 59.5 per cent from 2009, with an average cost of VNĐ66. 2 trillion (US$2.6 billion) a year, up 330 per cent against that in 2009.
Notably, during the period when the whole country was affected by the COVID-19 pandemic, the pivotal role of the health insurance policy in the social security system was further promoted, contributing to health care and stabilisation of people's lives, and enhancing faith in the humane social security policy of the Party and State.
In addition, the VSS has focused on solutions to create utilities and benefits for participants, beneficiaries and State management agencies in preventing the profiteering of health insurance funds. The sector has also sped up administrative procedure reform and expanded the application of information technology and digital transformation in professional work.
*** Universal health coverage (UHC) means everyone – all individuals and communities – having access to quality, needed services that are affordable. The spectrum of services includes health promotion, prevention, treatment, rehabilitation, and palliative care. UHC serves as the overarching platform for achieving the health-related Sustainable Development Goals (SDGs). UHC is not just about health financing – it reflects the importance of having equitable access to good quality health services and realizing the right to health, especially for vulnerable populations. Globally, countries monitor UHC through the service coverage delivery index (SDG target 3.8.1) and financial protection (SDG target 3.8.2) indicators, among other qualitative and quantitative measures.
Viet Nam is committed to accelerating UHC and strengthening primary health care as the foundation for UHC, especially when faced with emerging challenges of the rise of non-communicable diseases and increasing ageing population. It continues to make progress on addressing the needs of vulnerable populations, including the “missing middle.”
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VSS - ISSA Guidelines on Social Security