Accordingly, the payment of costs for drugs, medicinal herbs, and medicine used in heath facilities and self-prepared medicines of heath facilities must comply with the general rules: Health insurance fund shall pay for costs of medicines, ingredients and self-prepared medicines of health facilities according to the use quantity and buying prices of the health facility in accordance with the law on medicines bidding and regulations of the Minister of Health and other expenses (if any) to ensure compliance with the scope of benefits and benefit levels under the provisions of the Law on Health Insurance and guiding documents.

For ingredients:

In case a medical establishment buys medicinal materials for processing and preparation of drugs, the health insurance fund shall pay for the cost of medicinal materials according to the purchase price of the medical establishment, together with the cost of wastage in processing, preservation and distribution (if any); expenses for medicinal ingredients; processing costs including electricity, water, fuel; packaging cost (if any); labor cost; management and machine depreciation costs;

In case a medical facility buys ingredients from the supplier, the health insurance fund shall pay according to the price of the drug purchased from the drug store and the cost of wastage in storage and distribution (if any).

Illustrative image (source: Internet)

For herbal medicines with ingredients from medicinal herbs on the List of medicinal ingredients issued together with Circular No. 27/2020/TT-BYT, the health insurance fund shall pay for the ingredients according to regulations; decoction cost when medical facilities perform decoction at the establishment for inpatient and outpatient treatment according to the provisions of Circular No. 13/2019/TT-BYT; packaging cost (if any) when the medical facility does not perform decoction at the establishment for the patient.

In addition, in case drugs are processed and self-prepared by the medical facility, the health insurance fund shall pay on the basis of the product cost, including the cost of medicinal materials according to the purchase price of the medical facility or the cost of medicinal herbs as prescribed (medicinal ingredients or medicinal herbs included in the ingredients of the drug must be included in the List of traditional ingredients issued together with Circular No. 27/2020/TT-BYT; wastage costs (if any); cost of excipients, medicinal ingredients; processing and preparation costs, including electricity, water, fuel; packaging cost; cost of materials, chemicals and auxiliary materials for quality inspection before testing is performed according to Circular No. 13/2018/TT-BYT (if any); testing costs according to Circular 13/2018/TT-BYT; labor cost; administration and machine depreciation costs.