Proposal for health insurance payment for drugs used in remote medical examination and treatment
On October 25, in Hanoi, the Ministry of Health held a workshop to develop a circular stipulating principles, criteria for developing, updating, recording information, structure of the list and payment instructions for pharmaceutical drugs, biological products, radioactive drugs and markers within the scope of benefits of health insurance participants.
The opinions at the workshop contributed to overcoming and limiting difficulties related to payment of drug costs in medical examination and treatment under health insurance, ensuring that the drug list is updated regularly, continuously, publicly, transparently and conveniently for implementing units. In particular, many experts proposed health insurance payment for drugs used in remote medical examination and treatment.
According to Deputy Minister of Health Tran Van Thuan, currently, payment of drug costs for health insurance participants is implemented according to the list and regulations in Circular No. 20/2022/TT-BYT dated December 31, 2022 of the Ministry of Health promulgating the List and rates, payment conditions for pharmaceutical drugs, biological products, radioactive drugs and markers within the scope of benefits of health insurance participants, effective from March 1, 2023.
Accordingly, the list of drugs covered by health insurance includes: 1,037 active ingredients/chemical drugs and biological products divided into 27 major groups and 59 radioactive drugs and markers.
"Vietnam is considered one of the few countries in the world with a relatively complete, comprehensive and expanded drug list compared to the health insurance premium (while the health insurance drug list in Thailand, Singapore, and the Philippines only has 600 - 700 active ingredients)" - Deputy Minister Thuan emphasized.
According to Deputy Minister Thuan, currently, Circular No. 20/2022/TT-BYT has also revealed a number of limitations and problems that need to be adjusted and amended to suit the actual situation and is outdated compared to many other documents and regulations in the health sector.
For example, regarding payment for drugs used in remote medical examination and treatment and support for remote medical examination and treatment. Currently, the Law on Medical Examination and Treatment 2023 has stipulated many contents related to remote medical examination and treatment and support for remote medical examination and treatment. However, the list of health insurance drugs does not have regulations on health insurance payment for drugs used in remote medical examination and treatment.
Separate drug list for commune health stations
Ms. Tran Thi Trang - Director of the Ministry of Health - said that this Circular will update new drugs that have been granted registration numbers in the past, bringing high treatment efficiency to contribute to the diagnosis and treatment of diseases at all levels from central to grassroots health care.
Second, review the entire current drug list to remove any drugs with warnings related to treatment, low treatment effectiveness, or drugs with no cost effectiveness from the list.
Thus, there will be a balance between adding new drugs to the list and removing ineffective drugs from the list so that health insurance participants can enjoy the benefits of using drugs more effectively and reasonably.
Third, adjustments related to principles, adjusting drugs into the list must ensure timeliness and fastest updates. These principles and criteria also need to ensure objectivity and science, promote treatment effectiveness but ensure fund balance requirements.
This draft Circular also provides regulations to help lower-level medical facilities access the best and most effective treatment drugs, suitable for the professional capacity of the licensed facility.
"We ensure that the drug list is updated regularly, at least once a year. At the same time, this time, we have a separate drug list for the commune health station.
"Thus, lower-level medical staff know which drugs are allowed to be used, so they can be proactive in bidding and procurement, have enough drugs to promptly supply drugs to patients, and promptly treat diseases," Ms. Tran Thi Trang emphasized.
