PET/CT 20–25 million VND/time may be supported by health insurance
According to the draft, health insurance will expand the payment conditions for PET/CT scanning techniques - a method considered a "gold standard" in detecting, assessing stages and monitoring treatment responses for many types of cancer.
Notably, people with non-small cell lung cancer and esophageal cancer can be reimbursed by health insurance for PET/CT scan costs to assess treatment effectiveness - a right that was previously not applied.
In addition, patients with Hodgkin's lymphoma and non-Hodgkin's lymphoma are also proposed to supplement the indication of PET/CT payment during post-treatment monitoring.
According to the draft, the Health Insurance Fund can pay for a maximum of 4 PET/CT scans within the first 24 months from the time the disease is detected for eligible cases.
Meanwhile, the cost of one PET/CT scan currently ranges from about 20–25 million VND, causing many patients to consider or postpone check-ups due to financial pressure. If the policy is approved, this will be a significant change for cancer patients.
Expanding payment for more cancer marker tests
Not only stopping at PET/CT, the Ministry of Health also proposed expanding health insurance payments for many tumor marker tests.
Notably, the CA 19-9 test is proposed to supplement payment for colorectal cancer and liver cancer patients, instead of only applying to pancreatic and bile duct cancer as it is now.
The draft also supplements regulations on payment for many modern testing techniques that have not been specifically guided before, and allows calculation and payment for two tests when performing surgery or biopsy simultaneously on both sides of organs with symmetrical structures.
According to the Ministry of Health, the amendment of regulations aims to implement the amended Health Insurance Law in 2024, and at the same time overcome inadequacies in the process of applying current regulations.
The goal of the draft is to help patients access modern diagnostic and treatment techniques early, reduce the amount of money to be self-paid, create conditions for hospitals to develop expertise and technology, and at the same time ensure the balance and payment capacity of the Health Insurance Fund.
Currently, the draft is still in the process of being consulted before being considered for promulgation. If approved, this is expected to be one of the most notable changes in the rights of health insurance participants in the field of cancer treatment.
